Search results for: congestive heart failure

Authors: Dalyah Y. Al-Jamal, Maryam H. Eshtaiwi, Liyakathunisa Syed

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Connecting health services with technology has a huge demand as people health situations are becoming worse day by day. In fact, engaging new technologies such as Internet of Things (IOT) into the medical services can enhance the patient care services. Specifically, patients suffering from chronic diseases such as cardiac patients need a special care and monitoring. In reality, some efforts were previously taken to automate and improve the patient monitoring systems. However, the previous efforts have some limitations and lack the real-time feature needed for chronic kind of diseases. In this paper, an improved process model for patient monitoring system specialized for cardiac patients is presented. A survey was distributed and interviews were conducted to gather the needed requirements to improve the cardiac patient monitoring system. Business Process Model and Notation (BPMN) language was used to model the proposed process. In fact, the proposed system uses the IOT Technology to assist doctors to remotely monitor and follow-up with their heart patients in real-time. In order to validate the effectiveness of the proposed solution, simulation analysis was performed using Bizagi Modeler tool. Analysis results show performance improvements in the heart monitoring process. For the future, authors suggest enhancing the proposed system to cover all the chronic diseases.

Keywords: IoT, process model, remote patient monitoring system, smart watch

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Authors: A. Aarabzadeh, R. Hizaji

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Reinforced Concrete (RC) deep beams are a special type of beams due to their geometry, boundary conditions, and behavior compared to ordinary shallow beams. For example, assumption of a linear strain-stress distribution in the cross section is not valid. Little study has been dedicated to fixed-end RC deep beams. Also, most experimental studies are carried out on simply supported deep beams. Regarding recent tendency for application of deep beams, possibility of using fixed-ended deep beams has been widely increased in structures. Therefore, it seems necessary to investigate the aforementioned structural element in more details. In addition to experimental investigation of a concrete deep beam under cyclic load, different failure mechanisms of fixed-ended deep beams under this type of loading have been evaluated in the present study. The results show that failure mechanisms of deep beams under cyclic loads are quite different from monotonic loads.

Keywords: deep beam, cyclic load, reinforced concrete, fixed-ended

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Authors: Roy Y. C. Huang, J. S. Kuang, Hamdolah Behnam

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Beam-column connections play an important role in the reinforced concrete moment resisting frame (RCMRF), which is one of the most commonly used structural systems around the world. The premature failure of such connections would severely limit the seismic performance and increase the vulnerability of RCMRF. In the past decades, researchers primarily focused on investigating the structural behaviour and failure mechanisms of conventional beam-column joints, the beam width of which is either smaller than or equal to the column width, while studies in wide beam-column joints were scarce. This paper presents the preliminary experimental results of two full-scale exterior wide beam-column connections, which are mainly designed and detailed according to ACI 318-14 and ACI 352R-02, under reversed cyclic loading. The ratios of the design shear force to the nominal shear strength of these specimens are 1.0 and 1.7, respectively, so as to probe into differences of the joint shear strength between experimental results and predictions by design codes of practice. Flexural failure dominated in the specimen with ratio of 1.0 in which full-width plastic hinges were observed, while both beam hinges and post-peak joint shear failure occurred for the other specimen. No sign of premature joint shear failure was found which is inconsistent with ACI codes’ prediction. Finally, a modification of current codes of practice is provided to accurately predict the joint shear strength in wide beam-column joint.

Keywords: joint shear strength, reversed cyclic loading, seismic vulnerability, wide beam-column joints

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Authors: Sayali Vyas, Atharva Desai, Shreyas Badave, Apurv Kulkarni, B. Rajiv

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The Failure Modes and Effect Analysis (FMEA) is an efficient evaluation technique to identify potential failures in products, processes, and services. FMEA is designed to identify and prioritize failure modes. It proves to be a useful method for identifying and correcting possible failures at its earliest possible level so that one can avoid consequences of poor performance. In this paper, FMEA tool is used in detection of failures of various components of heat exchanger cycle and to identify critical failures of the components which may hamper the system’s performance. Further, a detailed Pareto analysis is done to find out the most critical components of the cycle, the causes of its failures, and possible recommended actions. This paper can be used as a checklist which will help in maintainability of the system.

Keywords: FMEA, heat exchanger cycle, Ishikawa diagram, pareto analysis, RPN (Risk Priority Number)

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Authors: Kelsi Hagerty, Ami Rosen, Aaliyah Heyward, Nadia Ali, Emily Brown, Erin Demo, Yue Guan, Modele Ogunniyi, Brianna McDaniels, Alanna Morris, Kunal Bhatt

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Hereditary transthyretin amyloidosis (hATTR) is a progressive, multi-systemic, and life-threatening disease caused by a disruption in the TTR protein that delivers thyroxine and retinol to the liver. This disruption causes the protein to misfold into amyloid fibrils, leading to the accumulation of the amyloid fibrils in the heart, nerves, and GI tract. Over 130 variants in the TTR gene are known to cause hATTR. The Val122Ile variant is the most common in the United States and is seen almost exclusively in people of African descent. TTR variants are inherited in an autosomal dominant fashion and have incomplete penetrance and variable expressivity. Individuals with hATTR may exhibit symptoms from as early as 30 years to as late as 80 years of age. hATTR is characterized by a wide range of clinical symptoms such as cardiomyopathy, neuropathy, carpal tunnel syndrome, and GI complications. Without treatment, hATTR leads to progressive disease and can ultimately lead to heart failure. hATTR disproportionately affects individuals of African descent; the estimated prevalence of hATTR among Black individuals in the US is 3.4%. Unfortunately, hATTR is often underdiagnosed and misdiagnosed because many symptoms of the disease overlap with other cardiac conditions. Due to the progressive nature of the disease, multi-systemic manifestations that can lead to a shortened lifespan, and the availability of free genetic testing and promising FDA-approved therapies that enhance treatability, early identification of individuals with a pathogenic hATTR variant is important, as this can significantly impact medical management for patients and their relatives. Furthermore, recent literature suggests that TTR genetic testing should be performed in all patients with suspicion of TTR-related cardiomyopathy, regardless of age, and that follow-up with genetic counseling services is recommended. Relatives of patients with hATTR benefit from genetic testing because testing can identify carriers early and allow relatives to receive regular screening and management. Despite the striking prevalence of hATTR among Black individuals, hATTR remains underdiagnosed in this patient population, and germline genetic testing for hATTR in Black individuals seems to be underrepresented, though the reasons for this have not yet been brought to light. Historically, Black patients experience a number of barriers to seeking healthcare that has been hypothesized to perpetuate the underdiagnosis of hATTR, such as lack of access and mistrust of healthcare professionals. Prior research has described a myriad of factors that shape an individual’s decision about whether to pursue presymptomatic genetic testing for a familial pathogenic variant, such as family closeness and communication, family dynamics, and a desire to inform other family members about potential health risks. This study explores these factors through 10 in-depth interviews with patients with hATTR about what factors may be contributing to the underdiagnosis of hATTR in the Black population. Participants were selected from the Emory University Amyloidosis clinic based on having a molecular diagnosis of hATTR. Interviews were recorded and transcribed verbatim, then coded using MAXQDA software. Thematic analysis was completed to draw commonalities between participants. Upon preliminary analysis, several themes have emerged. Barriers identified include i) Misdiagnosis and a prolonged diagnostic odyssey, ii) Family communication and dynamics surrounding health issues, iii) Perceptions of healthcare and one’s own health risks, and iv) The need for more intimate provider-patient relationships and communication. Overall, this study gleaned valuable insight from members of the Black community about possible factors contributing to the underdiagnosis of hATTR, as well as potential solutions to go about resolving this issue.

Keywords: cardiac amyloidosis, heart failure, TTR, genetic testing

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Authors: Nivine Abbas, Sergio Lagomarsino, Serena Cattari

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The resistance domain of a generally loaded rigid shallow foundation is normally represented as an interaction diagram limited by a failure surface in the three dimensional (3D) load space (N, V, M), where N is the vertical centric load component, V is the horizontal load component and M is the bending moment component. Usually, this resistance domain is constructed neglecting the foundation sliding mechanism that take place at the level of soil-foundation interface once the applied horizontal load exceeds the interface frictional resistance of the foundation. This issue is translated in the literature by the fact that the failure limit in the (2D) load space (N, V) is constructed as a parabola having an initial slope, at the center of the coordinate system, that depends, in some works, only of the soil friction angle, and in other works, has an empirical value. However, considering a given geometry of the foundation lying on a given soil type, the initial slope of the failure limit must change, for instance, when varying the roughness of the foundation surface at its interface with the soil. The present study discusses the effect of the soil-foundation interface condition on the construction of the resistance domain, and proposes a correction to be applied to the failure limit in order to overcome this effect.

Keywords: soil-foundation interface, sliding mechanism, soil shearing, resistance domain, rigid shallow foundation

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Authors: Saleem Z. Ramadan

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In this paper, a model is proposed to determine the life distribution parameters of the useful life region for the PV system utilizing a combination of non-parametric and linear regression analysis for the failure data of these systems. Results showed that this method is dependable for analyzing failure time data for such reliable systems when the data is scarce.

Keywords: masking, bathtub model, reliability, non-parametric analysis, useful life

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Authors: V. S. S. Kumar, B. Vikram

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The development of effective decision support tools that adopted in the construction industry is vital in the world we live in today, since it can lead to substantial cost reduction and efficient resource consumption. Solving the time-cost trade off problems and its related variants is at the heart of scientific research for optimizing construction planning problems. In general, the classical optimization techniques have difficulties in dealing with TCT problems. One of the main reasons of their failure is that they can easily be entrapped in local minima. This paper presents an investigation on the application of meta-heuristic techniques to two particular variants of the time-cost trade of analysis, the time-cost trade off problem (TCT), and time-cost trade off optimization problem (TCO). In first problem, the total project cost should be minimized, and in the second problem, the total project cost and total project duration should be minimized simultaneously. Finally it is expected that, the optimization models developed in this paper will contribute significantly for efficient planning and management of construction project.

Keywords: fuzzy sets, uncertainty, optimization, time cost trade off problems

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Authors: Inuwa Abdu Ibrahim

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The research assessed representative democracy as an administrative system in Nigeria, by highlighting the failure of the state. It also looked at some components of direct democracy in Switzerland. Therefore, the paper focused on direct democracy, using secondary sources of data. In conclusion, the research offers direct democracy as a solution to the failure of the Nigerian administrative system especially as it affects participation, developmental programmes and institutionalized corruption.

Keywords: corruption, direct democracy, national development, Nigeria, participation

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Authors: Sohair Hassan, Olfat Hammam, Sahar Hussein, Wessam Magdi

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Objective: Acute liver failure (ALF) is a clinical condition with an unclear history of pathophysiology, making it a challenging task for scientists to reverse the disease in its initial phase and to help the liver re-function customary: this study aimed to estimate the hepatoprotective effects of Punica granatum Lpeel and Pistacia atlantica leaves as a multi-rich antioxidants ingredients either in their normal and/or in their nanoforms against thioacetamide induced acute liver failure in a rodent model. Method: Male Wistar rats (n=60) were divided into six equal groups, the first group employed as a control; The second group administered a dose of 350 mg /Kg/ b.w of thioacetamide (TAA)-IP, from the third to the sixth group received TAA + [2mls / 100 g b.w/d] of aqueous extracts of Punica granatum L and Pistacia atlantica either in their normal and/or Nano forms consecutively for (14 days) Results: Recorded significant elevation in liver enzymes, lipid profiles, LPO (p= 0.05) and NO with a marked significant decrease in GSH and SOD accompanied by an elevation in inflammatory cytokine (IL6, TNF-α, and AFP) in addition to a noticeable increase in HSP70 level & degradation in DNA respectively in TAA challenged group. However significant and subsequent amelioration of most of the impaired markers was observed with ip nano treatment of both extracts. Conclusion: The current results highlighted the high performance of both plant nano extracts and their hepatoprotective impact and their possible therapeutic role in the amelioration of TAA induced acute liver failure in experimental animals.

Keywords: acute liver failure HPLC, IL6, nano extracts, thioacetamide, TNF-α

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Authors: F. Sangiorgio, J. Silfwerbrand, G. Mancini

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Geometric and mechanical properties all influence the resistance of RC structures and may, in certain combination of property values, increase the risk of a brittle failure of the whole system. This paper presents a statistical and probabilistic investigation on the resistance of RC beams designed according to Eurocodes 2 and 8, and subjected to multiple failure modes, under both the natural variation of material properties and the uncertainty associated with cross-section and transverse reinforcement geometry. A full probabilistic model based on JCSS Probabilistic Model Code is derived. Different beams are studied through material nonlinear analysis via Monte Carlo simulations. The resistance model is consistent with Eurocode 2. Both a multivariate statistical evaluation and the data clustering analysis of outcomes are then performed. Results show that the ultimate load behaviour of RC beams subjected to flexural and shear failure modes seems to be mainly influenced by the combination of the mechanical properties of both longitudinal reinforcement and stirrups, and the tensile strength of concrete, of which the latter appears to affect the overall response of the system in a nonlinear way. The model uncertainty of the resistance model used in the analysis plays undoubtedly an important role in interpreting results.

Keywords: modelling, Monte Carlo simulations, probabilistic models, data clustering, reinforced concrete members, structural design

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Authors: Rhodine Hickman, Craig Wylie, Michael G. McCaul

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Introduction: The World Health Organisation has called on governments around the world to recognise emergency conditions as a global public health problem and respond with appropriate steps for effective preventative strategies. However, to understand the magnitude of the problem, good quality epidemiological data is required. This is especially challenging in low and middle-income countries, where routine data is scarce, specifically within the prehospital setting. Methods: We conducted a retrospective cross-sectional study of a national prehospital private sector EMS database. The database being the property of ER24 (private Emergency Medical Services (EMS) company in South Africa) contains claims submitted by the majority of ambulance services in South Africa during the period between 1 January 2008 to 28 March 2017. We used descriptive statistics and control charts to describe the data using STATA 14. Results: 299,257 calls were included in the analysis. The top clinical conditions requiring ambulance transport were transport accidents (10% of total call volume) and ischaemic heart disease (4.4%). The number of transport accidents consistently increased between 2009 and 2014 and reached beyond the limit for normal variation in 2015. Victims of transport accidents required basic life support services 60% of the time with 80% of injuries being minor to moderate. The frequency of ischaemic heart disease had a steady incline from 2011 to 2016. Advanced life support services were required about 50% of the time, with 60% of patients needing urgent care. Conclusion: Transport accidents, followed by ischaemic heart disease, are the most prevalent conditions in South African private EMS. There is a potential to address these conditions by developing the capacity of low and mid-level providers in trauma and advanced EMS providers in ischaemic heart disease.

Keywords: emergency care, emergency medicine, prehospital providers, South Africa

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Authors: Gehan Hussein, Hams Ahmad, Baher Matta, Yasmeen Mansi, Mohamad Fawzi

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Background: Congenital heart disease (CHD) is a common problem worldwide with variable incidence in different countries. The exact etiology is unknown, suggested to be multifactorial. We aimed to study the incidence of various CHD in a neonatal intensive care unit (NICU) in a tertiary care hospital in Egypt and the possible associations with variable risk factors. Methods: Prospective study was conducted over a period of one year (2013 /2014) at NICU KasrAlAini School of Medicine, Cairo University. Questionnaire about possible maternal and/or paternal risk factors for CHD, clinical examination, bedside echocardiography were done. Cases were classified into groups: group 1 without CHD and group 2 with CHD. Results: from 723 neonates admitted to NICU, 180 cases were proved to have CHD, 58 % of them were males. patent ductus arteriosus(PDA) was the most common CHD (70%), followed by an atrial septal defect (ASD8%), while Fallot tetralogy and single ventricle were the least common (0.45 %) for each. CHD was found in 30 % of consanguineous parents Maternal age ≥ 35 years at the time of conception was associated with increased incidence of PDA (p= 0.45 %). Maternal diabetes and insulin intake were significantly associated with cases of CHD (p=0.02 &0.001 respectively), maternal hypertension and hypothyroidism were both associated with VSD, but the difference did not reach statistical significance (P=0.36 &0.44respectively). Maternal passive smoking was significantly associated with PDA (p=0.03). Conclusion: The most frequent CHD in the studied population was PDA, followed by ASD. Maternal conditions as diabetes was associated with VSD occurrence.

Keywords: NICU, risk factors, congenital heart disease, echocardiography

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Authors: Iulia Crisan

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Objective: The present study investigates the cross-cultural validity of three North-American performance validity indicators (PVTs) by comparing base rates of failure (BRF) in Romanian and Canadian disability applicants. Methods: Three PVTs (Test of Memory Malingering Trial 1 [TOMM-1], Rey Fifteen Item Test free recall [Rey-15 FR], and Rey FR+Recognition [Rey COMB]) were administered to a heterogeneous Romanian clinical sample (N Ro =54) and a similar Canadian sample (N Can = 52). Patients were referred for assessment to determine the severity of their cognitive deficits. Results: We compared the BRF in both samples at various cutoffs. BRF on TOMM-1 at ≤ 43 was similar (Ro = 33.3% vs. Can = 40.4%); at ≤40, Ro = 22.2% vs. Can = 25.0%. Likewise, comparable BRF were observed on Rey-15 FR at ≤ 8 (Ro = 7.4% vs. Can = 11.5%) and ≤ 11 (Ro = 27.8% vs. Can = 23.1%). However, the Romanian sample produced significantly higher failure rates on the Rey COMB at variable cutoffs (p <.05), possibly because Romanian patients were significantly older than the Canadian sample. Conclusion: Our findings offer proof of concept for the cross-cultural validity of the TOMM and Rey-15 FR. At the same time, they serve as a reminder that the generalizability of PVT cutoffs to different populations should not be assumed but verified empirically. Employing the TOMM as a criterion measure for newly developed PVTs is discussed.

Keywords: performance validity indicators, cross-cultural validity, failure base rates, clinical samples, cognitive dysfunction, TOMM-1, Rey-15, Rey COMB

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Authors: Majid Saaly, Shahriar Tavousi Tafreshi, Mehdi Nazari Afshar

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Most reinforced concrete structures are designed only under heavy loads have large transverse reinforcement spacing values, and therefore suffer severe failure after intense ground movements. The main goal of this paper is to compare the shear- and axial failure of concrete bending frames available in Tehran using incremental dynamic analysis under near- and far-field records. For this purpose, IDA analyses of 5, 10, and 15-story concrete structures were done under seven far-fault records and five near-faults records. The results show that in two-dimensional models of short-rise, mid-rise and high-rise reinforced concrete frames located on Type-3 soil, increasing the distance of the transverse reinforcement can increase the maximum inter-story drift ratio values up to 37%. According to the existing results on 5, 10, and 15-story reinforced concrete models located on Type-3 soil, records with characteristics such as fling-step and directivity create maximum drift values between floors more than far-fault earthquakes. The results indicated that in the case of seismic excitation modes under earthquake encompassing directivity or fling-step, the probability values of failure and failure possibility increasing rate values are much smaller than the corresponding values of far-fault earthquakes. However, in near-fault frame records, the probability of exceedance occurs at lower seismic intensities compared to far-fault records.

Keywords: IDA, failure curve, directivity, maximum floor drift, fling step, evaluating probable bending of frames, near-field and far-field earthquake records

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Authors: Mai A. Aljaberi

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The anchorage of fibre-reinforced polymer (FRP) sheets is the most effective solution to prevent or delay debonding failure; this system has proven to get better levels of FRP utilization. Unfortunately, the related design information is still unclear. This shortcoming limits the widespread use of the anchorage system. In order to minimize the knowledge gap about the design of U-wrap anchors, this paper reports the results of tested beams which were strengthened with carbon fiber-reinforced polymer (CFRP) sheets at their tension sides and secured with U-wrap anchors at each end of the longitudinal CFRP. The beams were tested under four-point loading until failure. The parameters examined include the compressive strength of the concrete and the number of longitudinal CFRP. It is concluded that these parameters have a considerable effect on the debonding of the strain. The greatest improvement in the strain was 55.8% over the control beam.

Keywords: CFRP, concrete strengthening, debonding failure, debonding strain, U-wrap anchor

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Authors: Gurbir Kaur, Surinder Pal Singh

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The present study is a part of the research work on the effect of limestone powder (LP), silica fume (SF) and metakaolin (MK), on the flexural fatigue performance of steel fibre reinforced concrete (SFRC). Corrugated rectangular steel fibres of size 0.6x2.0x35 mm at a constant volume fraction of 1.0% have been incorporated in all mix combinations as the reinforcing material. Three mix combinations were prepared by replacing 30% of ordinary Portland cement (OPC) by weight with these cement additives in binary and ternary fashion to demonstrate their contribution. An experimental programme was conducted to obtain the fatigue lives of all mix combinations at various stress levels. The fatigue life data have been analysed as an attempt to determine the relationship between stress level ‘S’, number of cycles to failure ‘N’ and probability of failure ‘Pf’ for all mix combinations. The experimental coefficients of the fatigue equation have also been obtained from the fatigue data to represent the S-N-Pf curves analytically.

Keywords: cement additives, fatigue life, probability of failure, steel fibre reinforced concrete

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Authors: A. A. Omonori, K. T. Alade, A. F. Lawal

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This research was conducted to identify the causes of project abandonment in Nigeria and the effect it has on the host community. The aim of the research was to identify the causes and effects of project failure and abandonment. Project abandonment is a major course of concern in the country as different projects fail and are abandoned at various levels. These projects do not fulfill the purpose for which they were initiated. This is the absolute definition of failure and hence the selection of the Ajaokuta Steel Project as an interesting case study and a typical example of project failure and abandonment. This has been done by conducting field study through the administration of questionnaires. This study was carried out on the Ajaokuta Steel Project to investigate the causes of the abandonment of the project and the effects it has had on the people of Ajaokuta community. Qualitative method of data analysis was used to analyze the findings through frequency tables and ranking. This study brought to light the major factors that led to the abandonment of the Ajaokuta Steel Project. The effects the abandonment of the project has had on the immediate community were identified and recommendations made to prevent the menace of Project abandonment.

Keywords: abandonment, case-study, Nigeria, project

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Authors: Gelacio Juárez-Luna, Gustavo Ayala, Jaime Retama-Velasco

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This paper shows the advantages of the material failure process simulation by improve finite elements with embedded discontinuities, using a new definition of traction vector, dependent on the discontinuity length and the angle. Particularly, two families of this kind of elements are compared: kinematically optimal symmetric and statically and kinematically optimal non-symmetric. The constitutive model to describe the behavior of the material in the symmetric formulation is a traction-displacement jump relationship equipped with softening after reaching the failure surface. To show the validity of this symmetric formulation, representative numerical examples illustrating the performance of the proposed formulation are presented. It is shown that the non-symmetric family may over or underestimate the energy required to create a discontinuity, as this effect is related with the total length of the discontinuity, fact that is not noticed when the discontinuity path is a straight line.

Keywords: variational formulation, strong discontinuity, embedded discontinuities, strain localization

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Authors: Shweh Fern Loo, Jun Yin Ong, Than Zaw Oo

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Acute respiratory distress syndrome (ARDS) is a common serious condition of bilateral lung infiltrates that develops secondary to various underlying conditions such as diseases or injuries. ARDS with severe hypercapnia is associated with higher ICU mortality and morbidity. Venovenous Extracorporeal membrane oxygenation (VV-ECMO) support has been established to avert life-threatening hypoxemia and hypercapnic respiratory failure despite optimal conventional mechanical ventilation. However, VV-ECMO is relatively not advisable in particular groups of patients, especially in multi-organ failure, advanced age, hemorrhagic complications and irreversible central nervous system pathology. We presented a case of a 79-year-old Chinese lady without any pre-existing lung disease admitted to our hospital intensive care unit (ICU) after acute presentation of breathlessness and chest pain. After extensive workup, she was diagnosed with rapidly progressing acute interstitial pneumonia with ARDS and hypercapnia respiratory failure. The patient received lung protective strategies of mechanical ventilation and neuromuscular blockage therapy as per clinical guidelines. However, hypercapnia respiratory failure was refractory, and she was deemed not a good candidate for VV-ECMO support given her advanced age and high vasopressor requirements from shock. Alternative therapy with extracorporeal CO2 removal (ECCO2R) was considered and implemented. The patient received 12 days of ECCO2R paired with muscle paralysis, optimization of lung-protective mechanical ventilation and dialysis. Unfortunately, the patient still had refractory hypercapnic respiratory failure with dual vasopressor support despite prolonged therapy. Given failed and futile medical treatment, the family opted for withdrawal of care, a conservative approach, and comfort care, which led to her demise. The effectivity of extracorporeal CO2 removal may depend on disease burden, involvement and severity of the disease. There is insufficient data to make strong recommendations about its benefit-risk ratio for ECCO2R devices, and further studies and data would be required. Nonetheless, ECCO2R can be considered an alternative treatment for refractory hypercapnic respiratory failure patients who are unsuitable for initiating venovenous ECMO.

Keywords: extracorporeal CO2 removal (ECCO2R), acute respiratory distress syndrome (ARDS), acute interstitial pneumonia (AIP), hypercapnic respiratory failure

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Authors: Jelena Vucicevic

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Reliability analysis represents a very important task in different areas of work. In any industry, this is crucial for maintenance, efficiency, safety and monetary costs. There are ways to calculate reliability, unreliability, failure density and failure rate. In this paper, the results for the reliability of diesel generator fans were calculated through Extreme Value Theory. The Extreme Value Theory is not widely used in the engineering field. Its usage is well known in other areas such as hydrology, meteorology, finance. The significance of this theory is in the fact that unlike the other statistical methods it is focused on rare and extreme values, and not on average. It should be noted that this theory is not designed exclusively for extreme events, but for extreme values in any event. Therefore, this is a great opportunity to apply the theory and test if it could be applied in this situation. The significance of the work is the calculation of time to failure or reliability in a new way, using statistic. Another advantage of this calculation is that there is no need for technical details and it can be implemented in any part for which we need to know the time to fail in order to have appropriate maintenance, but also to maximize usage and minimize costs. In this case, calculations have been made on diesel generator fans but the same principle can be applied to any other part. The data for this paper came from a field engineering study of the time to failure of diesel generator fans. The ultimate goal was to decide whether or not to replace the working fans with a higher quality fan to prevent future failures. The results achieved in this method will show the approximation of time for which the fans will work as they should, and the percentage of probability of fans working more than certain estimated time. Extreme Value Theory can be applied not only for rare and extreme events, but for any event that has values which we can consider as extreme.

Keywords: extreme value theory, lifetime, reliability analysis, statistic, time to failure

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Authors: Magdy Abouzeid

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Objectives: The aim of this study was to examine the influence of Monofin training, 36 weeks, 6 times per week, 90 min/unit on left ventricular performance in elite Egyptian Monofin athletes. Background: The elite athletes are one who has superior athletic talent. Monofin swimming already provide the most efficient way of swimming for human being, it is an aquatics sport practice on the surface or under water. Methods :To study these effects,14 elite Monofin children(3 girls and 11boys) aged(11.95± 1.09yr) HT (153.07± 4.2 cm) , WT(52.4 ± 3.7 kg ) , body surface area (BSA.m2 1.48 ± 5.6 m2 ) took part in long-term Monofin Training(LTMT).All subjects underwent two-dimension and M-mode Echordiography at rest before and after(LTMT). Results: There was significant difference (P < 0.01) and percentage improvement for all echocardiography parameter after (LTMT). Inter ventricular septal thickness in diastole and in systole increased by 27.9 % and 42.75 %. Left ventricular end systolic dimension and diastole increased by 16.81 % and 42.7 % respectively. Posterior wall thickness in systole was very highly increased by 283.3 % and in diastole increased by 51.78 %. Left ventricular mass in diastole and in systole increased by 44.8 % and 40.1 % respectively. Stroke volume and resting heart rate (HR) significant changed (sv) 25 %, (HR) 14.7 %. Conclusion: Monofin training is an effective sport to enhance ‘Heart athlete's’ for children, because the unique swim fin tool and create propulsion and overcome resistance. Further researches are needed to determine the effects of Monofin training on right ventricular in child athletes.

Keywords: prepubertal, monofin training, heart athlete's, elite child athlete, echocardiography

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Authors: Urbi Pal, Piyas Palit, Jitendra Mathur, Abhay Chaturvedi, Sandip Bhattacharya

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The hot rolled slab lifting crane cable reel drum (CRD) failed due to failure of cable reel flat spring which are inside the cassette of CRD. CRD is used for the movement of tong cable. Stereoscopic observation revealed beach marks and Scanning Electron Microscopy showed striations confirming fatigue mode of failure. Chemical composition should be spring steel (Cr-Mo-V) as per IS 3431:1982 instead of C-Mn steel. To find out the reason of fatigue failure, the theoretical fatigue life of flat spiral spring has been calculated. The calculation of number of fatigue cycles included bending moment, maximum stress on the spring, ultimate tensile strength and alternative stress. The bending moment determination has been taken account with various parameters like Young’s Modulus, width, thickness, outer diameter, arbor diameter, pay out the length and angular deflection in rotations. With all the required data, the calculated fatigue life turned to be 10000 cycles, but the spring served 15000 cycles which clearly indicated beyond fatigue life usage. Different UTS values have been plotted with respect to the number of fatigue cycles and clearly showed that the increase in UTS by 40% increases fatigue life by 50%. The significance of higher UTS lied here, and higher UTS depends on modified chemistry with proper tempered martensite microstructure. This kind of failure can be easily avoided by changing the crane spring maintenance schedule from 2 years to 1.5 years considering 600 cycles per month. The plant has changed changing the schedule of cable reel spring and procured new flat reel spring made of 50CrV2 steel.

Keywords: cable reel spring, fatigue life, stress, spring steel

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Authors: Priyashri Kamlesh Sridhar, Suranga Nanayakkara

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Current frameworks in assessment follow lesson delivery and rely heavily on test performance or teacher’s observations. This, however, neglects the underlying cognitive load during the learning process. Identifying the pivotal points when the load occurs helps design effective pedagogies and tools that respond to learners’ cognitive state. There has been limited research on quantifying cognitive load in preschoolers, real-time. In this study, we recorded electrodermal activity and heart rate variability (HRV) from 10 kindergarteners performing executive function tasks and Johnson Woodcock test of cognitive abilities. Preliminary findings suggest that there are indeed sensitive task-dependent markers in skin conductance (number of SCRs and average amplitude of SCRs) and HRV (mean heart rate and low frequency component) captured during the learning process.

Keywords: early childhood, learning, methodologies, pedagogies

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Authors: Reza Behmanesh, Mohammad Nasrolahzadeh-Masouleh, Ehsan Khaksar, Saeed Bokaie

Abstract:

Domestic rabbits (Oryctolagus cuniculus) are an excellent model for cardiovascular research because the size of these animals is more suitable for study and experimentation than smaller animals. One of the most important diagnostic imaging methods is echocardiography, which is used today to evaluate the anatomical and functional cardiovascular system and is one of the most accurate and sensitive non-invasive methods for examining heart disease. Ventricular function indices can be assessed with cardiac imaging techniques. One of these important cardiac parameters is the ejection fraction (EF), which has a valuable place along with other involved parameters. EF is a measure of the percentage of blood that comes out of the heart with each contraction. For this study, 100 adult and young standard domestic rabbits, six months to one year old and of both sexes (50 female and 50 male rabbits) without anesthesia and sedation were used. In this study, the mean EF in domestic rabbits studied in males was 58.753 ± 6.889 and in females, 61.397 ± 6.530, which are comparable to the items mentioned in the valid books and the average size of EF measured in this study; there is no significant difference between this research and other research. There was no significant difference in the percentage of EF between most weight groups, but there was a significant difference (p < 0.05) in weight groups (2161–2320 g and 2481–2640 g). Echocardiographic EF reference values for domestic rabbits (Oryctolagus cuniculus) non-anesthetized are presented, providing reference values for future studies.

Keywords: echocardiography, ejection fraction, rabbit, heart

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Authors: Nicholas Pearce, Eun-jin Kim

Abstract:

Pathologies of the cardiovascular (CV) system remain a serious and deadly health problem for human society. Computational modelling provides a relatively accessible tool for diagnosis, treatment, and research into CV disorders. However, numerical models of the CV system have largely focused on the function of the ventricles, frequently overlooking the behaviour of the atria. Furthermore, in the study of the pressure-volume relationship of the heart, which is a key diagnosis of cardiac vascular pathologies, previous works often evoke popular yet questionable time-varying elastance (TVE) method that imposes the pressure-volume relationship instead of calculating it consistently. Despite the convenience of the TVE method, there have been various indications of its limitations and the need for checking its validity in different scenarios. A model of the combined left ventricle (LV) and left atrium (LA) is presented, which consistently considers various feedback mechanisms in the heart without having to use the TVE method. Specifically, a synergistic model of the left ventricle is extended and modified to include the function of the LA. The synergy of the original model is preserved by modelling the electro-mechanical and chemical functions of the micro-scale myofiber for the LA and integrating it with the microscale and macro-organ-scale heart dynamics of the left ventricle and CV circulation. The atrioventricular node function is included and forms the conduction pathway for electrical signals between the atria and ventricle. The model reproduces the essential features of LA behaviour, such as the two-phase pressure-volume relationship and the classic figure of eight pressure-volume loops. Using this model, disorders in the internal cardiac electrical signalling are investigated by recreating the mechano-electric feedback (MEF), which is impossible where the time-varying elastance method is used. The effects of AV node block and slow conduction are then investigated in the presence of an atrial arrhythmia. It is found that electrical disorders and arrhythmia in the LA degrade the CV system by reducing the cardiac output, power, and heart rate.

Keywords: cardiovascular system, left atrium, numerical model, MEF

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Authors: Aysan Esgandanian, Sabalan Daneshvar

Abstract:

The study is done to determine the comparison between proportional-integral-derivative controller (PID controller) and tilt-integral-derivative (TID controller) for cardiac pacemaker systems, which can automatically control the heart rate to accurately track a desired preset profile. The controller offers good adaption of heart to the physiological needs of the patient. The parameters of the both controllers are tuned by particle swarm optimization (PSO) algorithm which uses the integral of time square error as a fitness function to be minimized. Simulation results are performed on the developed cardiovascular system of humans and results demonstrate that the TID controller produces superior control performance than PID controllers. In this paper, all simulations were performed in Matlab.

Keywords: integral of time square error, pacemaker systems, proportional-integral-derivative controller, PSO algorithm, tilt-integral-derivative controller

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Authors: Mohamed Osama Hassaan

Abstract:

Recent earthquakes have demonstrated the vulnerability of older reinforced concrete buildings to fail under imposed seismic loads. Accordingly, the need to strengthen existing reinforced concrete structures, mainly columns, to resist high seismic loads has increased. Conventional strengthening techniques such as using steel plates, steel angles and concrete overlay are used to achieve the required increase in strength or ductility. However, techniques using advanced composite materials are established. The column's splice zone is the most critical zone that failed under seismic loads. There are three types of splice zone failure that can be observed under seismic action, namely, Failure of the flexural plastic hinge region, shear failure and failure due to short lap splice. A lapped splice transfers the force from one bar to another through the concrete surrounding both bars. At any point along the splice, force is transferred from one bar by a bond to the surrounding concrete and also by a bond to the other bar of the pair forming the splice. The integrity of the lap splice depends on the development of adequate bond length. The R.C. columns built in seismic regions are expected to undergo a large number of inelastic deformation cycles while maintaining the overall strength and stability of the structure. This can be ensured by proper confinement of the concrete core. The last type of failure is focused in this research. There are insufficient studies that address the problem of strengthening existing reinforced concrete columns at splice zone through confinement with “advanced composite materials". Accordingly, more investigation regarding the seismic behavior of strengthened reinforced concrete columns using the new generation of composite materials such as (Carbon fiber polymer), (Glass fiber polymer), (Armiad fiber polymer).

Keywords: strengthening, columns, advanced composite materials, earthquakes

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Authors: Ali Shubbar, Hasanain Alwan, Ee Yu Phur, John McLoughlin, Ameer Al-khaykan

Abstract:

This paper aims to investigate the structural behaviour of RC beams with circular openings of different sizes and locations modelled using ABAQUS FEM software. Seven RC beams with the dimensions of 1200 mm×150 mm×150 mm were tested under three-point loading. Group A consists of three RC beams incorporating circular openings with diameters of 40 mm, 55 mm and 65 mm in the shear zone. However, Group B consists of three RC beams incorporating circular openings with diameters of 40 mm, 55 mm and 65 mm in the flexural zone. The final RC beam did not have any openings, to provide a control beam for comparison. The results show that increasing the diameter of the openings increases the maximum deflection and the ultimate failure load decreases relative to the control beam. In the shear zone, the presence of the openings caused an increase in the maximum deflection ranging between 4% and 22% and a decrease in the ultimate failure load of between 26% and 36% compared to the control beam. However, the presence of the openings in the flexural zone caused an increase in the maximum deflection of between 1.5% and 19.7% and a decrease in the ultimate failure load of between 6% and 13% relative to the control beam. In this study, the optimum location for placing circular openings was found to be in the flexural zone of the beam with a diameter of less than 30% of the depth of the beam.

Keywords: ultimate failure load, maximum deflection, shear zone and flexural zone

Procedia PDF Downloads 275

Authors: Lauren Dhugga, Meena Parameswaran, David Blundell, Abbas Khushnood

Abstract:

Context: A multidisciplinary weekly safety briefing was implemented at the Paediatric Cardiothoracic Unit at the Freeman Hospital in Newcastle-upon-Tyne. It is a tertiary referral centre with a quarternary cardiac paediatric intensive care unit and provides complexed care including heart and lung transplants, mechanical support and advanced heart failure assessment. Aim: The aim of this briefing is to provide a structured platform of communication, in an effort to improve efficiency, safety, and patient care. Problem: The paediatric cardiothoracic unit is made up of a vast multidisciplinary team including doctors, intensivists, anaesthetists, surgeons, specialist nurses, echocardiogram technicians, physiotherapists, psychologists, dentists, and dietitians. It provides care for children with congenital and acquired cardiac disease and is one of only two units in the UK to offer paediatric heart transplant. The complexity of cases means that there can be many teams involved in providing care to each patient, and frequent movement of children between ward, high dependency, and intensive care areas. Currently, there is no structured forum for communicating important information across the department, for example, staffing shortages, prescribing errors and significant events. Strategy: An initial survey questioning the need for better communication found 90% of respondents agreed that they could think of an incident that had occurred due to ineffective communication, and 85% felt that incident could have been avoided had there been a better form of communication. Lastly, 80% of respondents felt that a weekly 60 second safety briefing would be beneficial to improve communication within our multidisciplinary team. Based on those promising results, a weekly 60 second safety briefing was implemented to be conducted on a Monday morning. The safety briefing covered four key areas (SAFE): staffing, awareness, fix and events. This was to highlight any staffing gaps, any incident reports to be learned from, any issues that required fixing and any events including teachings for the week ahead. The teams were encouraged to email suggestions or issues to be raised for the week or to approach in person with information to add. The safety briefing was implemented using change theory. Effect: The safety briefing has been trialled over 6 weeks and has received a good buy in from staff across specialties. The aim is to embed this safety briefing into a weekly meeting using the PDSA cycle. There will be a second survey in one month to assess the efficacy of the safety briefing and to continue to improve the delivery of information. The project will be presented at the next clinical governance briefing to attract wider feedback and input from across the trust. Lessons: The briefing displays promise as a tool to improve vigilance and communication in a busy multi-disciplinary unit. We have learned about how to implement quality improvement and about the culture of our hospital - how hierarchy influences change. We demonstrate how to implement change through a grassroots process, using a junior led briefing to improve the efficiency, safety, and communication in the workplace.

Keywords: briefing, communication, safety, team

Procedia PDF Downloads 143