Search results for: single tooth restoration
780 Regional Anesthesia in Carotid Surgery: A Single Center Experience
Authors: Daniel Thompson, Muhammad Peerbux, Sophie Cerutti, Hansraj Riteesh Bookun
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Patients with carotid stenosis, which may be asymptomatic or symptomatic in the form of transient ischaemic attack (TIA), amaurosis fugax, or stroke, often require an endarterectomy to reduce stroke risk. Risks of this procedure include stroke, death, myocardial infarction, and cranial nerve damage. Carotid endarterectomy is most commonly performed under general anaesthetic, however, it can also be undertaken with a regional anaesthetic approach. Our tertiary centre generally performs carotid endarterectomy under regional anaesthetic. Our major tertiary hospital mostly utilises regional anaesthesia for carotid endarterectomy. We completed a cross-sectional analysis of all cases of carotid endarterectomy performed under regional anaesthesia across a 10-year period between January 2010 to March 2020 at our institution. 350 patients were included in this descriptive analysis, and demographic details for patients, indications for surgery, procedural details, length of surgery, and complications were collected. Data was cross tabulated and presented in frequency tables to describe these categorical variables. 263 of the 350 patients in the analysis were male, with a mean age of 71 ± 9. 172 patients had a history of ischaemic heart disease, 104 had diabetes mellitus, 318 had hypertension, and 17 patients had chronic kidney disease greater than Stage 3. 13.1% (46 patients) were current smokers, and the majority (63%) were ex-smokers. Most commonly, carotid endarterectomy was performed conventionally with patch arterioplasty 96% of the time (337 patients). The most common indication was TIA and stroke in 64% of patients, 18.9% were classified as asymptomatic, and 13.7% had amaurosis fugax. There were few general complications, with 9 wound complications/infections, 7 postoperative haematomas requiring return to theatre, 3 myocardial infarctions, 3 arrhythmias, 1 exacerbation of congestive heart failure, 1 chest infection, and 1 urinary tract infection. Specific complications to carotid endarterectomy included 3 strokes, 1 postoperative TIA, and 1 cerebral bleed. There were no deaths in our cohort. This analysis of a large cohort of patients from a major tertiary centre who underwent carotid endarterectomy under regional anaesthesia indicates the safety of such an approach for these patients. Regional anaesthesia holds the promise of less general respiratory and cardiac events compared to general anaesthesia, and in this vulnerable patient group, calls for comparative research between local and general anaesthesia in carotid surgery.Keywords: anaesthesia, carotid endarterectomy, stroke, carotid stenosis
Procedia PDF Downloads 121779 The Role of Learning in Stimulation Policies to Increase Participation in Lifelong Development: A Government Policy Analysis
Authors: Björn de Kruijf, Arjen Edzes, Sietske Waslander
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In an ever-quickly changing society, lifelong development is seen as a solution to labor market problems by politicians and policymakers. In this paper, we investigate how policy instruments are used to increase participation in lifelong development and on which behavioral principles policy is based. Digitization, automation, and an aging population change society and the labor market accordingly. Skills that were once most sought after in the workforce can become abundantly present. For people to remain relevant in the working population, they need to continue adapting new skills useful in the current labor market. Many reports have been written that focus on the role of lifelong development in this changing society and how lifelong development can help keep people adapt and stay relevant. Inspired by these reports, governments have implemented a broad range of policies to support participation in lifelong development. The question we ask ourselves is how government policies promote participation in lifelong development. This stems from a complex interplay of policy instruments and learning. Regulation, economic and soft instruments can be combined to promote lifelong development, and different types of education further complex policies on lifelong development. Literature suggests that different stages in people’s lives might warrant different methods of learning. Governments could anticipate this in their policies. In order to influence people’s behavior, the government can tap into a broad range of sociological, psychological, and (behavioral) economic principles. The traditional economic assumption that behavior is rational is known to be only partially true, and the government can use many biases in human behavior to stimulate participation in lifelong development. In this paper, we also try to find which biases the government taps into to promote participation if they tap into any of these biases. The goal of this paper is to analyze government policies intended to promote participation in lifelong development. To do this, we develop a framework to analyze the policies on lifelong development. We specifically incorporate the role of learning and the behavioral principles underlying policy instruments in the framework. We apply this framework to the case of the Netherlands, where we examine a set of policy documents. We single out the policies the government has put in place and how they are vertically and horizontally related. Afterward, we apply the framework and classify the individual policies by policy instrument and by type of learning. We find that the Dutch government focuses on formal and non-formal learning in their policy instruments. However, the literature suggests that learning at a later age is mainly done in an informal manner through experiences.Keywords: learning, lifelong development, policy analysis, policy instruments
Procedia PDF Downloads 82778 Acute Effects of Exogenous Hormone Treatments on Postprandial Acylation Stimulating Protein Levels in Ovariectomized Rats After a Fat Load
Authors: Bashair Al Riyami
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Background: Acylation stimulating protein (ASP) is a small basic protein that was isolated based on its function as a potent lipogenic factor. The role of ASP in lipid metabolism has been described in numerous studies. Several association studies suggest that ASP may play a prominent role in female fat metabolism and distribution. Progesterone is established as a female lipogenic hormone, however the mechanisms by which progesterone exert its effects are not fully understood. AIM: Since ASP is an established potent lipogenic factor with a known mechanism of action, in this study we aim to investigate acute effects of different hormone treatments on ASP levels in vivo after a fat load. Methods: This is a longitudinal study including 24 female wister rats that were randomly divided into 4 groups including controls (n=6). The rats were ovariectomized, and fourteen days later the fasting rats were injected subcutaneously with a single dose of different hormone treatments (progesterone, estrogen and testosterone). An hour later, olive was administered by oral gavage, and plasma blood samples were collected at several time points after oil administration for ASP and triglyceride measurements. Area under the curve (TG-AUC) was calculated to represent TG clearance Results: RM-ANCOVA and post-analysis showed that only the progesterone treated group had a significant postprandial ASP increase at two hours compared to basal levels and to the controls (439.8± 62.4 vs 253.45± 59.03 ug/ml), P= 0.04. Interestingly, increased postprandial ASP levels coordinated negatively with corresponding TG levels and TG-AUC across the postprandial period most apparent in the progesterone and testosterone treated groups that behaved in an opposite manner. ASP levels were 3-fold higher in the progesterone compared to the testosterone treated group, whereas TG-AUC was significantly lower in the progesterone treated group compared to the testosterone treated group. Conclusion: These findings suggest that progesterone treatment enhances ASP production and TG clearance in a simultaneous manner. The strong association of postprandial ASP levels and TG clearance in the progesterone treated group support the notion of a stimulatory role for progesterone on ASP mediated TG clearance. This is the first functional study to demonstrate a cause-effect relationship between hormone treatment and ASP levels in vivo. These findings are promising and may contribute to further understanding the mechanism of progesterone function as a female lipogenic hormone through enhancing ASP production and plasma levels.Keywords: ASP, lipids, sex hormones, wister rats
Procedia PDF Downloads 342777 Durability of Functionally Graded Concrete
Authors: Prasanna Kumar Acharya, Mausam Kumari Yadav
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Cement concrete has emerged as the most consumed construction material. It has also dominated all other construction materials because of its versatility. Apart from numerous advantages it has a disadvantage concerning durability. The large structures constructed with cement concrete involving the consumption of huge natural materials remain in serviceable condition for 5 – 7 decades only while structures made with stones stand for many centuries. The short life span of structures not only affects the economy but also affects the ecology greatly. As such, the improvement of durability of cement concrete is a global concern and scientists around the globe are trying for this purpose. Functionally graded concrete (FGC) is an exciting development. In contrast to conventional concrete, FGC demonstrates different characteristics depending on its thickness, which enables it to conform to particular structural specifications. The purpose of FGC is to improve the performance and longevity of conventional concrete structures with cutting-edge building materials. By carefully distributing various kinds and amounts of reinforcements, additives, mix designs and/or aggregates throughout the concrete matrix, this variety is produced. A key component of functionally graded concrete's performance is its durability, which affects the material's capacity to tolerate aggressive environmental influences and load-bearing circumstances. This paper reports the durability of FGC made using Portland slag cement (PSC). For this purpose, control concretes (CC) of M20, M30 and M40 grades were designed. Single-layered samples were prepared using each grade of concrete. Further using combinations of M20 + M30, M30 + M40 and M40 + M20, doubled layered concrete samples in a depth ratio of 1:1 was prepared those are herein called FGC samples. The efficiency of FGC samples was compared with that of the higher-grade concrete of parent materials in terms of compressive strength, water absorption, sorptivity, acid resistance, sulphate resistance, chloride resistance and abrasion resistance. The properties were checked at the age of 28 and 91 days. Apart from strength and durability parameters, the microstructure of CC and FGC were studied in terms of X-ray diffraction, scanning electron microscopy and energy-dispersive X-ray. The result of the study revealed that there is an increase in the efficiency of concrete evaluated in terms of strength and durability when it is made functionally graded using a layered technology having different grades of concrete in layers. The results may help to enhance the efficiency of structural concrete and its durability.Keywords: fresh on compacted, functionally graded concrete, acid, chloride, sulphate test, sorptivity, abrasion, water absorption test
Procedia PDF Downloads 18776 Maintenance Optimization for a Multi-Component System Using Factored Partially Observable Markov Decision Processes
Authors: Ipek Kivanc, Demet Ozgur-Unluakin
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Over the past years, technological innovations and advancements have played an important role in the industrial world. Due to technological improvements, the degree of complexity of the systems has increased. Hence, all systems are getting more uncertain that emerges from increased complexity, resulting in more cost. It is challenging to cope with this situation. So, implementing efficient planning of maintenance activities in such systems are getting more essential. Partially Observable Markov Decision Processes (POMDPs) are powerful tools for stochastic sequential decision problems under uncertainty. Although maintenance optimization in a dynamic environment can be modeled as such a sequential decision problem, POMDPs are not widely used for tackling maintenance problems. However, they can be well-suited frameworks for obtaining optimal maintenance policies. In the classical representation of the POMDP framework, the system is denoted by a single node which has multiple states. The main drawback of this classical approach is that the state space grows exponentially with the number of state variables. On the other side, factored representation of POMDPs enables to simplify the complexity of the states by taking advantage of the factored structure already available in the nature of the problem. The main idea of factored POMDPs is that they can be compactly modeled through dynamic Bayesian networks (DBNs), which are graphical representations for stochastic processes, by exploiting the structure of this representation. This study aims to demonstrate how maintenance planning of dynamic systems can be modeled with factored POMDPs. An empirical maintenance planning problem of a dynamic system consisting of four partially observable components deteriorating in time is designed. To solve the empirical model, we resort to Symbolic Perseus solver which is one of the state-of-the-art factored POMDP solvers enabling approximate solutions. We generate some more predefined policies based on corrective or proactive maintenance strategies. We execute the policies on the empirical problem for many replications and compare their performances under various scenarios. The results show that the computed policies from the POMDP model are superior to the others. Acknowledgment: This work is supported by the Scientific and Technological Research Council of Turkey (TÜBİTAK) under grant no: 117M587.Keywords: factored representation, maintenance, multi-component system, partially observable Markov decision processes
Procedia PDF Downloads 134775 Comparison of the Common Factors of the Top Academic Elementary Schools to the Average Elementary Schools in California: Looking beyond School Leadership
Authors: Lindy Valdez, Daryl Parker
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Introduction: There has been much research on academic achievement in elementary schools. Most of the research has been on school leadership. While research has focused on the role of leadership on school improvement, little research has examined what variables the top elementary schools have in common. To undertake school improvement, it is important to understand what factors the best schools share. The purpose of this study was to examine data of the “Best Elementary Schools in California,” based on academic achievement as rated by three prominent websites and determine if these schools had any common factors which were different than the statewide averages. The variables examined included access to subject matter specialists (physical education, art, and music), librarians, after school programs, class size, socioeconomic status, and diversity. The participants consisted of the top public elementary schools in California based on the websites i)https://www.niche.com/k12/search/best-schools/, ii)https://www.finder.com/best-schools-california,and iii)https://www.schooldigger.com/go/CA/schoolrank.aspx. The data for subject matter specialists (physical education, art, and music), librarians, after school programs, class size, socioeconomic status, and diversity were collected from these top schools and compared to California statewide averages. Results indicate that top public elementary schools in California have a high number of subject matter specialists that teach physical education, art, and music. These positions are on the decline in the average public elementary school in California, but the top schools have abundant access to these specialists. The physical education specialist has the highest statistically significant difference between the nationwide average and the top schools—librarians, and after school programs are also most commonly high in top public elementary schools in California. The high presence of these programs may be aiding academic achievement in less visible ways. Class size is small, socio-economic status is high, and diversity is low among top public elementary schools in California when compared to the statewide average public elementary schools in California. The single largest area of discrepancy was between physical education specialists in a top school and their state and nationwide averages. The socioeconomic status of schools and parents may be an underlining factor affecting several other variables. This affluence could explain how these schools were able to have access to subject matter specialists, after-school activities, and, therefore, more opportunities for physical activity and greater learning opportunities affecting academic achievement.Keywords: academic achievement, elementary education, factors, schools
Procedia PDF Downloads 133774 Integrated Human Resources and Work Environment Management System
Authors: Loreta Kaklauskiene, Arturas Kaklauskas
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The Integrated Human Resources and Work Environment Management (HOWE) System optimises employee productivity, improves the work environment, and, at the same time, meets the employer’s strategic goals. The HOWE system has been designed to ensure an organisation can successfully compete in the global market, thanks to the high performance of its employees. The HOWE system focuses on raising workforce productivity and improving work conditions to boost employee performance and motivation. The methods used in our research are linear correlation, INVAR multiple criteria analysis, digital twin, and affective computing. The HOWE system is based on two patents issued in Lithuania (LT 6866, LT 6841) and one European Patent application (No: EP 4 020 134 A1). Our research analyses ways to make human resource management more efficient and boost labour productivity by improving and adapting a personalised work environment. The efficiency of human capital and labour productivity can be increased by applying personalised workplace improvement systems that can optimise lighting colours and intensity, scents, data, information, knowledge, activities, media, games, videos, music, air pollution, humidity, temperature, vibrations, and other workplace aspects. HOWE generates and maintains a personalised workspace for an employee, taking into account the person’s affective, physiological and emotional (APSE) states. The purpose of this project was to create a HOWE for the customisation of quality control in smart workspaces taking into account the user’s APSE states in an integrated manner as a single unit. This customised management of quality control covers the levels of lighting and colour intensities, scents, media, information, activities, learning materials, games, music, videos, temperature, energy efficiency, the carbon footprint of a workspace, humidity, air pollution, vibrations and other aspects of smart spaces. The system is based on Digital Twins technology, seen as a logical extension of BIM.Keywords: human resource management, health economics, work environment, organizational behaviour and employee productivity, prosperity in work, smart system
Procedia PDF Downloads 75773 Image Making: The Spectacle of Photography and Text in Obituary Programs as Contemporary Practice of Social Visibility in Southern Nigeria
Authors: Soiduate Ogoye-Atanga
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During funeral ceremonies, it has become common for attendees to jostle for burial programs in some southern Nigerian towns. Beginning from ordinary typewritten text only sheets of paper in the 1980s to their current digitally formatted multicolor magazine style, burial programs continue to be collected and kept in homes where they remain as archival documents of family photo histories and as a veritable form of leveraging family status and visibility in a social economy through the inclusion of lots of choreographically arranged photographs and text. The biographical texts speak of idealized and often lofty and aestheticized accomplishments of deceased peoples, which are often corroborated by an accompanying section of tributes from first the immediate family members, and then from affiliations as well as organizations deceased people belonged, in the form of scanned letterheaded corporate tributes. Others speak of modest biographical texts when the deceased accomplished little. Usually, in majority of the cases, the display of photographs and text in these programs follow a trajectory of historical compartmentalization of the deceased, beginning from parentage to the period of youth, occupation, retirement, and old age as the case may be, which usually drives from black and white historical photographs to the color photography of today. This compartmentalization follows varied models but is designed to show the deceased in varying activities during his lifetime. The production of these programs ranges from the extremely expensive and luscious full colors of near fifty-eighty pages to bland and very simplified low-quality few-page editions in a single color and no photographs, except on the cover. Cost and quality, therefore, become determinants of varying family status and social visibility. By a critical selection of photographs and text, family members construct an idealized image of deceased people and themselves, concentrating on mutuality based on appropriate sartorial selections, socioeconomic grade, and social temperaments that are framed to corroborate the public’s perception of them. Burial magazines, therefore, serve purposes beyond their primary use; they symbolize an orchestrated social site for image-making and the validation of the social status of families, shaped by prior family histories.Keywords: biographical texts, burial programs, compartmentalization, magazine, multicolor, photo-histories, social status
Procedia PDF Downloads 188772 An Assessment of Nodulation and Nitrogen Fixation of Lessertia Frutescens Plants Inoculated with Rhizobial Isolates from the Cape Fynbos
Authors: Mokgadi Miranda Hlongwane, Ntebogeng Sharon Mokgalaka, Felix Dapare Dakora
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Lessertia (L.) frutescens (syn. Sutherlandia frutescens) is a leguminous medicinal plant indigenous to South Africa. Traditionally, L. frutescens has been used to treat cancer, diabetes, epilepsy, fever, HIV, stomach problems, wounds and other ailments. This legume is endemic to the Cape fynbos, with large populations occurring wild and cultivated in the Cape Florist Region. Its widespread distribution in the Western Cape, Northern Cape, Eastern Cape and Kwazulu-Natal is linked to its increased use as a phytomedicine in the treatment of various diseases by traditional healers. The frequent harvesting of field plants for use as a medicine has made it necessary to undertake studies towards the conservation of Lessertia frutescens. As a legume, this species can form root nodules and fix atmospheric N₂ when in symbiosis with soil bacteria called rhizobia. So far, however, few studies (if any) have been done on the efficacy and diversity of native bacterial symbionts nodulating L. frutescens in South Africa. The aim of this project was to isolate and characterize L. frutescens-nodulating bacteria from five different locations in the Western Cape Province. This was done by trapping soil rhizobia using rhizosphere soil suspension to inoculate L. frutescens seedlings growing in sterilized sand and receiving sterile N-free Hoagland nutrient solution under glasshouse conditions. At 60 days after planting, root nodules were harvested from L. frutescens plants, surface-sterilized, macerated, and streaked on yeast mannitol agar (YMA) plates and incubated at 28 ˚C for observation of bacterial growth. The majority of isolates were slow-growers that took 6-14 days to appear on YMA plates. However, seven isolates were fast-growers, taking 2-4 days to appear on YMA plates. Single-colony cultures of the isolates were assessed for their ability to nodulate L. frutescens as a homologous host under glasshouse conditions. Of the 92 bacterial isolates tested, 63 elicited nodule formation on L. frutescens. Symbiotic effectiveness varied markedly between and among test isolates. There were also significant (p≤0.005) differences in nodulation, shoot biomass, photosynthetic rates, leaf transpiration and stomatal conductance of L. frutescens plants inoculated with the test isolates, which is an indication of their functional diversity.Keywords: lessertia frutescens, nodulating, rhizobia, symbiotic effectiveness
Procedia PDF Downloads 193771 Optimizing Cell Culture Performance in an Ambr15 Microbioreactor Using Dynamic Flux Balance and Computational Fluid Dynamic Modelling
Authors: William Kelly, Sorelle Veigne, Xianhua Li, Zuyi Huang, Shyamsundar Subramanian, Eugene Schaefer
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The ambr15™ bioreactor is a single-use microbioreactor for cell line development and process optimization. The ambr system offers fully automatic liquid handling with the possibility of fed-batch operation and automatic control of pH and oxygen delivery. With operating conditions for large scale biopharmaceutical production properly scaled down, micro bioreactors such as the ambr15™ can potentially be used to predict the effect of process changes such as modified media or different cell lines. In this study, gassing rates and dilution rates were varied for a semi-continuous cell culture system in the ambr15™ bioreactor. The corresponding changes to metabolite production and consumption, as well as cell growth rate and therapeutic protein production were measured. Conditions were identified in the ambr15™ bioreactor that produced metabolic shifts and specific metabolic and protein production rates also seen in the corresponding larger (5 liter) scale perfusion process. A Dynamic Flux Balance model was employed to understand and predict the metabolic changes observed. The DFB model-predicted trends observed experimentally, including lower specific glucose consumption when CO₂ was maintained at higher levels (i.e. 100 mm Hg) in the broth. A Computational Fluid Dynamic (CFD) model of the ambr15™ was also developed, to understand transfer of O₂ and CO₂ to the liquid. This CFD model predicted gas-liquid flow in the bioreactor using the ANSYS software. The two-phase flow equations were solved via an Eulerian method, with population balance equations tracking the size of the gas bubbles resulting from breakage and coalescence. Reasonable results were obtained in that the Carbon Dioxide mass transfer coefficient (kLa) and the air hold up increased with higher gas flow rate. Volume-averaged kLa values at 500 RPM increased as the gas flow rate was doubled and matched experimentally determined values. These results form a solid basis for optimizing the ambr15™, using both CFD and FBA modelling approaches together, for use in microscale simulations of larger scale cell culture processes.Keywords: cell culture, computational fluid dynamics, dynamic flux balance analysis, microbioreactor
Procedia PDF Downloads 282770 Analysis of Ozone Episodes in the Forest and Vegetation Areas with Using HYSPLIT Model: A Case Study of the North-West Side of Biga Peninsula, Turkey
Authors: Deniz Sari, Selahattin İncecik, Nesimi Ozkurt
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Surface ozone, which named as one of the most critical pollutants in the 21th century, threats to human health, forest and vegetation. Specifically, in rural areas surface ozone cause significant influences on agricultural productions and trees. In this study, in order to understand to the surface ozone levels in rural areas we focus on the north-western side of Biga Peninsula which covers by the mountainous and forested area. Ozone concentrations were measured for the first time with passive sampling at 10 sites and two online monitoring stations in this rural area from 2013 and 2015. Using with the daytime hourly O3 measurements during light hours (08:00–20:00) exceeding the threshold of 40 ppb over the 3 months (May, June and July) for agricultural crops, and over the six months (April to September) for forest trees AOT40 (Accumulated hourly O3 concentrations Over a Threshold of 40 ppb) cumulative index was calculated. AOT40 is defined by EU Directive 2008/50/EC to evaluate whether ozone pollution is a risk for vegetation, and is calculated by using hourly ozone concentrations from monitoring systems. In the present study, we performed the trajectory analysis by The Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model to follow the long-range transport sources contributing to the high ozone levels in the region. The ozone episodes observed between 2013 and 2015 were analysed using the HYSPLIT model developed by the NOAA-ARL. In addition, the cluster analysis is used to identify homogeneous groups of air mass transport patterns can be conducted through air trajectory clustering by grouping similar trajectories in terms of air mass movement. Backward trajectories produced for 3 years by HYSPLIT model were assigned to different clusters according to their moving speed and direction using a k-means clustering algorithm. According to cluster analysis results, northerly flows to study area cause to high ozone levels in the region. The results present that the ozone values in the study area are above the critical levels for forest and vegetation based on EU Directive 2008/50/EC.Keywords: AOT40, Biga Peninsula, HYSPLIT, surface ozone
Procedia PDF Downloads 255769 Laser-Dicing Modeling: Implementation of a High Accuracy Tool for Laser-Grooving and Cutting Application
Authors: Jeff Moussodji, Dominique Drouin
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The highly complex technology requirements of today’s integrated circuits (ICs), lead to the increased use of several materials types such as metal structures, brittle and porous low-k materials which are used in both front end of line (FEOL) and back end of line (BEOL) process for wafer manufacturing. In order to singulate chip from wafer, a critical laser-grooving process, prior to blade dicing, is used to remove these layers of materials out of the dicing street. The combination of laser-grooving and blade dicing allows to reduce the potential risk of induced mechanical defects such micro-cracks, chipping, on the wafer top surface where circuitry is located. It seems, therefore, essential to have a fundamental understanding of the physics involving laser-dicing in order to maximize control of these critical process and reduce their undesirable effects on process efficiency, quality, and reliability. In this paper, the study was based on the convergence of two approaches, numerical and experimental studies which allowed us to investigate the interaction of a nanosecond pulsed laser and BEOL wafer materials. To evaluate this interaction, several laser grooved samples were compared with finite element modeling, in which three different aspects; phase change, thermo-mechanical and optic sensitive parameters were considered. The mathematical model makes it possible to highlight a groove profile (depth, width, etc.) of a single pulse or multi-pulses on BEOL wafer material. Moreover, the heat affected zone, and thermo-mechanical stress can be also predicted as a function of laser operating parameters (power, frequency, spot size, defocus, speed, etc.). After modeling validation and calibration, a satisfying correlation between experiment and modeling, results have been observed in terms of groove depth, width and heat affected zone. The study proposed in this work is a first step toward implementing a quick assessment tool for design and debug of multiple laser grooving conditions with limited experiments on hardware in industrial application. More correlations and validation tests are in progress and will be included in the full paper.Keywords: laser-dicing, nano-second pulsed laser, wafer multi-stack, multiphysics modeling
Procedia PDF Downloads 209768 Management of Urinary Tract Infections by Nurse Practitioners in a Canadian Pediatric Emergency Department: A Rretrospective Cohort Study
Authors: T. Mcgraw, F. N. Morin, N. Desai
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Background: Antimicrobial resistance is a critical issue in global health care and a significant contributor to increased patient morbidity and mortality. Suspected urinary tract infection (UTI) is a key area of inappropriate antibiotic prescription in pediatrics. Management patterns of infectious diseases have been shown to vary by provider type within a single setting. The aim of this study was to assess compliance with national UTI management guidelines by nurse practitioners in a pediatric emergency department (ED). Methods: This was a post-hoc analysis of a retrospective cohort study to review and evaluate visits to a tertiary care freestanding pediatric emergency department. Patients were included if they were 60 days to 36 months old and discharged with a diagnosis of UTI or ‘rule-out UTI’ between July 2015 and July 2020. Primary outcome measure was proportion of visits seen by Nurse Practitioners (NP) which were associated with national guideline compliance in the diagnosis and treatment of suspected UTI. We performed descriptive statistics and comparative analyses to determine differences in practice patterns between NPs, and physicians. Results: A total of 636 charts were reviewed, of which 402 patients met inclusion criteria. 17 patients were treated by NPs, 385 were treated by either Pediatric Emergency Medicine physicians (PEM) or non-PEM physicians. Overall, the proportion of infants receiving guideline-compliant care was 25.9% (21.8-30.4%). Of those who were prescribed antibiotics, 79.6% (74.7-83.8%) received first line guideline recommended therapy and 58.9% (53.8-63.8%) received fully compliant therapy with respect to age, dose, duration, and frequency. In patients treated by NPs, 16/17 (94%(95% CI:73.0-99.0)) required antibiotics, 15/16 (93%(95% CI: 71.7-98.9)) were treated with first line agent (cephalexin), 8/16 (50%(95% CI:28-72)) were guideline compliant of dose and duration. 5/8 (63%(95% CI:30.6-86.3)) were noncompliant for dose being too high. There was no difference in receiving guideline compliant empiric antibiotic therapy between physicians and nurse practitioners (OR: 0.837 CI: 0.302-2.69). Conclusion: In this post-hoc analysis, guideline noncompliance by nurse practitioners is common in children tested and treated for UTIs in a pediatric emergency department. Care by a Nurse Practitioner was not associated with greater rate of noncompliance than care by a Pediatric Emergency Medicine physician. Future appropriately powered studies may focus on confirming these results.Keywords: antibiotic stewardship, infectious disease, nurse practitioner, urinary tract infection
Procedia PDF Downloads 104767 Exchanges between Literature and Cinema: Scripted Writing in the Novel "Miguel e os Demônios", by Lourenço Mutarelli
Authors: Marilia Correa Parecis De Oliveira
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This research looks at the novel Miguel e os demônios (2009), by the contemporary Brazilian author Lourenço Mutarelli. In it, the presence of film language resources is remarkable, creating thus a kind of scripted writing. We intend to analyze the presence of film language in work under study, in which there is a mixture of the characteristics of the novel and screenplay genres, trying to explore which aesthetic and meaning effects of the ownership of a visual language for the creation of a literary text create in the novel. The objective of this research is to identify and analyze the formal and thematic aspects that characterize the hybridity of literature and film in the novel by Lourenço Mutarelli. The method employed comprises reading and production cataloging of theoretical and critical texts, literary and film theory, historical review about the author, and also the realization of an analytical and interpretative reading of novel. In Miguel e os demônios there is a range of formal and thematic elements of popular narrative genres such as the detective story and action film, with a predominance of verb forms in the present and NPs - features that tend to make present the narrated scenes, as in the cinema. The novel, in this sense, is located in an intermediate position between the literary text and the pre-film text, as though filled with proper elements of the language of film, you can not fit it categorically in the genre script, since it does not reduce the script because aspires to be read as a novel. Therefore, the difficulty of fitting the work in a single gender also refused to be extra-textual factors - such as your publication as novel - but, rather, by the binary classifications serve solely to imprison the work on a label, which impoverish not only reading the text, as also the possibility of recognizing literature as a constant dialogue space and interaction with other media. We can say, therefore, that frame the work Miguel e os demônios in one of the two genres (novel or screenplay) proves not enough, since the text is revealed a hybrid narrative, consisting in a kind of scripted writing. In this sense, it is like a text that is born in a society saturated by audiovisual in their daily lives in order to be consumed by readers who, in ascending scale, exchange books by visual narratives. However, the novel uses film's resources without giving up its constitution as literature; on the contrary, it enriches the visual and linguistically, dialoguing with the complex contemporary horizon marked by the cultural industry.Keywords: Brazilian literature, cinema, Lourenço Mutarelli, screenplay
Procedia PDF Downloads 310766 The Toxicity of Doxorubicin Connected with Nanotransporters
Authors: Iva Blazkova, Amitava Moulick, Vedran Milosavljevic, Pavel Kopel, Marketa Vaculovicova, Vojtech Adam, Rene Kizek
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Doxorubicin is one of the most commonly used and the most effective chemotherapeutic drugs. This antracycline drug isolated from the bacteria Streptomyces peuceticus var. caesius is sold under the trade name Adriamycin (hydroxydaunomycin, hydroxydaunorubicin). Doxorubicin is used in single therapy to treat hematological malignancies (blood cancers, leukaemia, lymphoma), many types of carcinoma (solid tumors) and soft tissue sarcomas. It has many serious side effects like nausea and vomiting, hair lost, myelosupression, oral mucositis, skin reactions and redness, but the most serious one is the cardiotoxicity. Because of the risk of heart attack and congestive heart failure, the total dose administered to patients has to be accurately monitored. With the aim to lower the side effects and to targeted delivery of doxorubicin into the tumor tissue, the different nanoparticles are studied. The drug can be bound on a surface of nanoparticle, encapsulated in the inner cavity, or incorporated into the structure of nanoparticle. Among others, carbon nanoparticles (graphene, carbon nanotubes, fullerenes) are highly studied. Besides the number of inorganic nanoparticles, a great potential exhibit also organic ones mainly lipid-based and polymeric nanoparticle. The aim of this work was to perform a toxicity study of free doxorubicin compared to doxorubicin conjugated with various nanotransporters. The effect of liposomes, fullerenes, graphene, and carbon nanotubes on the toxicity was analyzed. As a first step, the binding efficacy of between doxorubicin and the nanotransporter was determined. The highest efficacy was detected in case of liposomes (85% of applied drug was encapsulated) followed by graphene, carbon nanotubes and fullerenes. For the toxicological studies, the chicken embryos incubated under controlled conditions (37.5 °C, 45% rH, rotation every 2 hours) were used. In 7th developmental day of chicken embryos doxorubicin or doxorubicin-nanotransporter complex was applied on the chorioallantoic membrane of the eggs and the viability was analyzed every day till the 17th developmental day. Then the embryos were extracted from the shell and the distribution of doxorubicin in the body was analyzed by measurement of organs extracts using laser induce fluorescence detection. The chicken embryo mortality caused by free doxorubicin (30%) was significantly lowered by using the conjugation with nanomaterials. The highest accumulation of doxorubicin and doxorubicin nanotransporter complexes was observed in the liver tissueKeywords: doxorubicin, chicken embryos, nanotransporters, toxicity
Procedia PDF Downloads 449765 Patterns of Eosinophilia in Cardiac Patients and its Association with Endomyocardial Disease Presenting to Tertiary Care Hospital in Peshawar
Authors: Rashid Azeem
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Introduction: Eosinophilia, which can be categorized as mild, moderate, and severe form on the basis of increasing eosinophil counts, might be responsible for a wide range of cardiac manifestations, varying from a simple myocarditis to a severe state like endomyocardial fibrosis. Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorder like Loffler endocarditis, eosinophilic granulomatosis with polyangitis (EGPH), and hyper eosinophilic (HES). Among them HES carries and incidence rate b/w 48% and 75% and is the main causes of cardiac motility and mobility due to eosinophilia involvement. Aims and objectives: The aim of this study is to determine the frequency of eosinophilia in cardiac patients and to ascertain the evidence of endomyocardial diseases in eosinophilic patients in a cardiology institution Material and Methods: This cross sectional analytical study was conducted in hematology Department of Peshawar institute of Cardiology after approval from hospital ethical and research committee. All 70 patients were subjected to detailed history and clinical examination. Investigation like CBC, Chest X-ray, ECG, Echo, Angiography findings were used to monitor patient’s clinical status. Data is analyzed using SPSS version 25 and MS Excel. Results: Out of 70 patients in our study, a total of 66 patients(94 %) shows evidence of cardiac manifestations. In our study, we have observed a number of abnormal ECG patterns in cardiac patients presenting with eosinophilia, like T wave changes, loss of R wave, sinus bradycardia with LVH strain, and ST wave abnormality. abnormal echocardiographic findings were observed in our patients, like valvular abnormalities (in 45.7%), RWMA abnormalities (in 2.8%), isolated ventricular dysfunction (in 21.4%), and in 10% patients, normal echocardiography. We further noted abnormal coronary angiography findings in cardiac patients with eosinophilia ranging from single vessel to multi vessel occlusions. Conclusions: Eosinophils are involved in the pathogenesis of a variety of cardiovascular disorders which can be detected by various diagnostic means, and the severity of the disease increases with time and with increasing eosinophil count ranging from simple myocarditis to a fatal condition like endomyocardial fibrosis. Thus, increased eosinophilic count as a laboratory parameter in cardiac patients may be a sign of endomyocardial damage which will further help cardiologist to intervene more aggressively then routine approach to a cardiac patient.Keywords: eosinophilia, endomyocardial fibrosis, cardiac, hypereosinophilic syndrome
Procedia PDF Downloads 65764 Occupational Exposure and Contamination to Antineoplastic Drugs of Healthcare Professionals in Mauritania
Authors: Antoine Villa, Moustapha Mohamedou, Florence Pilliere, Catherine Verdun-Esquer, Mathieu Molimard, Mohamed Sidatt Cheikh El Moustaph, Mireille Canal-Raffin
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Context: In Mauritania, the activity of the National Center of Oncology (NCO) has steadily risen leading to an increase in the handling of antineoplastic drugs (AD) by healthcare professionals. In this context, the AD contamination of those professionals is a major concern for occupational physicians. It has been evaluated using biological monitoring of occupational exposure (BMOE). Methods: The intervention took place in 2015, in 2 care units, and evaluated nurses preparing and/or infusing AD and agents in charge of hygiene. Participants provided a single urine sample, at the end of the week, at the end of their shift. Five molecules were sought using specific high sensitivity methods (UHPLC-MS/MS) with very low limits of quantification (LOQ) (cyclophosphamide (CP), Ifosfamide (IF), methotrexate (MTX): 2.5ng/L; doxorubicin (Doxo): 10ng/L; α-fluoro-β-alanine (FBAL, 5-FU metabolite): 20ng/L). A healthcare worker was considered as 'contaminated' when an AD was detected at a urine concentration equal to or greater than the LOQ of the analytical method or at trace concentration. Results: Twelve persons participated (6 nurses, 6 agents in charge of hygiene). Twelve urine samples were collected and analyzed. The percentage of contamination was 66.6% for all participants (n=8/12), 100% for nurses (6/6) and 33% for agents in charge of hygiene (2/6). In 62.5% (n=5/8) of the contaminated workers, two to four of the AD were detected in the urine. CP was found in the urine of all contaminated workers. FBAL was found in four, MTX in three and Doxo in one. Only IF was not detected. Urinary concentrations (all drugs combined) ranged from 3 to 844 ng/L for nurses and from 3 to 44 ng/L for agents in charge of hygiene. The median urinary concentrations were 87 ng/L, 15.1 ng/L and 4.4 ng/L for FBAL, CP and MTX, respectively. The Doxo urinary concentration was found 218ng/L. Discussion: There is no current biological exposure index for the interpretation of AD contamination. The contamination of these healthcare professionals is therefore established by the detection of one or more AD in urine. These urinary contaminations are higher than the LOQ of the analytical methods, which must be as low as possible. Given the danger of AD, the implementation of corrective measures is essential for the staff. Biological monitoring of occupational exposure is the most reliable process to identify groups at risk, tracing insufficiently controlled exposures and as an alarm signal. These results show the necessity to educate professionals about the risks of handling AD and/or to care for treated patients.Keywords: antineoplastic drugs, Mauritania, biological monitoring of occupational exposure, contamination
Procedia PDF Downloads 316763 Youth and Employment: An Outlook on Challenges of Demographic Dividend
Authors: Vidya Yadav
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India’s youth bulge is now sharpest at the critical 15-24 age group, even as its youngest, and oldest age groups begin to narrow. As the ‘single year, age data’ for the 2011 Census releases the data on the number of people at each year of age in the population. The data shows that India’s working age population (15-64 years) is now 63.4 percent of the total, as against just short of 60 percent in 2001. The numbers also show that the ‘dependency ratio’ the ratio of children (0-14) and the elderly (65 above) to those in the working age has shrunk further to 0.55. “Even as the western world is in ageing situation, these new numbers show that India’s population is still very young”. As the fertility falls faster in urban areas, rural India is younger than urban India; while 51.73 percent of rural Indians are under the age of 24 and 45.9 percent of urban Indians are under 24. The percentage of the population under the age of 24 has dropped, but many demographers say that it should not be interpreted as a sign of the youth bulge is shrinking. Rather it is because of “declining fertility, the number of infants and children reduces first, and this is what we see with the number of under age 24. Indeed the figure shows that the proportion of children in the 0-4 and 5-9 age groups has fallen in 2011 compared to 2001. For the first time, the percentage of children in the 10-14 age group has also fallen, as the effect of families reducing the number of children they have begins to be felt. The present paper key issue is to examine that “whether this growing youth bulge has the right skills for the workforce or not”. The study seeks to examine the youth population structure and employment distribution among them in India during 2001-2011 in different industrial category. It also tries to analyze the workforce participation rate as main and marginal workers both for male and female workers in rural and urban India by utilizing an abundant source of census data from 2001-2011. Result shows that an unconscionable number of adolescents are working when they should study. In rural areas, large numbers of youths are working as an agricultural labourer. Study shows that most of the youths working are in the 15-19 age groups. In fact, this is the age of entry into higher education, but due to economic compulsion forces them to take up jobs, killing their dreams of higher skills or education. Youths are primarily engaged in low paying irregular jobs which are clearly revealed by census data on marginal workers. That is those who get work for less than six months in a year. Large proportions of youths are involved in the cultivation and household industries works.Keywords: main, marginal, youth, work
Procedia PDF Downloads 290762 Empirical Studies of Indigenous Career Choice in Taiwan
Authors: Zichun Chu
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The issue of tribal poverty has always attracted attentions. Due to social and economic difficulties, the indigenous people's personal development and tribal development have been greatly restricted. Past studies have pointed out that poverty may come from a lack of education. The United Nations Sustainable Development Goals (SDGs) also stated that if we are to solve the poverty problem, providing education widely is an important key. According to the theory of intellectual capital adaptation, “being capable” and “willing to do” are the keys of development. Therefore, we can say that the "ability" and "will" of tribal residents for their tribal development is the core concern of the tribal development. This research was designed to investigate the career choice development model of indigenous tribe people by investigating the current status of human capital, social capital, and cultural capital of tribal residents. This study collected 327 questionnaires (70% of total households) from Truku tribe to answer the research question: Did education help them for job choosing decisions from the aspects of human capital, social capital, and cultural capital in tribal status. This project highlighted the ‘single tribal research approach’ to gain an in-depth understanding of the human capital formed under the unique culture of the tribe (Truku tribe). The results show that the education level of most research participants was high school, very few high school graduates chose to further their education to college level; due to the lack of education of their parents, the social capital was limited to support them for jobs choice, most of them work for labor and service industries; however, their culture capital was comparably rich for works, the sharing culture of Taiwanese indigenous people made their work status stable. The results suggested that we should emphasize more on the development of vocational education based on the tribe’s location and resources. The self-advocacy of indigenous people should be developed so that they would gain more power on making career decisions. This research project is part of a pilot project called “INDIGENOUS PEOPLES, POVERTY, AND DEVELOPMENT,” sponsored by the National Science and Technology Council of Taiwan. If this paper were accepted to present in the 2023 ICIP, it would be lovely if a panel is formed for me and other co-researchers (Chuanju Cheng, Chih-Yuan Weng, and YiXuan Chen), for the audience will be able to get a full picture of this pilot project.Keywords: career choices, career model, indegenous career development, indigenous education, tribe
Procedia PDF Downloads 82761 Prediction of the Factors Influencing the Utilization of HIV Testing among Young People Aged between 17-25 Years in Saudi Arabia
Authors: Abdullah Almilaibary, Jeremy Jolley, Mark Hayter
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Background: Despite recent progress in enhancing the accessibility of HIV-related health services worldwide, opportunities to diagnose patients are often missed due to genuine barriers at different levels. The aim of the study is to explore the factors that affect the utilization of HIV testing services by young people aged 17-25 in Saudi Arabia. Methods: A non-experimental descriptive cross-sectional design was used to predict factors that influenced HIV testing among Umm- Al Qura University students aged 17-25 years. A newly developed self-completed online questionnaire was used and the study sample was drawn using a convenience sampling technique. The questionnaire consisted of 52 items divided into three scales: 12 items for HIV/AIDS-related knowledge, 3 items for risk perception, and 37 items for attitudes toward HIV testing. Five experts in the field of HIV/AIDS validated the contents of the questionnaire and agreed that the items included were related to the construct being measured. The reliability of the questionnaire was also assessed using a test/re-test strategy with 27 participants recruited from the population under study. The reliability assessment revealed that the questionnaire was consistent as Cronbach’s Alpha was 0.80 for HIV/ADS knowledge, 0.88 for risk perception and 0.78 for attitudes towards HIV testing. The data were collected between 14th of July and 14th of October 2014. Results: 394 participants completed the questionnaires: 116 (29.4%) male and 278 (70%) female. 50.5% of the participants were aged 20 to 22 years, 34.8% were 17-19 years and 14.7% were aged between 23-25 years; about 93% of the participants were single. Only 20 (6%) participants had previously been tested for HIV. The main reasons for not being tested for HIV were: exposure to HIV was considered unlikely (48%), HIV test was not offered (36%) and unawareness of HIV testing centres (16%). On HIV/AIDS-related knowledge, the male participants scored higher than the females as the mean score for males was (M = 6.4, SD = 2.4) while for females it was (M 5.7, SD 2.5). In terms of risk perception, female participants appeared to have lower levels of risk perception than male participants, with the mean score for males being (M 11.7, SD 2.5) and (M 10.5, SD 2.4) for females. The female participants showed slightly more positive attitudes towards HIV testing than male participants: the mean score for males was (M = 108.14, SD = 17.9) and was (M = 111.32, SD = 17.3) for females. Conclusions: The data reveal that misconceptions about HIV/AIDS in Saudi Arabia are still a challenge. Although the attitudes towards HIV testing were reasonably positive, the utilization of the HIV test was low. Thus, tailoring HIV/AIDS preventive strategies in Saudi Arabia should focus on the needs of young people and other high risk groups in the country.Keywords: attitude toward hiv testing, hiv testing, hiv/aids related knowledge, risk perception
Procedia PDF Downloads 327760 Predicting the Effect of Vibro Stone Column Installation on Performance of Reinforced Foundations
Authors: K. Al Ammari, B. G. Clarke
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Soil improvement using vibro stone column techniques consists of two main parts: (1) the installed load bearing columns of well-compacted, coarse-grained material and (2) the improvements to the surrounding soil due to vibro compaction. Extensive research work has been carried out over the last 20 years to understand the improvement in the composite foundation performance due to the second part mentioned above. Nevertheless, few of these studies have tried to quantify some of the key design parameters, namely the changes in the stiffness and stress state of the treated soil, or have consider these parameters in the design and calculation process. Consequently, empirical and conservative design methods are still being used by ground improvement companies with a significant variety of results in engineering practice. Two-dimensional finite element study to develop an axisymmetric model of a single stone column reinforced foundation was performed using PLAXIS 2D AE to quantify the effect of the vibro installation of this column in soft saturated clay. Settlement and bearing performance were studied as an essential part of the design and calculation of the stone column foundation. Particular attention was paid to the large deformation in the soft clay around the installed column caused by the lateral expansion. So updated mesh advanced option was taken in the analysis. In this analysis, different degrees of stone column lateral expansions were simulated and numerically analyzed, and then the changes in the stress state, stiffness, settlement performance and bearing capacity were quantified. It was found that application of radial expansion will produce a horizontal stress in the soft clay mass that gradually decrease as the distance from the stone column axis increases. The excess pore pressure due to the undrained conditions starts to dissipate immediately after finishing the column installation, allowing the horizontal stress to relax. Changes in the coefficient of the lateral earth pressure K ٭, which is very important in representing the stress state, and the new stiffness distribution in the reinforced clay mass, were estimated. More encouraging results showed that increasing the expansion during column installation has a noticeable effect on improving the bearing capacity and reducing the settlement of reinforced ground, So, a design method should include this significant effect of the applied lateral displacement during the stone column instillation in simulation and numerical analysis design.Keywords: bearing capacity, design, installation, numerical analysis, settlement, stone column
Procedia PDF Downloads 374759 Individual Cylinder Ignition Advance Control Algorithms of the Aircraft Piston Engine
Authors: G. Barański, P. Kacejko, M. Wendeker
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The impact of the ignition advance control algorithms of the ASz-62IR-16X aircraft piston engine on a combustion process has been presented in this paper. This aircraft engine is a nine-cylinder 1000 hp engine with a special electronic control ignition system. This engine has two spark plugs per cylinder with an ignition advance angle dependent on load and the rotational speed of the crankshaft. Accordingly, in most cases, these angles are not optimal for power generated. The scope of this paper is focused on developing algorithms to control the ignition advance angle in an electronic ignition control system of an engine. For this type of engine, i.e. radial engine, an ignition advance angle should be controlled independently for each cylinder because of the design of such an engine and its crankshaft system. The ignition advance angle is controlled in an open-loop way, which means that the control signal (i.e. ignition advance angle) is determined according to the previously developed maps, i.e. recorded tables of the correlation between the ignition advance angle and engine speed and load. Load can be measured by engine crankshaft speed or intake manifold pressure. Due to a limited memory of a controller, the impact of other independent variables (such as cylinder head temperature or knock) on the ignition advance angle is given as a series of one-dimensional arrays known as corrective characteristics. The value of the ignition advance angle specified combines the value calculated from the primary characteristics and several correction factors calculated from correction characteristics. Individual cylinder control can proceed in line with certain indicators determined from pressure registered in a combustion chamber. Control is assumed to be based on the following indicators: maximum pressure, maximum pressure angle, indicated mean effective pressure. Additionally, a knocking combustion indicator was defined. Individual control can be applied to a single set of spark plugs only, which results from two fundamental ideas behind designing a control system. Independent operation of two ignition control systems – if two control systems operate simultaneously. It is assumed that the entire individual control should be performed for a front spark plug only and a rear spark plug shall be controlled with a fixed (or specific) offset relative to the front one or from a reference map. The developed algorithms will be verified by simulation and engine test sand experiments. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.Keywords: algorithm, combustion process, radial engine, spark plug
Procedia PDF Downloads 293758 Evaluation of Health Services after Emergency Decrees in Turkey
Authors: Sengul Celik, Alper Ketenci
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In Turkish Constitution about health care in Article 56, it is said that: everyone has the right to live in a healthy and balanced environment. It is the duty of the state and citizens to improve the environment, protect environmental health, and prevent environmental pollution. The state ensures that everyone lives their lives in physical and mental health; it organizes the planning and service of health institutions from a single source in order to realize cooperation by increasing savings and efficiency in human and substance power. The state fulfills this task by utilizing and supervising health and social institutions in the public and private sectors. General health insurance can be established by law for the widespread delivery of health services. To have health care is one of the basic rights of patients. After the coupe attempt in July 2016, the Government of Turkey has announced a state of emergency and issued lots of emergency decrees. By these emergency decrees, lots of people were dismissed from their jobs and lost their some basic social rights. The violations occur in social life. One of the most common observations is the discrimination by government in health care system. This study aims to put forward the violation of human rights in health care system in Turkey due to their discriminated position by an emergency decree. The study is a case study that is based on nine interviews with the people or relatives of people who lost their jobs by an emergency decree in Turkey. In this study, no personally identifiable information was obtained for the safety of individuals. Also no distinctive questions regarding the identity of individuals were asked. The interviews are obtained through internet call applications. The data were analyzed through the requirements of regular health care system in Turkey. The interviews expose that the people or the relatives of people lost their right to have regular health care. They have to pay extra amount both in clinical services and in medication treatment. The patient right to quality medical care without prejudice is violated. It was assessed that the people who are involved in emergency decree and their relatives are discriminated by government and deprived of regular medical care and supervision. Although international legal arrangements and legal responsibilities of the state have been put forward by Article 56, they are violated in practice. To prevent these kinds of violations, some measures should be taken against the deprivation in health care system especially towards the discriminated people by an emergency decree.Keywords: emergency decree in Turkey, health care, discriminated people, patients rights
Procedia PDF Downloads 109757 SNP g.1007A>G within the Porcine DNAL4 Gene Affects Sperm Motility Traits
Authors: I. Wiedemann, A. R. Sharifi, A. Mählmeyer, C. Knorr
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A requirement for sperm motility is a morphologically intact flagellum with a central axoneme. The flagellar beating is caused by the varying activation and inactivation of dynein molecules which are located in the axoneme. DNAL4 (dynein, axonemal, light chain 4) is regarded as a possible functional candidate gene encoding a small subunit of the dyneins. In the present study, 5814bp of the porcine DNAL4 (GenBank Acc. No. AM284696.1, 6097 bp, 4 exons) were comparatively sequenced using three boars with a high motility (>68%) and three with a low motility (<60%). Primers were self-designed except for those covering exons 1, 2 and 3. Prior to sequencing, the PCR products were purified. Sequencing was performed with an ABI PRISM 3100 Genetic Analyzer using the BigDyeTM Terminator v3.1 Cycle Sequencing Reaction Kit. Finally, 23 SNPs were described and genotyped for 82 AI boars representing the breeds Piétrain, German Large White and German Landrace. The genotypes were used to assess possible associations with standard spermatological parameters (ejaculate volume, density, and sperm motility (undiluted (Motud), 24h (Mot1) and 48h (Mot2) after semen collection) that were regularly recorded on the AI station. The analysis included a total of 8,833 spermatological data sets which ranged from 2 to 295 sets per boar in five years. Only SNP g.1007A>G had a significant effect. Finally, the gene substitution effect using the following statistical model was calculated: Yijk= µ+αi+βj+αβij+b1Sijk+b2Aijk+b3T ijk + b4Vijk+b5(α*A)ijk +b6(β*A)ijk+b7(A*T)ijk+Uijk+eijk where Yijk is the semen characteristics, µ is the general mean, α is the main effect of breed, β is the main effect of season, S is the effect of SNP (g.1007A > G), A is the effect of age at semen collection, V is the effect of diluter, αβ, α*A, β*A, A*T are interactions between the fixed effects, b1-b7 are regression coefficients between y and the respective covariate, U is the random effect of repeated observation on animal and e is the random error. The results from the single marker regression analysis revealed highly significant effects (p < 0.0001) of SNP g.1007A > G on Mot1 resp. on Mot2, resulting in a marked reduction by 11.4% resp. 15.4%. Furthermore a loss of Motud by 4.6% was detected (p < 0.0178). Considering the SNP g.1007A > G as a main factor (dominant-recessive model), significant differences between genotypes AA and AG as well as AA and GG for Mot1 and Mot2 exist. For Motud there was a significant difference between AA and GG.Keywords: association, DNAL4, porcine, sperm traits
Procedia PDF Downloads 460756 CFD Simulation of Spacer Effect on Turbulent Mixing Phenomena in Sub Channels of Boiling Nuclear Assemblies
Authors: Shashi Kant Verma, S. L. Sinha, D. K. Chandraker
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Numerical simulations of selected subchannel tracer (Potassium Nitrate) based experiments have been performed to study the capabilities of state-of-the-art of Computational Fluid Dynamics (CFD) codes. The Computational Fluid Dynamics (CFD) methodology can be useful for investigating the spacer effect on turbulent mixing to predict turbulent flow behavior such as Dimensionless mixing scalar distributions, radial velocity and vortices in the nuclear fuel assembly. A Gibson and Launder (GL) Reynolds stress model (RSM) has been selected as the primary turbulence model to be applied for the simulation case as it has been previously found reasonably accurate to predict flows inside rod bundles. As a comparison, the case is also simulated using a standard k-ε turbulence model that is widely used in industry. Despite being an isotropic turbulence model, it has also been used in the modeling of flow in rod bundles and to produce lateral velocities after thorough mixing of coolant fairly. Both these models have been solved numerically to find out fully developed isothermal turbulent flow in a 30º segment of a 54-rod bundle. Numerical simulation has been carried out for the study of natural mixing of a Tracer (Passive scalar) to characterize the growth of turbulent diffusion in an injected sub-channel and, afterwards on, cross-mixing between adjacent sub-channels. The mixing with water has been numerically studied by means of steady state CFD simulations with the commercial code STAR-CCM+. Flow enters into the computational domain through the mass inflow at the three subchannel faces. Turbulence intensity and hydraulic diameter of 1% and 5.9 mm respectively were used for the inlet. A passive scalar (Potassium nitrate) is injected through the mass fraction of 5.536 PPM at subchannel 2 (Upstream of the mixing section). Flow exited the domain through the pressure outlet boundary (0 Pa), and the reference pressure was 1 atm. Simulation results have been extracted at different locations of the mixing zone and downstream zone. The local mass fraction shows uniform mixing. The effect of the applied turbulence model is nearly negligible just before the outlet plane because the distributions look like almost identical and the flow is fully developed. On the other hand, quantitatively the dimensionless mixing scalar distributions change noticeably, which is visible in the different scale of the colour bars.Keywords: single-phase flow, turbulent mixing, tracer, sub channel analysis
Procedia PDF Downloads 207755 Structural Optimization, Design, and Fabrication of Dissolvable Microneedle Arrays
Authors: Choupani Andisheh, Temucin Elif Sevval, Bediz Bekir
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Due to their various advantages compared to many other drug delivery systems such as hypodermic injections and oral medications, microneedle arrays (MNAs) are a promising drug delivery system. To achieve enhanced performance of the MN, it is crucial to develop numerical models, optimization methods, and simulations. Accordingly, in this work, the optimized design of dissolvable MNAs, as well as their manufacturing, is investigated. For this purpose, a mechanical model of a single MN, having the geometry of an obelisk, is developed using commercial finite element software. The model considers the condition in which the MN is under pressure at the tip caused by the reaction force when penetrating the skin. Then, a multi-objective optimization based on non-dominated sorting genetic algorithm II (NSGA-II) is performed to obtain geometrical properties such as needle width, tip (apex) angle, and base fillet radius. The objective of the optimization study is to reach a painless and effortless penetration into the skin along with minimizing its mechanical failures caused by the maximum stress occurring throughout the structure. Based on the obtained optimal design parameters, master (male) molds are then fabricated from PMMA using a mechanical micromachining process. This fabrication method is selected mainly due to the geometry capability, production speed, production cost, and the variety of materials that can be used. Then to remove any chip residues, the master molds are cleaned using ultrasonic cleaning. These fabricated master molds can then be used repeatedly to fabricate Polydimethylsiloxane (PDMS) production (female) molds through a micro-molding approach. Finally, Polyvinylpyrrolidone (PVP) as a dissolvable polymer is cast into the production molds under vacuum to produce the dissolvable MNAs. This fabrication methodology can also be used to fabricate MNAs that include bioactive cargo. To characterize and demonstrate the performance of the fabricated needles, (i) scanning electron microscope images are taken to show the accuracy of the fabricated geometries, and (ii) in-vitro piercing tests are performed on artificial skin. It is shown that optimized MN geometries can be precisely fabricated using the presented fabrication methodology and the fabricated MNAs effectively pierce the skin without failure.Keywords: microneedle, microneedle array fabrication, micro-manufacturing structural optimization, finite element analysis
Procedia PDF Downloads 113754 Evaluation of Triage Performance: Nurse Practice and Problem Classifications
Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli
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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.Keywords: assessment, education, nurse, triage
Procedia PDF Downloads 232753 Multiaxial Fatigue in Thermal Elastohydrodynamic Lubricated Contacts with Asperities and Slip
Authors: Carl-Magnus Everitt, Bo Alfredsson
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Contact mechanics and tribology have been combined with fundamental fatigue and fracture mechanics to form the asperity mechanism which supplies an explanation for the surface-initiated rolling contact fatigue damage, called pitting or spalling. The cracks causing the pits initiates at one surface point and thereafter they slowly grow into the material before chipping of a material piece to form the pit. In the current study, the lubrication aspects on fatigue initiation are simulated by passing a single asperity through a thermal elastohydrodynamic lubricated, TEHL, contact. The physics of the lubricant was described with Reynolds equation and the lubricants pressure-viscosity relation was modeled by Roelands equation, formulated to include temperature dependence. A pressure dependent shear limit was incorporated. To capture the full phenomena of the sliding contact the temperature field was resolved through the incorporation of the energy flow. The heat was mainly generated due to shearing of the lubricant and from dry friction where metal contact occurred. The heat was then transported, and conducted, away by the solids and the lubricant. The fatigue damage caused by the asperities was evaluated through Findley’s fatigue criterion. The results show that asperities, in the size of surface roughness found in applications, may cause surface initiated fatigue damage and crack initiation. The simulations also show that the asperities broke through the lubricant in the inlet, causing metal to metal contact with high friction. When the asperities thereafter moved through the contact, the sliding provided the asperities with lubricant releasing the metal contact. The release of metal contact was possible due to the high viscosity the lubricant obtained from the high pressure. The metal contact in the inlet caused higher friction which increased the risk of fatigue damage. Since the metal contact occurred in the inlet it increased the fatigue risk more for asperities subjected to negative slip than positive slip. Therefore the fatigue evaluations showed that the asperities subjected to negative slip yielded higher fatigue stresses than the asperities subjected to positive slip of equal magnitude. This is one explanation for why pitting is more common in the dedendum than the addendum on pinion gear teeth. The simulations produced further validation for the asperity mechanism by showing that asperities cause surface initiated fatigue and crack initiation.Keywords: fatigue, rolling, sliding, thermal elastohydrodynamic
Procedia PDF Downloads 121752 Microorganisms in Fresh and Stored Bee Pollen Originated from Slovakia
Authors: Vladimíra Kňazovická, Mária Dovičičová, Miroslava Kačániová, Margita Čanigová
Abstract:
The aim of the study was to test the storage of bee pollen at room temperature and in cold store, and to describe microorganisms originated from it. Fresh bee pollen originating in West Slovakia was collected in May 2010. It was tested for presence of particular microbial groups using dilution plating method, and divided into two parts with different storage (in cold store and at room temperature). Microbial analyses of pollen were repeated after one year of storage. Several bacterial strains were isolated and tested using Gram staining, for catalase and fructose-6-phosphate-phosphoketolase presence, and by rapid ID 32A (BioMérieux, France). Micromycetes were identified at genus level. Fresh pollen contained coliform bacteria, which were not detected after one year of storage in both ways. Total plate count (TPC) of aerobes and anaerobes and of yeasts in fresh bee pollen exceeded 5.00 log CFU/g. TPC of aerobes and anaerobes decreased below 2.00 log CFU/g after one year of storage in both ways. Count of yeasts decreased to 2.32 log CFU/g (at room temperature) and to 3.66 log CFU/g (in cold store). Microscopic filamentous fungi decreased from 3.41 log CFU/g (fresh bee pollen) to 1.13 log CFU/g (at room temperature) and to 1.89 log CFU/g (in cold store). In fresh bee pollen, 12 genera of micromycetes were identified in the following order according to their relative density: Penicillium > Mucor > Absidia > Cladosporium, Fusarium > Alternaria > Eurotium > Aspergillus, Rhizopus > Emericella > Arthrinium and Mycelium sterilium. After one year at room temperature, only three genera were detected in bee pollen (Penicillium > Aspergillus, Mucor) and after one year in cold store, seven genera were detected (Mucor > Penicillium, Emericella > Aspergillus, Absidia > Arthrinium, Eurotium). From the plates designated for anaerobes, eight colonies originating in fresh bee pollen were isolated. Among them, a single yeast isolate occurred. Other isolates were G+ bacteria, with a total of five rod shaped. In three out of these five, catalase was absent and fructose-6-phosphate-phosphoketolase was present. Bacterial isolates originating in fresh pollen belonged probably to genus Bifidobacterium or relative genera, but their identity was not confirmed unequivocally. In general, cold conditions are suitable for maintaining the natural properties of foodstuffs for a longer time. Slight decrease of microscopic fungal number and diversity was recorded in cold temperatures compared with storage at room temperature.Keywords: bacteria, bee product, microscopic fungi, biosystems engineering
Procedia PDF Downloads 343751 Construction of Graph Signal Modulations via Graph Fourier Transform and Its Applications
Authors: Xianwei Zheng, Yuan Yan Tang
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Classical window Fourier transform has been widely used in signal processing, image processing, machine learning and pattern recognition. The related Gabor transform is powerful enough to capture the texture information of any given dataset. Recently, in the emerging field of graph signal processing, researchers devoting themselves to develop a graph signal processing theory to handle the so-called graph signals. Among the new developing theory, windowed graph Fourier transform has been constructed to establish a time-frequency analysis framework of graph signals. The windowed graph Fourier transform is defined by using the translation and modulation operators of graph signals, following the similar calculations in classical windowed Fourier transform. Specifically, the translation and modulation operators of graph signals are defined by using the Laplacian eigenvectors as follows. For a given graph signal, its translation is defined by a similar manner as its definition in classical signal processing. Specifically, the translation operator can be defined by using the Fourier atoms; the graph signal translation is defined similarly by using the Laplacian eigenvectors. The modulation of the graph can also be established by using the Laplacian eigenvectors. The windowed graph Fourier transform based on these two operators has been applied to obtain time-frequency representations of graph signals. Fundamentally, the modulation operator is defined similarly to the classical modulation by multiplying a graph signal with the entries in each Fourier atom. However, a single Laplacian eigenvector entry cannot play a similar role as the Fourier atom. This definition ignored the relationship between the translation and modulation operators. In this paper, a new definition of the modulation operator is proposed and thus another time-frequency framework for graph signal is constructed. Specifically, the relationship between the translation and modulation operations can be established by the Fourier transform. Specifically, for any signal, the Fourier transform of its translation is the modulation of its Fourier transform. Thus, the modulation of any signal can be defined as the inverse Fourier transform of the translation of its Fourier transform. Therefore, similarly, the graph modulation of any graph signal can be defined as the inverse graph Fourier transform of the translation of its graph Fourier. The novel definition of the graph modulation operator established a relationship of the translation and modulation operations. The new modulation operation and the original translation operation are applied to construct a new framework of graph signal time-frequency analysis. Furthermore, a windowed graph Fourier frame theory is developed. Necessary and sufficient conditions for constructing windowed graph Fourier frames, tight frames and dual frames are presented in this paper. The novel graph signal time-frequency analysis framework is applied to signals defined on well-known graphs, e.g. Minnesota road graph and random graphs. Experimental results show that the novel framework captures new features of graph signals.Keywords: graph signals, windowed graph Fourier transform, windowed graph Fourier frames, vertex frequency analysis
Procedia PDF Downloads 341