Search results for: return flow
1332 Saudi State Arabia’s Struggle for a Post-Rentier Regional Order
Authors: Omair Anas
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The Persian Gulf has been in turmoil for a long time since the colonial administration has handed over the role to the small and weak kings and emirs who were assured of protection in return of many economic and security promises to them. The regional order, Saudi Arabia evolved was a rentier regional order secured by an expansion of rentier economy and taking responsibility for much of the expenses of the regional order on behalf of relatively poor countries. The two oil booms helped the Saudi state to expand the 'rentier order' driven stability and bring the countries like Egypt, Jordan, Syria, and Palestine under its tutelage. The disruptive misadventure, however, came with Iran's proclamation of the Islamic Revolution in 1979 which it wanted to be exported to its 'un-Islamic and American puppet' Arab neighbours. For Saudi Arabia, even the challenge presented by the socialist-nationalist Arab dictators like Gamal Abdul Nasser and Hafez Al-Assad was not that much threatening to the Saudi Arabia’s then-defensive realism. In the Arab uprisings, the Gulf monarchies saw a wave of insecurity and Iran found it an opportune time to complete the revolutionary process it could not complete after 1979. An alliance of convenience and ideology between Iran and Islamist groups had the real potential to challenge both Saudi Arabia’s own security and its leadership in the region. The disruptive threat appeared at a time when the Saudi state had already sensed an impending crisis originating from the shifts in the energy markets. Low energy prices, declining global demands, and huge investments in alternative energy resources required Saudi Arabia to rationalize its economy according to changing the global political economy. The domestic Saudi reforms remained gradual until the death of King Abdullah in 2015. What is happening now in the region, the Qatar crisis, the Lebanon crisis and the Saudi-Iranian proxy war in Iraq, Syria, and Yemen has combined three immediate objectives, rationalising Saudi economy and most importantly, the resetting the Saudi royal power for Saudi Arabia’s longest-serving future King Mohammad bin Salman. The Saudi King perhaps has no time to wait and watch the power vacuum appearing because of Iran’s expansionist foreign policy. The Saudis appear to be employing an offensive realism by advancing a pro-active regional policy to counter Iran’s threatening influence amid disappearing Western security from the region. As the Syrian civil war is coming to a compromised end with ceding much ground to Iran-controlled militias, Hezbollah and Al-Hashad, the Saudi state has lost much ground in these years and the threat from Iranian proxies is more than a reality, more clearly in Bahrain, Iraq, Syria, and Yemen. This paper attempts to analyse the changing Saudi behaviour in the region, which, the author understands, is shaped by an offensive-realist approach towards finding a favourable security environment for the Saudi-led regional order, a post-rentier order perhaps.Keywords: terrorism, Saudi Arabia, Rentier State, gulf crisis
Procedia PDF Downloads 1391331 The Pigeon Circovirus Evolution and Epidemiology under Conditions of One Loft Race Rearing System: The Preliminary Results
Authors: Tomasz Stenzel, Daria Dziewulska, Ewa Łukaszuk, Joy Custer, Simona Kraberger, Arvind Varsani
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Viral diseases, especially those leading to impairment of the immune system, are among the most important problems in avian pathology. However, there is not much data available on this subject other than commercial poultry bird species. Recently, increasing attention has been paid to racing pigeons, which have been refined for many years in terms of their ability to return to their place of origin. Currently, these birds are used for races at distances from 100 to 1000 km, and winning pigeons are highly valuable. The rearing system of racing pigeons contradicts the principles of biosecurity, as birds originating from various breeding facilities are commonly transported and reared in “One Loft Race” (OLR) facilities. This favors the spread of multiple infections and provides conditions for the development of novel variants of various pathogens through recombination. One of the most significant viruses occurring in this avian species is the pigeon circovirus (PiCV), which is detected in ca. 70% of pigeons. Circoviruses are characterized by vast genetic diversity which is due to, among other things, the recombination phenomenon. It consists of an exchange of fragments of genetic material among various strains of the virus during the infection of one organism. The rate and intensity of the development of PiCV recombinants have not been determined so far. For this reason, an experiment was performed to investigate the frequency of development of novel PiCV recombinants in racing pigeons kept in OLR-type conditions. 15 racing pigeons originating from 5 different breeding facilities, subclinically infected with various PiCV strains, were housed in one room for eight weeks, which was supposed to mimic the conditions of OLR rearing. Blood and swab samples were collected from birds every seven days to recover complete PiCV genomes that were amplified through Rolling Circle Amplification (RCA), cloned, sequenced, and subjected to bioinformatic analyses aimed at determining the genetic diversity and the dynamics of recombination phenomenon among the viruses. In addition, virus shedding rate/level of viremia, expression of the IFN-γ and interferon-related genes, and anti-PiCV antibodies were determined to enable the complete analysis of the course of infection in the flock. Initial results have shown that 336 full PiCV genomes were obtained, exhibiting nucleotide similarity ranging from 86.6 to 100%, and 8 of those were recombinants originating from viruses of different lofts of origin. The first recombinant appeared after seven days of experiment, but most of the recombinants appeared after 14 and 21 days of joint housing. The level of viremia and virus shedding was the highest in the 2nd week of the experiment and gradually decreased to the end of the experiment, which partially corresponded with Mx 1 gene expression and antibody dynamics. The results have shown that the OLR pigeon-rearing system could play a significant role in spreading infectious agents such as circoviruses and contributing to PiCV evolution through recombination. Therefore, it is worth considering whether a popular gambling game such as pigeon racing is sensible from both animal welfare and epidemiological point of view.Keywords: pigeon circovirus, recombination, evolution, one loft race
Procedia PDF Downloads 741330 Citizens’ Expectations, Motivations, and Evaluation of Participatory Use of Social Media Tools for Civic Engagement in Oman
Authors: Ali S. Al-Aufi, Ibrahim S. Al-Harthi, Yousuf S. AlHinai, Ali H.S. Al-Badi, Zahran S. Al-Salti
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Social media tools have currently been leading a major change in the flow and use of information for different life aspects within people and between people and their governments. They represent powerful channels for direct exchanges of information, ideas, and suggestions for purposes of civic participation. The current study aims at investigating Omani citizens’ perceptions, expectations, and motivations of their uses of social media tools to interact with the government for civic participation. A quantitative methodology was used to collect data through self-administered questionnaires from a random sample of university students and staff drawn from Sultan Qaboos University, considering them as well-informed and typically active users of social media. The literature was comprehensively reviewed to retrieve relevant empirical studies that particularly investigated the use of social media for civic engagement which provided a basis for the construct of the questionnaire; taken into consideration the delineated dimensions of perceptions, expectations, and motivations. The findings of the study offer practical and useful recommendations for governmental units in Oman and similar contexts in the region to inform better and efficient use of social media tools to interact with citizens in issues related to civic engagement; particularly to make best use of these tools for improving services and developing existing and newer initiatives, and hence, encouraging and strengthening citizens’ involvement for civic engagement.Keywords: social media, social networking sites, web 2.0, civic engagement, civic participation, oman
Procedia PDF Downloads 4981329 Shark Cartilage Modulate IL-23/IL-17 Axis by Increasing IFN-γ and Decreasing IL-4 in Patients with Gastric Cancer
Authors: Razieh Zareia, Hassan ZMB, Darush Moslemic, Amrollah Mostafa-Zaded
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Introduction: Shark is a murine organism and its cartilage has antitumor peptides to prevent angiogenesis, at least, in vitro. The purpose of our research was to evaluate the immune-effectiveness on imbalance between IL-23/IL-17 axis, as an inflammatory pathway and TGF/Foxp3 T regulatory as a inhibitory pathway of commercial shark cartilage that is available as a non-common dietary supplement in IRAN. Materials and Methods: First investigated an imbalanced supernatant of cytokines exist in patients with gastric cancer by ELISA. Associated with cytokines measuring such as IL-23, IL-17, TGF-β, IL-4, and γ-IFN, then flow cytometry was employed to determine whether the peripheral blood mononuclear cells such as CD4+CD25+Foxp3highT regulatory cells in patients with gastric cancer were changed correspondingly. Results: The simultaneously presented up-regulation IL-17A indicated, at least cytokine level without changing in TGF-β amount or CD4+CD25+Foxp3 T regulatory cells, that there are not a direct correlation between IL-23/IL-17 axis and Treg/TGF-β pathway in patients with gastric cancer treated by shark cartilage, but IL-23 was not expressed differentially in this group. So, accompany these changes, an imbalance between Th1 immunity (γ-IFN production) and TH2 immunity (IL-4 secretion) evaluated in patients with gastric cancer treated by shark cartilage. Conclusion: On the basis of results, we propose that shark cartilage, by reducing IL-4, decreasing IL-17 a central cytokine in angiogenesis and increasing γ-IFN amplify anti-tumor immune responses in patients with gastric cancer.Keywords: IL-23/IL17 axis, TGF-β/CD4+CD25+Foxp3high T regulatory pathway, γ-IFN, IL-4, shark cartilage, gastric cancer
Procedia PDF Downloads 3971328 An Improved Discrete Version of Teaching–Learning-Based Optimization for Supply Chain Network Design
Authors: Ehsan Yadegari
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While there are several metaheuristics and exact approaches to solving the Supply Chain Network Design (SCND) problem, there still remains an unfilled gap in using the Teaching-Learning-Based Optimization (TLBO) algorithm. The algorithm has demonstrated desirable results with problems with complicated combinational optimization. The present study introduces a Discrete Self-Study TLBO (DSS-TLBO) with priority-based solution representation that can solve a supply chain network configuration model to lower the total expenses of establishing facilities and the flow of materials. The network features four layers, namely suppliers, plants, distribution centers (DCs), and customer zones. It is designed to meet the customer’s demand through transporting the material between layers of network and providing facilities in the best economic Potential locations. To have a higher quality of the solution and increase the speed of TLBO, a distinct operator was introduced that ensures self-adaptation (self-study) in the algorithm based on the four types of local search. In addition, while TLBO is used in continuous solution representation and priority-based solution representation is discrete, a few modifications were added to the algorithm to remove the solutions that are infeasible. As shown by the results of experiments, the superiority of DSS-TLBO compared to pure TLBO, genetic algorithm (GA) and firefly Algorithm (FA) was established.Keywords: supply chain network design, teaching–learning-based optimization, improved metaheuristics, discrete solution representation
Procedia PDF Downloads 561327 Site Suitability Analysis for Multipurpose Dams Using Geospatial Technologies
Authors: Saima Iftikhar Rida Shabbir, Zeeshan Hassan
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Water shortage, energy crisis and natural misfortunes are the glitches which reduce the efficacy of agricultural ecosystems especially in Pakistan where these are more frequent besides being intense. Accordingly, the agricultural water resources, food security and country’s economy are at risk. To address this, we have used Geospatial techniques incorporating ASTER Global DEM, Geological map, rainfall data, discharge data, Landsat 5 image of Swat valley in order to assess the viability of selected sites. The sites have been studied via GIS tools, Hydrological investigation and multiparametric analysis for their potentialities of collecting and securing the rain water; regulating floods by storing the surplus water bulks by check dams and developing them for power generation. Our results showed that Siat1-1 was very useful for low-cost dam with main objective of as Debris dam; Site-2 and Site 3 were check dams sites having adequate storing reservoir so as to arrest the inconsistent flow accompanied by catering the sedimentation effects and the debris flows; Site 4 had a huge reservoir capacity but it entails enormous edifice cost over very great flood plain. Thus, there is necessity of active Hydrological developments to estimate the flooded area using advanced and multifarious GIS and remote sensing approaches so that the sites could be developed for harnessing those sites for agricultural and energy drives.Keywords: site suitability, check dams, SHP, terrain analysis, volume estimation
Procedia PDF Downloads 3151326 Kinesio Taping in Treatment Patients with Intermittent Claudication
Authors: Izabela Zielinska
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Kinesio Taping is classified as physiotherapy method supporting rehabilitation and modulating some physiological processes. It is commonly used in sports medicine and orthopedics. This sensory method has influence on muscle function, pain sensation, intensifies lymphatic system as well as improves microcirculation. The aim of this study was to assess the effect of Kinesio Taping in patients with ongoing treatment of peripheral artery disease (PAD). The study group comprised 60 patients (stadium II B at Fontain's scale). All patients were divided into two groups (30 person/each), where 12 weeks long treadmill training was administrated. In the second group, the Kinesio Taping was applied to support the function of the gastrocnemius muscle. The measurements of distance and time until claudication pain, blood flow of arteries in lower limbs and ankle brachial index were taken under evaluation. Examination performed after Kinesio Taping therapy showed statistically significant increase in gait parameters and muscle strength in patients with intermittent claudication. The Kinesio Taping method has clinically significant effects on enhancement of pain-free distance and time until claudication pain in patients with peripheral artery disease. Kinesio Taping application can be used to support non-invasive treatment in patients with intermittent claudication. Kinesio Taping can be employed as an alternative way of therapy for patients with orthopedic or cardiac contraindications to be treated with treadmill training.Keywords: intermittent claudication, kinesiotaping, peripheral artery disease, treadmill training
Procedia PDF Downloads 2071325 Using Business Simulations and Game-Based Learning for Enterprise Resource Planning Implementation Training
Authors: Carin Chuang, Kuan-Chou Chen
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An Enterprise Resource Planning (ERP) system is an integrated information system that supports the seamless integration of all the business processes of a company. Implementing an ERP system can increase efficiencies and decrease the costs while helping improve productivity. Many organizations including large, medium and small-sized companies have already adopted an ERP system for decades. Although ERP system can bring competitive advantages to organizations, the lack of proper training approach in ERP implementation is still a major concern. Organizations understand the importance of ERP training to adequately prepare managers and users. The low return on investment, however, for the ERP training makes the training difficult for knowledgeable workers to transfer what is learned in training to the jobs at workplace. Inadequate and inefficient ERP training limits the value realization and success of an ERP system. That is the need to call for a profound change and innovation for ERP training in both workplace at industry and the Information Systems (IS) education in academia. The innovated ERP training approach can improve the users’ knowledge in business processes and hands-on skills in mastering ERP system. It also can be instructed as educational material for IS students in universities. The purpose of the study is to examine the use of ERP simulation games via the ERPsim system to train the IS students in learning ERP implementation. The ERPsim is the business simulation game developed by ERPsim Lab at HEC Montréal, and the game is a real-life SAP (Systems Applications and Products) ERP system. The training uses the ERPsim system as the tool for the Internet-based simulation games and is designed as online student competitions during the class. The competitions involve student teams with the facilitation of instructor and put the students’ business skills to the test via intensive simulation games on a real-world SAP ERP system. The teams run the full business cycle of a manufacturing company while interacting with suppliers, vendors, and customers through sending and receiving orders, delivering products and completing the entire cash-to-cash cycle. To learn a range of business skills, student needs to adopt individual business role and make business decisions around the products and business processes. Based on the training experiences learned from rounds of business simulations, the findings show that learners have reduced risk in making mistakes that help learners build self-confidence in problem-solving. In addition, the learners’ reflections from their mistakes can speculate the root causes of the problems and further improve the efficiency of the training. ERP instructors teaching with the innovative approach report significant improvements in student evaluation, learner motivation, attendance, engagement as well as increased learner technology competency. The findings of the study can provide ERP instructors with guidelines to create an effective learning environment and can be transferred to a variety of other educational fields in which trainers are migrating towards a more active learning approach.Keywords: business simulations, ERP implementation training, ERPsim, game-based learning, instructional strategy, training innovation
Procedia PDF Downloads 1421324 Development of Membrane Reactor for Auto Thermal Reforming of Dimethyl Ether for Hydrogen Production
Authors: Tie-Qing Zhang, Seunghun Jung, Young-Bae Kim
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This research is devoted to developing a membrane reactor to flexibly meet the hydrogen demand of onboard fuel cells, which is an important part of green energy development. Among many renewable chemical products, dimethyl ether (DME) has the advantages of low reaction temperature (400 °C in this study), high hydrogen atom content, low toxicity, and easy preparation. Autothermal reforming, on the other hand, has a high hydrogen recovery rate and exhibits thermal neutrality during the reaction process, so the additional heat source in the hydrogen production process can be omitted. Therefore, the DME auto thermal reforming process was adopted in this study. To control the temperature of the reaction catalyst bed and hydrogen production rate, a Model Predictive Control (MPC) scheme was designed. Taking the above two variables as the control objectives, stable operation of the reformer can be achieved by controlling the flow rates of DME, steam, and high-purity air in real-time. To prevent catalyst poisoning in the fuel cell, the hydrogen needs to be purified to reduce the carbon monoxide content to below 50 ppm. Therefore, a Pd-Ag hydrogen semi-permeable membrane with a thickness of 3-5 μm was inserted into the auto thermal reactor, and the permeation efficiency of hydrogen was improved by steam purging on the permeation side. Finally, hydrogen with a purity of 99.99 was obtained.Keywords: hydrogen production, auto thermal reforming, membrane, fuel cell
Procedia PDF Downloads 1061323 Assessment Power and Oscillation Damping Using the POD Controller and Proposed FOD Controller
Authors: Tohid Rahimi, Yahya Naderi, Babak Yousefi, Seyed Hossein Hoseini
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Today’s modern interconnected power system is highly complex in nature. In this, one of the most important requirements during the operation of the electric power system is the reliability and security. Power and frequency oscillation damping mechanism improve the reliability. Because of power system stabilizer (PSS) low speed response against of major fault such as three phase short circuit, FACTs devise that can control the network condition in very fast time, are becoming popular. However, FACTs capability can be seen in a major fault present when nonlinear models of FACTs devise and power system equipment are applied. To realize this aim, the model of multi-machine power system with FACTs controller is developed in MATLAB/SIMULINK using Sim Power System (SPS) blockiest. Among the FACTs device, Static synchronous series compensator (SSSC) due to high speed changes its reactance characteristic inductive to capacitive, is effective power flow controller. Tuning process of controller parameter can be performed using different method. However, Genetic Algorithm (GA) ability tends to use it in controller parameter tuning process. In this paper, firstly POD controller is used to power oscillation damping. But in this station, frequency oscillation dos not has proper damping situation. Therefore, FOD controller that is tuned using GA is using that cause to damp out frequency oscillation properly and power oscillation damping has suitable situation.Keywords: power oscillation damping (POD), frequency oscillation damping (FOD), Static synchronous series compensator (SSSC), Genetic Algorithm (GA)
Procedia PDF Downloads 4791322 Opacity Synthesis with Orwellian Observers
Authors: Moez Yeddes
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The property of opacity is widely used in the formal verification of security in computer systems and protocols. Opacity is a general language-theoretic scheme of many security properties of systems. Opacity is parametrized with framework in which several security properties of a system can be expressed. A secret behaviour of a system is opaque if a passive attacker can never deduce its occurrence from the system observation. Instead of considering the case of static observability where the set of observable events is fixed off-line or dynamic observability where the set of observable events changes over time depending on the history of the trace, we introduce Orwellian partial observability where unobservable events are not revealed provided that downgrading events never occurs in the future of the trace. Orwellian partial observability is needed to model intransitive information flow. This Orwellian observability is knwon as ipurge function. We show in previous work how to verify opacity for regular secret is opaque for a regular language L w.r.t. an Orwellian projection is PSPACE-complete while it has been proved undecidable even for a regular language L w.r.t. a general Orwellian observation function. In this paper, we address two problems of opacification of a regular secret ϕ for a regular language L w.r.t. an Orwellian projection: Given L and a secret ϕ ∈ L, the first problem consist to compute some minimal regular super-language M of L, if it exists, such that ϕ is opaque for M and the second consists to compute the supremal sub-language M′ of L such that ϕ is opaque for M′. We derive both language-theoretic characterizations and algorithms to solve these two dual problems.Keywords: security policies, opacity, formal verification, orwellian observation
Procedia PDF Downloads 2281321 Non-Time and Non-Sense: Temporalities of Addiction for Heroin Users in Scotland
Authors: Laura Roe
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This study draws on twelve months of ethnographic fieldwork conducted in 2017 with heroin and poly-substance users in Scotland and explores experiences of time and temporality as factors in continuing drug use. The research largely took place over the year in which drug-related deaths in Scotland reached a record high, and were statistically recorded as the highest in Europe. This qualitative research is therefore significant in understanding both evolving patterns of drug use and the experiential lifeworlds of those who use heroin and other substances in high doses. Methodologies included participant observation, structured and semi-structured interviews, and unstructured conversations with twenty-two regular participants. The fieldwork was conducted in two needle exchanges, a community recovery group and in the community. The initial aim of the study was to assess evolving patterns of drug preferences in order to explore a clinical and user-reported rise in the use of novel psychoactive substances (NPS), which are typically considered to be highly potent, synthetic substances, often available at a low cost. It was found, however, that while most research participants had experimented with NPS with varying intensity, those who used every day regularly consumed heroin, methadone, and alcohol with benzodiazepines such as diazepam or anticonvulsants such as gabapentin. The research found that many participants deliberately pursued the non-fatal effects of overdose, aiming to induce states of dissociation, detachment and uneven consciousness, and did so by both mixing substances and experimenting with novel modes of consumption. Temporality was significant in the decision to consume cocktails of substances, as users described wishing to sever themselves from time; entering into states of ‘non-time’ and insensibility through specific modes of intoxication. Time and temporality similarly impacted other aspects of addicted life. Periods of attempted abstinence witnessed a slowing of time’s passage that was tied to affective states of boredom and melancholy, in addition to a disruptive return of distressing and difficult memories. Abject past memories frequently dominated and disrupted the present, which otherwise could be highly immersive due to the time and energy-consuming nature of seeking drugs while in financial difficulty. There was furthermore a discordance between individual user temporalities and the strict time-based regimes of recovery services and institutional bodies, and the study aims to highlight the impact of such a disjuncture on the efficacy of treatment programs. Many participants had difficulty in adhering to set appointments or temporal frameworks due to their specific temporal situatedness. Overall, exploring increasing tendencies of heroin users in Scotland towards poly-substance use, this study draws on experiences and perceptions of time, analysing how temporality comes to bear on the ways drugs are sought and consumed, and how recovery is imagined and enacted. The study attempts to outline the experiential, intimate and subjective worlds of heroin and poly-substance users while explicating the structural and historical factors that shape them.Keywords: addiction, poly-substance use, temporality, timelessness
Procedia PDF Downloads 1201320 Upregulation of CD40/CD40L System in Rheumatic Mitral Stenosis With or Without Atrial Fibrillation
Authors: Azzam H., Abousamra N. K., Wafa A. A., Hafez M. M., El-Gilany A. H.
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Platelet activation occurs in peripheral blood of patients with rheumatic mitral stenosis (MS) and atrial fibrillation (AF) and could be related to abnormal thrombogenesis. The CD40/CD40 ligand (CD40L) which reflects platelet activation, mediate a central role in thrombotic diseases. However, the role of CD40/CD40L system in rheumatic MS with or without AF remains unclear. Expressions of CD40 on monocytes and CD40L on platelets were determined by whole blood flow cytometry and serum levels of soluble CD40L were measured by enzyme-linked immunosorbent assay in group 1 (19 patients with MS) and group 2 (20 patients with MS and AF) compared to group 3 (10 controls). Patients with groups 1 and 2 had a significant increase in expression of CD40 on monocytes (P1 and P2 = 0.000) and serum levels of sCD40L (P1 = 0.014 and P2 = 0.033, respectively), but nonsignificant increase in expression of CD40L on platelets (P1 = 0.109 and P2 = 0.060, respectively) as compared to controls. There were no significant difference in all the parameters in group 1 compared to group 2. Correlation analysis demonstrated that there was a significant direct relationship between the severity of MS and serum levels of sCD40L (r = -0.469, p = 0.043). In conclusion, rheumatic MS patients with or without AF had upregulation of the CD40/CD40L system as well as elevated sCD40L levels. The levels of sCD40L had a significantly direct relationship with the severity of MS and it was the stenotic mitral valve, not AF, that had a significant impact on platelet activation.Keywords: CD40, CD40L, mitral stenosis, atrial fibrillation
Procedia PDF Downloads 961319 A Study of Heavy Hydrocarbons Upgrading by Microwave Pyrolysis
Authors: Thanida Sritangthong, Suksun Amornraksa
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By-product upgrading is crucial in hydrocarbon industries as it can increase overall profit margin of the business. Microwave-assisted pyrolysis is relatively new technique which induces heat directly to raw materials. This results in a more energy saving and more energy-efficient process. It is also a promising method to enhance and accelerate chemical reactions, thus reducing the pyrolysis reaction time and increasing the quality of value-added products from different kinds of feedstocks. In this study, upgrading opportunity of fuel oil by-product from an olefins plant is investigated by means of microwave pyrolysis. The experiment was conducted in a lab-scale quartz reactor placed inside a 1,100 watts household microwave oven. Operating temperature was varied from 500 to 900C to observe the consequence on the quality of pyrolysis products. Several microwave receptors i.e. activated carbon, silicon carbide (SiC) and copper oxide (CuO) were used as a material to enhance the heating and reaction in the reactor. The effect of residence time was determined by adjusting flow rate of N2 carrier gas. The chemical composition and product yield were analyzed by using gas chromatography (GC) and gas chromatography/mass spectrometry (GC/MS). The results showed that hydrogen, methane, ethylene, and ethane were obtained as the main gaseous products from all operating temperatures while the main liquid products were alkane, cycloalkane and polycyclic aromatic groups. The results indicated that microwave pyrolysis has a potential to upgrade low value hydrocarbons to high value products.Keywords: fuel oil, heavy hydrocarbons, microwave pyrolysis, pyrolysis
Procedia PDF Downloads 3211318 Exergy Analysis of Poultry Litter-to-Energy Production by the Advanced Combustion System
Authors: Samuel Oludayo Alamu, Seong Lee
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The need for generating energy from biomass in an efficient way as well as maximizing the yield of total energy from the thermal conversion process has been a major concern for researchers. A holistic approach which involves the combination of First law of thermodynamics (FLT) and the second law of thermodynamics (SLT) is required for conducting an effective assessment of an energy plant since FLT analysis alone fails to identify the quality of the dissipated energy and how much work potential is available. The overall purpose of this study is to investigate the exergy analysis of direct combustion of poultry waste being converted to energy with a handful of environmental assessment of the conversion processes in order to maximize thermal efficiency. The exergy analysis around the shell and tube heat exchanger (STHE) was investigated primarily by varying the operating parameters for different tube shapes and flow direction, and an exergy model was obtained from estimations of the higher heating value and standard entropy of poultry waste from the elemental compositions. The STHE was designed and fabricated by Lee Research Group at Morgan State University. The analysis conducted on theSTHE using the flue gas temperature entering and exiting show that only about one-third of the energy input to the STHE was available to do work with an overall efficiency of 13.8%, while a huge amount was lost to the surrounding. By recirculating the flue gas, the exergy efficiency of the combustion system can be maximized with a greater reduction in the amount of exergy loss.Keywords: exergy analysis, shell and tube heat exchanger, thermodynamics, combustion system, thermal efficiency
Procedia PDF Downloads 1111317 An Investigation of How Salad Rocket May Provide Its Own Defence Against Spoilage Bacteria
Authors: Huda Aldossari
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Members of the Brassicaceae family, such as rocket species, have high concentrations of glucosinolates (GLSs). GSLs and isothiocyanates (ITCs), the product of GLSs hydrolysis, are the most influential compounds that affect flavour in rocket species. Aside from their contribution to the flavour, GSLs and ITCs are of particular interest due to their potential ability to inhibit the growth of human pathogenic bacteria such as E. coli O157. Quantitative and qualitative analysis of glucosinolate compounds in rocket extracts was obtained by Liquid Chromatography-Mass Spectrometry (LC–MS).Each individual component of non-volatile GLSs and ITCs was isolated by High-Performance Liquid Chromatography (HPLC) fractionation. The identity and purity of each fraction were confirmed using Ultra High-Performance Liquid Chromatography (UPLC). The separation of glucosinolates in the complex rocket extractions was performed by optimizing a HPLC fractionation method through changing the mobile phase composition, solvent gradient, and the flow rate. As a result, six glucosinolates compounds (Glucosativin, 4-Methoxyglucobrassicin, Glucotropaeolin GTP, Glucoiberin GIB, Diglucothiobenin, and Sinigrin) have been isolated, identified and quantified in the complex samples. This step aims to evaluate the antibacterial activity of glucosinolates and their enzymatic hydrolysis against bacterial growth of E.coli k12. Therefore, fractions from this study will be used to determine the most active compounds by investigating the efficacy of each component of GLSs and ITCs at inhibiting bacterial growth.Keywords: rocket, glucosinolates, E.coli k12., HPLC fractionatio
Procedia PDF Downloads 991316 Estimation of the Effectiveness of Tasik Kemajuan and Tasik Inovasi as Flood Detention Pond at UTHM Campus
Authors: Noor Aliza Binti Ahmad, Azra Munirah Mat Daud, Sabariah Musa, Mohamad Azhar MK
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Flooding is a common natural disaster in Malaysia triggered by heavy rainfall. Urbanization that increases the construction of paved areas, subsequently raise surface runoff and reduce time of concentration. It increases flood magnitude and so that leads to greater flood problems as what has happened at Universiti Tun Hussein Onn Malaysia (UTHM) area in December 2006 and earlier 2007. Tasik Kemajuan and Tasik Inovasi were constructed as recreation ponds and have also functioned as flood ponds. Unfortunately, the flood problem still occurs persistently. Thus, the effectiveness of Tasik Kemajuan and Tasik Inovasi in reducing the flood problems need to be investigated and the causes of flood events at UTHM Campus need to be evaluated. The results from this study show that the conditions of Tasik Kemajuan and Tasik Inovasi are effective in reducing the flood water levels. It also can be concluded that increasing water level in both lakes in UTHM Campus are significantly influenced by presence of the grass and rubbish. During dry condition, the flow rates with three different days are 59.38m3/s, 60.71m3/s and 59.08m3/s and while for wet condition in two different days are 89.59 m3/s and 86.61m3/s. In conclusion, this system should be improved to prevent future flooding either widened or reduced drainage floor, and also perform maintenance on the plants that live around the lake.Keywords: drainage system, flood detention, lakes, storm water
Procedia PDF Downloads 3241315 Modelling and Investigation of Phase Change Phenomena of Multiple Water Droplets
Authors: K. R. Sultana, K. Pope, Y. S. Muzychka
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In recent years, the research of heat transfer or phase change phenomena of liquid water droplets experiences a growing interest in aircraft icing, power transmission line icing, marine icing and wind turbine icing applications. This growing interest speeding up the research from single to multiple droplet phenomena. Impingements of multiple droplets and the resulting solidification phenomena after impact on a very cold surface is computationally studied in this paper. The model used in the current study solves the flow equation, composed of energy balance and the volume fraction equations. The main aim of the study is to investigate the effects of several thermo-physical properties (density, thermal conductivity and specific heat) on droplets freezing. The outcome is examined by various important factors, for instance, liquid fraction, total freezing time, droplet temperature and total heat transfer rate in the interface region. The liquid fraction helps to understand the complete phase change phenomena during solidification. Temperature distribution and heat transfer rate help to demonstrate the overall thermal exchange behaviors between the droplets and substrate surface. Findings of this research provide an important technical achievement for ice modeling and prediction studies.Keywords: droplets, CFD, thermos-physical properties, solidification
Procedia PDF Downloads 2461314 Hot Corrosion and Oxidation Degradation Mechanism of Turbine Materials in a Water Vapor Environment at a Higher Temperature
Authors: Mairaj Ahmad, L. Paglia, F. Marra, V. Genova, G. Pulci
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This study employed Rene N4 and FSX 414 superalloys, which are used in numerous turbine engine components due of their high strength, outstanding fatigue, creep, thermal, and corrosion-resistant properties. An in-depth examination of corrosion mechanisms with vapor present at high temperature is necessary given the industrial trend toward introducing increasing amounts of hydrogen into combustion chambers in order to boost power generation and minimize pollution in contrast to conventional fuels. These superalloys were oxidized in recent tests for 500, 1000, 2000, 3000 and 4000 hours at 982±5°C temperatures with a steady airflow at a flow rate of 10L/min and 1.5 bar pressure. These superalloys were also examined for wet corrosion for 500, 1000, 2000, 3000, and 4000 hours in a combination of air and water vapor flowing at a 10L/min rate. Weight gain, X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy dispersive x-ray spectroscopy (EDS) were used to assess the oxidation and heat corrosion resistance capabilities of these alloys before and after 500, 1000, and 2000 hours. The oxidation/corrosion processes that accompany the formation of these oxide scales are shown in the graph of mass gain vs time. In both dry and wet oxidation, oxides like Al2O3, TiO2, NiCo2O4, Ni3Al, Ni3Ti, Cr2O3, MnCr2O4, CoCr2O4, and certain volatile compounds notably CrO2(OH)2, Cr(OH)3, Fe(OH)2, and Si(OH)4 are formed.Keywords: hot corrosion, oxidation, turbine materials, high temperature corrosion, super alloys
Procedia PDF Downloads 901313 Combating Money Laundering and Inroads into Banking Secrecy: Evidence from Malaysia
Authors: Aspalella A. Rahman
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It is widely accepted that the investigation of money laundering and the tracing and confiscation of criminal proceeds have intruded into the principles of banking secrecy. The inroads into banking secrecy present serious threats to democracy, and more importantly, to the traditional banker-customer relationship. It is generally accepted that the fight against money laundering is in conflict with the secrecy rule. Banking secrecy is a customer privilege whereas combating crime is critical for public safety and security. Indeed, achieving a proper balance is a desirable goal. But how we go about achieving such a balance is a question encountered by many law enforcement authorities. Therefore, this paper examines the effect of disclosure under the Malaysian anti-money laundering laws on the traditional duty of banks to keep the customer’s information confidential. It also analyzes whether the Malaysian laws provide a right balance between a duty to keep customer’s information secret and a duty to disclose such information in the fight against money laundering. On closer inspection, it is submitted that the Malaysian laws provide sufficient safeguards to ensure that the disclosure of customer’s information is carried out in a manner that is not prejudicial to the interest of legitimate customers. This is a positive approach that could protect the innocent customers from being mistreated by the law. Ultimately, it can be said that the growing threat of global money laundering and terrorism makes the overriding of banking secrecy justified because without a flow of information from the banks, the effective prevention of the menace is not possible.Keywords: anti-money laundering law, banker-customer relationship, banking secrecy, confidentiality, money laundering
Procedia PDF Downloads 4301312 Research on the Optimization of the Facility Layout of Efficient Cafeterias for Troops
Authors: Qing Zhang, Jiachen Nie, Yujia Wen, Guanyuan Kou, Peng Yu, Kun Xia, Qin Yang, Li Ding
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BACKGROUND: A facility layout problem (FLP) is an NP-complete (non-deterministic polynomial) problem, which is hard to obtain an exact optimal solution. FLP has been widely studied in various limited spaces and workflows. For example, cafeterias with many types of equipment for troops cause chaotic processes when dining. OBJECTIVE: This article tried to optimize the layout of troops’ cafeteria and to improve the overall efficiency of the dining process. METHODS: First, the original cafeteria layout design scheme was analyzed from an ergonomic perspective and two new design schemes were generated. Next, three facility layout models were designed, and further simulation was applied to compare the total time and density of troops between each scheme. Last, an experiment of the dining process with video observation and analysis verified the simulation results. RESULTS: In a simulation, the dining time under the second new layout is shortened by 2.25% and 1.89% (p<0.0001, p=0.0001) compared with the other two layouts, while troops-flow density and interference both greatly reduced in the two new layouts. In the experiment, process completing time and the number of interference reduced as well, which verified corresponding simulation results. CONCLUSIONS: Our two new layout schemes are tested to be optimal by a series of simulation and space experiments. In future research, similar approaches could be applied when taking layout-design algorithm calculation into consideration.Keywords: layout optimization, dining efficiency, troops’ cafeteria, anylogic simulation, field experiment
Procedia PDF Downloads 1451311 Approximation of PE-MOCVD to ALD for TiN Concerning Resistivity and Chemical Composition
Authors: D. Geringswald, B. Hintze
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The miniaturization of circuits is advancing. During chip manufacturing, structures are filled for example by metal organic chemical vapor deposition (MOCVD). Since this process reaches its limits in case of very high aspect ratios, the use of alternatives such as the atomic layer deposition (ALD) is possible, requiring the extension of existing coating systems. However, it is an unsolved question to what extent MOCVD can achieve results similar as an ALD process. In this context, this work addresses the characterization of a metal organic vapor deposition of titanium nitride. Based on the current state of the art, the film properties coating thickness, sheet resistance, resistivity, stress and chemical composition are considered. The used setting parameters are temperature, plasma gas ratio, plasma power, plasma treatment time, deposition time, deposition pressure, number of cycles and TDMAT flow. The derived process instructions for unstructured wafers and inside a structure with high aspect ratio include lowering the process temperature and increasing the number of cycles, the deposition and the plasma treatment time as well as the plasma gas ratio of hydrogen to nitrogen (H2:N2). In contrast to the current process configuration, the deposited titanium nitride (TiN) layer is more uniform inside the entire test structure. Consequently, this paper provides approaches to employ the MOCVD for structures with increasing aspect ratios.Keywords: ALD, high aspect ratio, PE-MOCVD, TiN
Procedia PDF Downloads 3021310 Artificial Neural Network to Predict the Optimum Performance of Air Conditioners under Environmental Conditions in Saudi Arabia
Authors: Amr Sadek, Abdelrahaman Al-Qahtany, Turkey Salem Al-Qahtany
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In this study, a backpropagation artificial neural network (ANN) model has been used to predict the cooling and heating capacities of air conditioners (AC) under different conditions. Sufficiently large measurement results were obtained from the national energy-efficiency laboratories in Saudi Arabia and were used for the learning process of the ANN model. The parameters affecting the performance of the AC, including temperature, humidity level, specific heat enthalpy indoors and outdoors, and the air volume flow rate of indoor units, have been considered. These parameters were used as inputs for the ANN model, while the cooling and heating capacity values were set as the targets. A backpropagation ANN model with two hidden layers and one output layer could successfully correlate the input parameters with the targets. The characteristics of the ANN model including the input-processing, transfer, neurons-distance, topology, and training functions have been discussed. The performance of the ANN model was monitored over the training epochs and assessed using the mean squared error function. The model was then used to predict the performance of the AC under conditions that were not included in the measurement results. The optimum performance of the AC was also predicted under the different environmental conditions in Saudi Arabia. The uncertainty of the ANN model predictions has been evaluated taking into account the randomness of the data and lack of learning.Keywords: artificial neural network, uncertainty of model predictions, efficiency of air conditioners, cooling and heating capacities
Procedia PDF Downloads 781309 Duality of Leagility and Governance: A New Normal Demand Network Management Paradigm under Pandemic
Authors: Jacky Hau
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The prevalence of emerging technologies disrupts various industries as well as consumer behavior. Data collection has been in the fingertip and inherited through enabled Internet-of-things (IOT) devices. Big data analytics (BDA) becomes possible and allows real-time demand network management (DNM) through leagile supply chain. To enhance further on its resilience and predictability, governance is going to be examined to promote supply chain transparency and trust in an efficient manner. Leagility combines lean thinking and agile techniques in supply chain management. It aims at reducing costs and waste, as well as maintaining responsiveness to any volatile consumer demand by means of adjusting the decoupling point where the product flow changes from push to pull. Leagility would only be successful when collaborative planning, forecasting, and replenishment (CPFR) process or alike is in place throughout the supply chain business entities. Governance and procurement of the supply chain, however, is crucial and challenging for the execution of CPFR as every entity has to walk-the-talk generously for the sake of overall benefits of supply chain performance, not to mention the complexity of exercising the polices at both of within across various supply chain business entities on account of organizational behavior and mutual trust. Empirical survey results showed that the effective timespan on demand forecasting had been drastically shortening in the magnitude of months to weeks planning horizon, thus agility shall come first and preferably following by lean approach in a timely manner.Keywords: governance, leagility, procure-to-pay, source-to-contract
Procedia PDF Downloads 1161308 Globalization as Instrument for Multi-National Corporation in Transforming Asian’s Perspective towards Clean Water Consumption
Authors: Atanta Gian
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It is inevitable that globalization has succeeded in transforming the world today. The influence of globalization has emerged in almost every aspect of life nowadays, especially in shaping the perception of the people. It can be seen on how easy for people are affected by the information surrounding them. Due to globalization, the flow of information has become more rapid along with the development of technology. People tend to believe in information that they actually get by themselves, if there is information where most of the people believe it is true, then this information could be categorized as factual and relevant. Therefore if people gain information on what is best for them in terms of daily consumption, then this information could transform their perspective, and it becomes a consideration in selecting their needs for daily consumption. By looking at this trend, the author sees that globalization could be used by Multi-National Corporation (MNC) to enhance the promotion of their products. This is applied by shaping the perspectives of the world regarding what is the best for them. Multi-National Corporation which has better technology in terms of the development of their external promotion could utilize this opportunity to affect people’s perspectives into what they want. In this paper, the author would like to elaborate how globalization is applied by MNC to shape people’s perspective regarding what is the best for them. The author would utilize a case study to analyze on how MNC could transform the perspectives of Asian people regarding the necessary of having a better quality drinking water, which in this case, MNC has shaped the perspective of Asian people in choosing their product by promoting the bottled water as the best choice for them. In the end of this paper, author would come to a conclusion that MNCs are able to shape the world’s perspective regarding the needs of their products which is supported by the globalization that is happening now.Keywords: consumption, globalisation, influence, information technology, multi-national corporations
Procedia PDF Downloads 2121307 Worldwide GIS Based Earthquake Information System/Alarming System for Microzonation/Liquefaction and It’s Application for Infrastructure Development
Authors: Rajinder Kumar Gupta, Rajni Kant Agrawal, Jaganniwas
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One of the most frightening phenomena of nature is the occurrence of earthquake as it has terrible and disastrous effects. Many earthquakes occur every day worldwide. There is need to have knowledge regarding the trends in earthquake occurrence worldwide. The recoding and interpretation of data obtained from the establishment of the worldwide system of seismological stations made this possible. From the analysis of recorded earthquake data, the earthquake parameters and source parameters can be computed and the earthquake catalogues can be prepared. These catalogues provide information on origin, time, epicenter locations (in term of latitude and longitudes) focal depths, magnitude and other related details of the recorded earthquakes. Theses catalogues are used for seismic hazard estimation. Manual interpretation and analysis of these data is tedious and time consuming. A geographical information system is a computer based system designed to store, analyzes and display geographic information. The implementation of integrated GIS technology provides an approach which permits rapid evaluation of complex inventor database under a variety of earthquake scenario and allows the user to interactively view results almost immediately. GIS technology provides a powerful tool for displaying outputs and permit to users to see graphical distribution of impacts of different earthquake scenarios and assumptions. An endeavor has been made in present study to compile the earthquake data for the whole world in visual Basic on ARC GIS Plate form so that it can be used easily for further analysis to be carried out by earthquake engineers. The basic data on time of occurrence, location and size of earthquake has been compiled for further querying based on various parameters. A preliminary analysis tool is also provided in the user interface to interpret the earthquake recurrence in region. The user interface also includes the seismic hazard information already worked out under GHSAP program. The seismic hazard in terms of probability of exceedance in definite return periods is provided for the world. The seismic zones of the Indian region are included in the user interface from IS 1893-2002 code on earthquake resistant design of buildings. The City wise satellite images has been inserted in Map and based on actual data the following information could be extracted in real time: • Analysis of soil parameters and its effect • Microzonation information • Seismic hazard and strong ground motion • Soil liquefaction and its effect in surrounding area • Impacts of liquefaction on buildings and infrastructure • Occurrence of earthquake in future and effect on existing soil • Propagation of earth vibration due of occurrence of Earthquake GIS based earthquake information system has been prepared for whole world in Visual Basic on ARC GIS Plate form and further extended micro level based on actual soil parameters. Individual tools has been developed for liquefaction, earthquake frequency etc. All information could be used for development of infrastructure i.e. multi story structure, Irrigation Dam & Its components, Hydro-power etc in real time for present and future.Keywords: GIS based earthquake information system, microzonation, analysis and real time information about liquefaction, infrastructure development
Procedia PDF Downloads 3181306 Optimal and Critical Path Analysis of State Transportation Network Using Neo4J
Authors: Pallavi Bhogaram, Xiaolong Wu, Min He, Onyedikachi Okenwa
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A transportation network is a realization of a spatial network, describing a structure which permits either vehicular movement or flow of some commodity. Examples include road networks, railways, air routes, pipelines, and many more. The transportation network plays a vital role in maintaining the vigor of the nation’s economy. Hence, ensuring the network stays resilient all the time, especially in the face of challenges such as heavy traffic loads and large scale natural disasters, is of utmost importance. In this paper, we used the Neo4j application to develop the graph. Neo4j is the world's leading open-source, NoSQL, a native graph database that implements an ACID-compliant transactional backend to applications. The Southern California network model is developed using the Neo4j application and obtained the most critical and optimal nodes and paths in the network using centrality algorithms. The edge betweenness centrality algorithm calculates the critical or optimal paths using Yen's k-shortest paths algorithm, and the node betweenness centrality algorithm calculates the amount of influence a node has over the network. The preliminary study results confirm that the Neo4j application can be a suitable tool to study the important nodes and the critical paths for the major congested metropolitan area.Keywords: critical path, transportation network, connectivity reliability, network model, Neo4j application, edge betweenness centrality index
Procedia PDF Downloads 1361305 A Case Study on the Value of Corporate Social Responsibility Systems
Authors: José M. Brotons, Manuel E. Sansalvador
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The relationship between Corporate Social Responsibility (CSR) and financial performance (FP) is a subject of great interest that has not yet been resolved. In this work, we have developed a new and original tool to measure this relation. The tool quantifies the value contributed to companies that are committed to CSR. The theoretical model used is the fuzzy discounted cash flow method. Two assumptions have been considered, the first, the company has implemented the IQNet SR10 certification, and the second, the company has not implemented that certification. For the first one, the growth rate used for the time horizon is the rate maintained by the company after obtaining the IQNet SR10 certificate. For the second one, both, the growth rates company prior to the implementation of the certification, and the evolution of the sector will be taken into account. By using triangular fuzzy numbers, it is possible to deal adequately with each company’s forecasts as well as the information corresponding to the sector. Once the annual growth rate of the sales is obtained, the profit and loss accounts are generated from the annual estimate sales. For the remaining elements of this account, their regression with the nets sales has been considered. The difference between these two valuations, made in a fuzzy environment, allows obtaining the value of the IQNet SR10 certification. Although this study presents an innovative methodology to quantify the relation between CSR and FP, the authors are aware that only one company has been analyzed. This is precisely the main limitation of this study which in turn opens up an interesting line for future research: to broaden the sample of companies.Keywords: corporate social responsibility, case study, financial performance, company valuation
Procedia PDF Downloads 1881304 Continuous Production of Prebiotic Pectic Oligosaccharides from Sugar Beet Pulp in a Continuous Cross Flow Membrane Bioreactor
Authors: Neha Babbar, S. Van Roy, W. Dejonghe, S. Sforza, K. Elst
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Pectic oligosaccharides (a class of prebiotics) are non-digestible carbohydrates which benefits the host by stimulating the growth of healthy gut micro flora. Production of prebiotic pectic oligosaccharides (POS) from pectin rich agricultural residues involves a cutting of long chain polymer of pectin to oligomers of pectin while avoiding the formation of monosaccharides. The objective of the present study is to develop a two-step continuous biocatalytic membrane reactor (MER) for the continuous production of POS (from sugar beet pulp) in which conversion is combined with separation. Optimization of the ratio of POS/monosaccharides, stability and productivities of the process was done by testing various residence times (RT) in the reactor vessel with diluted (10 RT, 20 RT, and 30 RT) and undiluted (30 RT, 40 RT and 60 RT) substrate. The results show that the most stable processes (steady state) were 20 RT and 30 RT for diluted substrate and 40 RT and 60 RT for undiluted substrate. The highest volumetric and specific productivities of 20 g/L/h and 11 g/gE/h; 17 g/l/h and 9 g/gE/h were respectively obtained with 20 RT (diluted substrate) and 40 RT (undiluted substrate). Under these conditions, the permeates of the reactor test with 20 RT (diluted substrate) consisted of 80 % POS fractions while that of 40 RT (undiluted substrate) resulted in 70% POS fractions. A two-step continuous biocatalytic MER for the continuous POS production looks very promising for the continuous production of tailor made POS. Although both the processes i.e 20 RT (diluted substrate) and 40 RT (undiluted substrate) gave the best results, but for an Industrial application it is preferable to use an undiluted substrate.Keywords: pectic oligosaccharides, membrane reactor, residence time, specific productivity, volumetric productivity
Procedia PDF Downloads 4431303 Endometrial Ablation and Resection Versus Hysterectomy for Heavy Menstrual Bleeding: A Systematic Review and Meta-Analysis of Effectiveness and Complications
Authors: Iliana Georganta, Clare Deehan, Marysia Thomson, Miriam McDonald, Kerrie McNulty, Anna Strachan, Elizabeth Anderson, Alyaa Mostafa
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Context: A meta-analysis of randomized controlled trials (RCTs) comparing hysterectomy versus endometrial ablation and resection in the management of heavy menstrual bleeding. Objective: To evaluate the clinical efficacy, satisfaction rates and adverse events of hysterectomy compared to more minimally invasive techniques in the treatment of HMB. Evidence Acquisition: A literature search was performed for all RCTs and quasi-RCTs comparing hysterectomy with either endometrial ablation endometrial resection of both. The search had no language restrictions and was last updated in June 2020 using MEDLINE, EMBASE, Cochrane Central Register of Clinical Trials, PubMed, Google Scholar, PsycINFO, Clinicaltrials.gov and Clinical trials. EU. In addition, a manual search of the abstract databases of the European Haemophilia Conference on women's health was performed and further studies were identified from references of acquired papers. The primary outcomes were patient-reported and objective reduction in heavy menstrual bleeding up to 2 years and after 2 years. Secondary outcomes included satisfaction rates, pain, adverse events short and long term, quality of life and sexual function, further surgery, duration of surgery and hospital stay and time to return to work and normal activities. Data were analysed using RevMan software. Evidence synthesis: 12 studies and a total of 2028 women were included (hysterectomy: n = 977 women vs endometrial ablation or resection: n = 1051 women). Hysterectomy was compared with endometrial ablation only in five studies (Lin, Dickersin, Sesti, Jain, Cooper) and endometrial resection only in five studies (Gannon, Schulpher, O’Connor, Crosignani, Zupi) and a mixture of the Ablation and Resection in two studies (Elmantwe, Pinion). Of the 1² studies, 10 reported women’s perception of bleeding symptoms as improved. Meta-analysis showed that women in the hysterectomy group were more likely to show improvement in bleeding symptoms when compared with endometrial ablation or resection up to 2-year follow-up (RR 0.75, 95% CI 0.71 to 0.79, I² = 95%). Objective outcomes of improvement in bleeding also favored hysterectomy. Patient satisfaction was higher after hysterectomy within the 2 years follow-up (RR: 0.90, 95%CI: 0.86 to 0.94, I²:58%), however, there was no significant difference between the two groups at more than 2 years follow up. Sepsis (RR: 0.03, 95% CI 0.002 to 0.56; 1 study), wound infection (RR: 0.05, 95% CI: 0.01 to 0.28, I²: 0%, 3 studies) and Urinary tract infection (UTI) (RR: 0.20, 95% CI: 0.10 to 0.42, I²: 0%, 4 studies) all favoured hysteroscopic techniques. Fluid overload (RR: 7.80, 95% CI: 2.16 to 28.16, I² :0%, 4 studies) and perforation (RR: 5.42, 95% CI: 1.25 to 23.45, I²: 0%, 4 studies) however favoured hysterectomy in the short term. Conclusions: This meta-analysis has demonstrated that endometrial ablation and endometrial resection are both viable options when compared with hysterectomy for the treatment of heavy menstrual bleeding. Hysteroscopic procedures had better outcomes in the short term with fewer adverse events including wound infection, UTI and sepsis. The hysterectomy performed better when measuring more long-term impacts such as recurrence of symptoms, overall satisfaction at two years and the need for further treatment or surgery.Keywords: menorrhagia, hysterectomy, ablation, resection
Procedia PDF Downloads 157