Search results for: inertial measurement unit (IMU)

Authors: Zhihao Peng, Qiong Zhang, Xiyao Li, Yongzhen Peng

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Nowadays, conventional nitrogen removal process (nitrification and denitrification) was adopted in most wastewater treatment plants, but many problems have occurred, such as: high aeration energy consumption, extra carbon sources dosage and high sludge treatment costs. The emergence of anammox has bring about the great revolution to the nitrogen removal technology, and only the ammonia and nitrite were required to remove nitrogen autotrophically, no demand for aeration and sludge treatment. However, there existed many challenges in anammox applications: difficulty of biomass retention, insufficiency of nitrite substrate, damage from complex organic etc. Much effort was put into the research in overcoming the above challenges, and the payment was rewarded. It was also imperative to establish an innovative process that can settle the above problems synchronously, after all any obstacle above mentioned can cause the collapse of anammox system. Therefore, in this study, a two-stage process was established that the sequencing batch reactor (SBR) and upflow anaerobic sludge blanket (UASB) were used in the pre-stage and post-stage, respectively. The domestic wastewater entered into the SBR first and went through anaerobic/aerobic/anoxic (An/O/A) mode, and the draining at the aerobic end of SBR was mixed with domestic wastewater, the mixture then entering to the UASB. In the long term, organic and nitrogen removal performance was evaluated. All along the operation, most COD was removed in pre-stage (COD removal efficiency > 64.1%), including some macromolecular organic matter, like: tryptophan, tyrosinase and fulvic acid, which could weaken the damage of organic matter to anammox. And the An/O/A operating mode of SBR was beneficial to the achievement and maintenance of partial nitrification (PN). Hence, sufficient and steady nitrite supply was another favorable condition to anammox enhancement. Besides, the flexible mixing ratio helped to gain a substrate ratio appropriate to anammox (1.32-1.46), which further enhance the anammox. Further, the UASB was used and gas recirculation strategy was adopted in the post-stage, aiming to achieve granulation by the selection pressure. As expected, the granules formed rapidly during 38 days, which increased from 153.3 to 354.3 μm. Based on bioactivity and gene measurement, the anammox metabolism and abundance level rose evidently, by 2.35 mgN/gVss·h and 5.3 x109. The anammox bacteria mainly distributed in the large granules (>1000 μm), while the biomass in the flocs (<200 μm) and microgranules (200-500 μm) barely displayed anammox bioactivity. Enhanced anammox promoted the advanced autotrophic nitrogen removal, which increased from 71.9% to 93.4%, even when the temperature was only 12.9 ℃. Therefore, it was feasible to enhance anammox in the multiple favorable conditions created, and the strategy extended the application of anammox to the full-scale mainstream, enhanced the understanding of anammox in the aspects of culturing conditions.

Keywords: anammox, granules, nitrite accumulation, nitrogen removal efficiency

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Authors: Virginia Vettori, Chiara Lorini, Vieri Lastrucci, Giulia Di Pisa, Alessia De Blasi, Sara Giuggioli, Guglielmo Bonaccorsi

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The design of the Nutrition Literacy Assessment Instrument (NLit) responds to the need to provide a tool to adequately assess the construct of nutrition literacy (NL), which is strictly connected to the quality of the diet and nutritional health status. The NLit was originally developed and validated in the US context, and it was recently validated for Italian people too (NLit-IT), involving a sample of N = 74 adults. The results of the cross-cultural adaptation of the tool confirmed its validity since it was established that the level of NL contributed to predicting the level of adherence to the Mediterranean Diet (convergent validity). Additionally, results obtained proved that Internal Consistency and reliability of the NLit-IT were good (Cronbach’s alpha (ρT) = 0.78; 95% CI, 0.69–0.84; Intraclass Correlation Coefficient (ICC) = 0.68, 95% CI, 0.46–0.85). However, the Subscale 3 of the NLit-IT “Household Food Measurement” showed lower values of ρT and ICC (ρT = 0.27; 95% CI, 0.1–0.55; ICC = 0.19, 95% CI, 0.01–0.63) than the entire instrument. Subscale 3 includes nine items which are constituted by written questions and the corresponding pictures of the meals. In particular, items 2, 3, and 8 of Subscale 3 had the lowest level of correct answers. The purpose of the present study was to identify the factors that influenced the Internal Consistency and reliability of Subscale 3 of NLit-IT using the methodology of a focus group. A panel of seven experts was formed, involving professionals in the field of public health nutrition, dietetics, and health promotion and all of them were trained on the concepts of nutrition literacy and food appearance. A member of the group drove the discussion, which was oriented in the identification of the reasons for the low levels of reliability and Internal Consistency. The members of the group discussed the level of comprehension of the items and how they could be readapted. From the discussion, it emerges that the written questions were clear and easy to understand, but it was observed that the representations of the meal needed to be improved. Firstly, it has been decided to introduce a fork or a spoon as a reference dimension to better understand the dimension of the food portion (items 1, 4 and 8). Additionally, the flat plate of items 3 and 5 should be substituted with a soup plate because, in the Italian national context, it is common to eat pasta or rice on this kind of plate. Secondly, specific measures should be considered for some kind of foods such as the brick of yogurt instead of a cup of yogurt (items 1 and 4). Lastly, it has been decided to redo the photos of the meals basing on professional photographic techniques. In conclusion, we noted that the graphical representation of the items strictly influenced the level of participants’ comprehension of the questions; moreover, the research group agreed that the level of knowledge about nutrition and food portion size is low in the general population.

Keywords: nutritional literacy, cross cultural adaptation, misinformation, food design

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Authors: Palita Sooksamran, Katcharin Mahawong

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This research aims to offer the development of innovator teachers training curriculum to create instructional innovation according to active learning approach to enhance learning achievement. The research and development process is carried out in 3 steps: Step 1 The study of the needs necessary to develop a training curriculum: the inquiry was conducted by a sample of teachers in private schools in Phayao province that provide basic education at the level of education. Using a questionnaire of 176 people, the sample was defined using a table of random numbers and stratified samples, using the school as a random layer. Step 2 Training curriculum development: the tools used are developed training curriculum and curriculum assessments, with nine experts checking the appropriateness of the draft curriculum. The statistic used in data analysis is the average ( ) and standard deviation (S.D.) Step 3 study on effectiveness of training curriculum: one group pretest/posttest design applied in this study. The sample consisted of 35 teachers from private schools in Phayao province. The participants volunteered to attend on their own. The results of the research showed that: 1.The essential demand index needed with the list of essential needs in descending order is the choice and create of multimedia media, videos, application for learning management at the highest level ,Developed of multimedia, video and applications for learning management and selection of innovative learning management techniques and methods of solve the problem Learning , respectively. 2. The components of the training curriculum include principles, aims, scope of content, training activities, learning materials and resources, supervision evaluation. The scope of the curriculum consists of basic knowledge about learning management innovation, active learning, lesson plan design, learning materials and resources, learning measurement and evaluation, implementation of lesson plans into classroom and supervision and motoring. The results of the evaluation of quality of the draft training curriculum at the highest level. The Experts suggestion is that the purpose of the course should be used words that convey the results. 3. The effectiveness of training curriculum 1) Cognitive outcomes of the teachers in creating innovative learning management was at a high level of relative gain score. 2) The assessment results of learning management ability according to the active learning approach to enhance learning achievement by assessing from 2 education supervisor as a whole were very high , 3) Quality of innovation learning management based on active learning approach to enhance learning achievement of the teachers, 7 instructional Innovations were evaluated as outstanding works and 26 instructional Innovations passed the standard 4) Overall learning achievement of students who learned from 35 the sample teachers was at a high level of relative gain score 5) teachers' satisfaction towards the training curriculum was at the highest level.

Keywords: training curriculum, innovator teachers, active learning approach, learning achievement

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Authors: I. N. Nwafia, U. C. Ozumba, M. E. Ohanu, S. O. Ebede

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Antibiotic resistance is increasing globally and has become a major health challenge. Extended-spectrum beta-lactamase is clinically important because the ESBL gene are mostly plasmid encoded and these plasmids frequently carry genes encoding resistance to other classes of antimicrobials thereby limiting antibiotic options in the treatment of infections caused by these organisms. The specific objectives of this study were to determine the prevalence of ESBLs production in Escherichia coli, to determine the antibiotic susceptibility pattern of ESBLs producing Escherichia coli, to detect TEM, SHV and CTX-M genes and the risk factors to acquisition of ESBL producing Escherichia coli. The protocol of the study was approved by Health Research and Ethics committee of the University of Nigeria Teaching Hospital (UNTH), Enugu. It was a descriptive cross-sectional study that involved all hospitalized patients in UNTH from whose specimens Escherichia coli was isolated during the period of the study. The samples analysed were urine, wound swabs, blood and cerebrospinal fluid. These samples were cultured in 5% sheep Blood agar and MacConkey agar (Oxoid Laboratories, Cambridge UK) and incubated at 35-370C for 24 hours. Escherichia coli was identified with standard biochemical tests and confirmed using API 20E auxanogram (bioMerieux, Marcy 1'Etoile, France). The antibiotic susceptibility testing was done by disc diffusion method and interpreted according to the Clinical and Laboratory Standard Institute guideline. ESBL production was confirmed using ESBL Epsilometer test strips (Liofilchem srl, Italy). The ESBL bla genes were detected with polymerase chain reaction, after extraction of DNA with plasmid mini-prep kit (Jena Bioscience, Jena, Germany). Data analysis was with appropriate descriptive and inferential statistics. One hundred and six isolates (53.00%) out of the 200 were from urine, followed by isolates from different swabs specimens 53(26.50%) and the least number of the isolates 4(2.00) were from blood (P value = 0.096). Seventy (35.00%) out of the 200 isolates, were confirmed positive for ESBL production. Forty-two (60.00%) of the isolates were from female patients while 28(40.00%) were from male patients (P value = 0.13). Sixty-eight (97.14%) of the isolates were susceptible to imipenem while all of the isolates were resistant to ampicillin, chloramphenicol and tetracycline. From the 70 positive isolates the ESBL genes detected with polymerase chain reaction were blaCTX-M (n=26; 37.14%), blaTEM (n=7; 10.00%), blaSHV (n=2; 2.86%), blaCTX-M/TEM (n=7; 10.0%), blaCTX-M/SHV (n=14; 20.0%) and blaCTX-M/TEM/SHV (n=10; 14.29%). There was no gene detected in 4(5.71%) of the isolates. The most associated risk factors to infections caused by ESBL producing Escherichia coli was previous antibiotics use for the past 3 months followed by admission in the intensive care unit, recent surgery, and urinary catheterization. In conclusion, ESBLs was detected in 4 of every 10 Escherichia coli with the predominant gene detected being CTX-M. This knowledge will enable appropriate measures towards improvement of patient health care, antibiotic stewardship, research and infection control in the hospital.

Keywords: antimicrobial, Escherichia coli, extended spectrum beta lactamase, resistance

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Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

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Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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Authors: Brenda Ravenscroft, Ulemu Luhanga, Bev King

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A comprehensive evaluation of online learning needs to include a blend of educational design, technology use, and online instructional practices that integrate technology appropriately for developing and delivering quality online courses. Research shows that classroom-based evaluation tools do not adequately capture the dynamic relationships between content, pedagogy, and technology in online courses. Furthermore, studies suggest that using classroom evaluations for online courses yields lower than normal scores for instructors, and may affect faculty negatively in terms of administrative decisions. In 2014, the Faculty of Arts and Science at Queen’s University responded to this evidence by seeking an alternative to the university-mandated evaluation tool, which is designed for classroom learning. The Faculty is deeply engaged in e-learning, offering large variety of online courses and programs in the sciences, social sciences, humanities and arts. This paper describes the process by which a new student survey instrument for online courses was developed and piloted, the methods used to analyze the data, and the ways in which the instrument was subsequently adapted based on the results. It concludes with a critical reflection on the challenges of evaluating e-learning. The Student Evaluation of Online Teaching Effectiveness (SEOTE), developed by Arthur W. Bangert in 2004 to assess constructivist-compatible online teaching practices, provided the starting point. Modifications were made in order to allow the instrument to serve the two functions required by the university: student survey results provide the instructor with feedback to enhance their teaching, and also provide the institution with evidence of teaching quality in personnel processes. Changes were therefore made to the SEOTE to distinguish more clearly between evaluation of the instructor’s teaching and evaluation of the course design, since, in the online environment, the instructor is not necessarily the course designer. After the first pilot phase, involving 35 courses, the results were analyzed using Stobart's validity framework as a guide. This process included statistical analyses of the data to test for reliability and validity, student and instructor focus groups to ascertain the tool’s usefulness in terms of the feedback it provided, and an assessment of the utility of the results by the Faculty’s e-learning unit responsible for supporting online course design. A set of recommendations led to further modifications to the survey instrument prior to a second pilot phase involving 19 courses. Following the second pilot, statistical analyses were repeated, and more focus groups were used, this time involving deans and other decision makers to determine the usefulness of the survey results in personnel processes. As a result of this inclusive process and robust analysis, the modified SEOTE instrument is currently being considered for adoption as the standard evaluation tool for all online courses at the university. Audience members at this presentation will be stimulated to consider factors that differentiate effective evaluation of online courses from classroom-based teaching. They will gain insight into strategies for introducing a new evaluation tool in a unionized institutional environment, and methodologies for evaluating the tool itself.

Keywords: evaluation, online courses, student survey, teaching effectiveness

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Mark Kennedy, E. Bantugon, Noruane A. Daileg

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Leaks arising from aircraft fuel tanks is a protracted problem for the aircraft manufacturers, operators, and maintenance crews. It principally arises from stress, structural defects, or degraded sealants as the aircraft age. It can be ignited by different sources, which can result in catastrophic flight and consequences, exhibiting a major drain both on time and budget. In order to mitigate and eliminate this kind of problem, the researcher produced an experimental sealant having a base material of natural tree resin, the Pili Tree Resin. Aside from producing an experimental sealant, the main objective of this research is to analyze its physical, chemical, mechanical, thermal, and rheological properties, which is beneficial and effective for specific aircraft parts, particularly the integral fuel tank. The experimental method of research was utilized in this study since it is a product invention. This study comprises two parts, specifically the Optimization Process and the Characterization Process. In the Optimization Process, the experimental sealant was subjected to the Flammability Test, an important test and consideration according to 14 Code of Federal Regulation Appendix N, Part 25 - Fuel Tank Flammability Exposure and Reliability Analysis, to get the most suitable formulation. Followed by the Characterization Process, where the formulated experimental sealant has undergone thirty-eight (38) different standard testing including Organoleptic, Instrumental Color Measurement Test, Smoothness of Appearance Test, Miscibility Test, Boiling Point Test, Flash Point Test, Curing Time, Adhesive Test, Toxicity Test, Shore A Hardness Test, Compressive Strength, Shear Strength, Static Bending Strength, Tensile Strength, Peel Strength Test, Knife Test, Adhesion by Tape Test, Leakage Test), Drip Test, Thermogravimetry-Differential Thermal Analysis (TG-DTA), Differential Scanning Calorimetry, Calorific Value, Viscosity Test, Creep Test, and Anti-Sag Resistance Test to determine and analyze the five (5) material properties of the sealant. The numerical values of the mentioned tests are determined using product application, testing, and calculation. These values are then used to calculate the efficiency of the experimental sealant. Accordingly, this efficiency is the means of comparison between the experimental and commercial sealant. Based on the results of the different standard testing conducted, the experimental sealant exceeded all the data results of the commercial sealant. This result shows that the physicochemical-mechanical, thermal, and rheological properties of the experimental sealant are far more effective as an aircraft integral fuel tank sealant alternative in comparison to the commercial sealant. Therefore, Pili Tree possesses a new role and function: a source of ingredients in sealant production.

Keywords: Aircraft Integral Fuel Tank, Physicochemi-mechanical, Pili Tree Resin, Properties, Rheological, Sealant, Thermal

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Authors: Elham Koohi, Silvio Jose Gumiere, Hossein Bonakdari, Saeid Homayouni

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Water used in agricultural crops can be managed by irrigation scheduling based on soil moisture levels and plant water stress thresholds. Automated irrigation scheduling limits crop physiological damage and yield reduction. Knowledge of crop water stress monitoring approaches can be effective in optimizing the use of agricultural water. Understanding the physiological mechanisms of crop responding and adapting to water deficit ensures sustainable agricultural management and food supply. This aim could be achieved by analyzing and diagnosing crop characteristics and their interlinkage with the surrounding environment. Assessments of plant functional types (e.g., leaf area and structure, tree height, rate of evapotranspiration, rate of photosynthesis), controlling changes, and irrigated areas mapping. Calculating thresholds of soil water content parameters, crop water use efficiency, and Nitrogen status make irrigation scheduling decisions more accurate by preventing water limitations between irrigations. Combining Remote Sensing (RS), the Internet of Things (IoT), Artificial Intelligence (AI), and Machine Learning Algorithms (MLAs) can improve measurement accuracies and automate irrigation scheduling. This paper is a review structured by surveying about 100 recent research studies to analyze varied approaches in terms of providing high spatial and temporal resolution mapping, sensor-based Variable Rate Application (VRA) mapping, the relation between spectral and thermal reflectance and different features of crop and soil. The other objective is to assess RS indices formed by choosing specific reflectance bands and identifying the correct spectral band to optimize classification techniques and analyze Proximal Optical Sensors (POSs) to control changes. The innovation of this paper can be defined as categorizing evaluation methodologies of precision irrigation (applying the right practice, at the right place, at the right time, with the right quantity) controlled by soil moisture levels and sensitiveness of crops to water stress, into pre-processing, processing (retrieval algorithms), and post-processing parts. Then, the main idea of this research is to analyze the error reasons and/or values in employing different approaches in three proposed parts reported by recent studies. Additionally, as an overview conclusion tried to decompose different approaches to optimizing indices, calibration methods for the sensors, thresholding and prediction models prone to errors, and improvements in classification accuracy for mapping changes.

Keywords: agricultural crops, crop water stress detection, irrigation scheduling, precision agriculture, remote sensing

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Authors: Yifan Lu, Ying Cui, Ying Zhu, Edward S. Lu, Rebecca Zeng, Rohan Bajaj, Raviv Katz, Rongrong Le, Jay C. Wang, John B. Miller

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Purpose: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events. Fluorescein angiography (FA) is the traditional diagnostic tool for RAO; however, wide-field swept-source optical coherence tomography angiography (WF SS-OCTA), as a nascent imaging technology, is able to provide quick and non-invasive angiographic information with a wide field of view. In this study, we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO. Methods: Patients with diagnoses of central retinal artery occlusion (CRAO) or branched retinal artery occlusion (BRAO) were included. A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The average measurement of the central foveal subfield, inner ring, and outer ring was calculated for each parameter. Non-perfusion area (NPA) was manually measured using 15mm x 15mm Montage images. A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity. A P-value less than 0.05 was considered to be statistically significant. Results: Twenty-five subjects were included in the study. For RAO eyes, there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density (SCP VD). A negative correlation was found between vision and deep capillary plexus vessel density (DCP VD) without statistical significance. There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance. No statistically significant correlation was found between vision and the above metrics in contralateral eyes. For NPA measurements, no significant correlation was found between vision and NPA. Conclusions: This is the first study to our best knowledge to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes. Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke. The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO. Furthermore, they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO.

Keywords: OCTA, swept-source OCT, retinal artery occlusion, Zeiss Plex Elite

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Authors: Gokulan Vethanayakam, Daniel Aston

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Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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Authors: Yusuf Hesham Mohamed

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Introduction: Three-dimensional printing technology includes multiple procedures that fabricate three-dimensional objects through consecutively layering two-dimensional cross-sections on top of each other. 3D bioprinting is a promising field of 3D printing, which fabricates tissues and organs by accurately controlling the proper arrangement of diverse biological components. 3D bioprinting uses software and prints biological materials and their supporting components layer-by-layer on a substrate or in a tissue culture plate to produce complex live tissues and organs. 3D food printing is an emerging field of 3D bioprinting in which the 3D printed products are food products that are cheap, require less effort to produce, and have more desirable traits. The Aim of the Study is the development of an affordable 3D bioprinter by altering a locally made CNC instrument with an open-source platform to suit the 3D bio-printer purposes. Later, we went through applying the prototype in several applications regarding food technology and drug testing, including the organ-On-Chip. Materials and Methods: An off-the-shelf 3D printer was modified by designing and fabricating the syringe unit, which was designed on the basis of the Milli-fluidics system. Sodium alginate and gelatin hydrogels were prepared, followed by leaf cell suspension preparation from narrow sections of Fragaria’s viable leaves. The desired 3D structure was modeled, and 3D printing preparations took place. Cell-free and cell-laden hydrogels were printed at room temperature under sterile conditions. Post printing curing process was performed. The printed structure was further studied. Results: Positive results have been achieved using the altered 3D bioprinter where a 3D hydrogel construct of two layers made of the combination of sodium alginate to gelatin (15%: 0.5%) has been printed. DLP 3D printer was used to design the syringe component with a transparent PLA-Pro resin for the creation of a microfluidics system having two channels altered to the double extruder. The hydrogel extruder’s design was based on peristaltic pumps, which utilized a stepper motor. The design and fabrication were made using DIY-3D printed parts. Hard plastic PLA was the material utilized for printing. SEM was used to carry out the porous 3D construct imaging. Multiple physical and chemical tests were performed in order to ensure that the cell line was suitable for hosting. Fragaria plant was developed by suspending Fragaria’s cells from its leaves using the 3D bioprinter. Conclusion: 3D bioprinting is considered to be an emerging scientific field that can facilitate and improve many scientific tests and studies. Thus, having a 3D bioprinter in labs is considered to be an essential requirement. 3D bioprinters are very expensive; however, the fabrication of a 3D printer into a 3D bioprinter can lower the cost of the bioprinter. The 3D bioprinter implemented made use of peristaltic pumps instead of syringe-based pumps in order to extend the ability to print multiple types of materials and cells.

Keywords: scaffold, eco on chip, 3D bioprinter, DLP printer

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Authors: Andrew Cummings, Rhianne Boag, Sarah Bryson, Gordon Turner

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Packages designed for transport of radioactive material must satisfy rigorous safety regulations specified by the International Atomic Energy Agency (IAEA). Higher Activity Waste (HAW) transport packages have to maintain containment of their contents during normal and accident conditions of transport (NCT and ACT). To ensure containment criteria is satisfied these packages are required to be leak-tight in all transport conditions to meet allowable activity release rates. Package design safety reports are the safety cases that provide the claims, evidence and arguments to demonstrate that packages meet the regulations and once approved by the competent authority (in the UK this is the Office for Nuclear Regulation) a licence to transport radioactive material is issued for the package(s). The standard approach to demonstrating containment in the RWM transport safety case is set out in BS EN ISO 12807. In this document a method for measuring a leak rate from the package is explained by way of a small interspace test volume situated between two O-ring seals on the underside of the package lid. The interspace volume is pressurised and a pressure drop measured. A small interspace test volume makes the method more sensitive enabling the measurement of smaller leak rates. By ascertaining the activity of the contents, identifying a releasable fraction of material and by treating that fraction of material as a gas, allowable leak rates for NCT and ACT are calculated. The adherence to basic safety principles in ISO12807 is very pessimistic and current practice in the demonstration of transport safety, which is accepted by the UK regulator. It is UK government policy that management of HAW will be through geological disposal. It is proposed that the intermediate level waste be transported to the geological disposal facility (GDF) in large cuboid packages. This poses a challenge for containment demonstration because such packages will have long seals and therefore large interspace test volumes. There is also uncertainty on the releasable fraction of material within the package ullage space. This is because the waste may be in many different forms which makes it difficult to define the fraction of material released by the waste package. Additionally because of the large interspace test volume, measuring the calculated leak rates may not be achievable. For this reason a justification for a lower releasable fraction of material is sought. This paper considers the use of aerosol processes to reduce the releasable fraction for both NCT and ACT. It reviews the basic coagulation and removal processes and applies the dynamic aerosol balance equation. The proposed solution includes only the most well understood physical processes namely; Brownian coagulation and gravitational settling. Other processes have been eliminated either on the basis that they would serve to reduce the release to the environment further (pessimistically in keeping with the essence of nuclear transport safety cases) or that they are not credible in the conditions of transport considered.

Keywords: aerosol processes, Brownian coagulation, gravitational settling, transport regulations

Procedia PDF Downloads 100

Authors: Pamela Chia, Tay Yoong Chuan

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Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.

Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery

Procedia PDF Downloads 190

Authors: Robert H. Bradley

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Many minority adolescents in the United States live in adverse circumstances that pose long-term threats to their well-being. A strong sense of personal control and self-efficacy can help youth mitigate some of those risks and may help protect youth from influences connected with deviant peer groups. Accordingly, it is important to identify conditions that help foster feelings of efficacy in areas that seem critical for the accomplishment of developmental tasks during adolescence. The purpose of this study is to examine two aspects of the home environment (modeling and encouragement of maturity, family companionship and investment) and their relation to three components of self efficacy (self efficacy in enlisting social resources, self efficacy for engaging in independent learning, and self-efficacy for self-regulatory behavior) in three groups of minority adolescents (Native American, African American, Latino). The sample for this study included 54 Native American, 131 African American, and 159 Latino families, each with a child between 16 and 20 years old. The families were recruited from four states: Arizona, Arkansas, California, and Oklahoma. Each family was administered the Late Adolescence version of the Home Observation for Measurement of the Environment (HOME) Inventory and each adolescent completed a 30-item measure of perceived self-efficacy. Three areas of self-efficacy beliefs were examined for this study: enlisting social resources, independent learning, and self-regulation. Each of the three areas of self-efficacy was regressed on the two aspects of the home environment plus overall household risk. For Native Americans, modeling and encouragement were significant for self-efficacy pertaining to enlisting social resources and independent learning. For African Americans, companionship and investment was significant in all three models. For Latinos, modeling and encouragement was significant for self-efficacy pertaining to enlisting social resources and companionship and investment were significant for the other two areas of self-efficacy. The findings show that even as minority adolescents are becoming more individuated from their parents, the quality of experiences at home continues to be associated with their feelings of self-efficacy in areas important for adaptive functioning in adult life. Specifically, individuals can develop a sense that they are efficacious in performing key tasks relevant to work, social relationships, and management of their own behavior if they are guided in how to deal with key challenges and they have been exposed and supported by others who are competent in dealing with such challenges. The findings presented in this study would seem useful given that there is so little current research on home environmental factors connected to self-efficacy beliefs among adolescents in the three groups examined. It would seem worthwhile that personnel from health, human service and juvenile justice agencies give attention to supporting parents in communicating with adolescents, offering expectations to adolescents in mutually supportive ways, and in engaging with adolescents in productive activities. In comparison to programs for parents of young children, there are few specifically designed for parents of children in middle childhood and adolescence.

Keywords: family companionship, home environment, household income, modeling, self-efficacy

Procedia PDF Downloads 220

Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

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Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

Procedia PDF Downloads 271

Authors: Ramiz M. Shubbar, Dong In Lee, Hatem A. Gzar, Arthur S. Rood

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Air pollution is one of the biggest environmental problems in Baghdad, Iraq. The Daura refinery located nearest the center of Baghdad, represents the largest industrial area, which transmits enormous amounts of pollutants, therefore study the gaseous pollutants and particulate matter are very important to the environment and the health of the workers in refinery and the people whom leaving in areas around the refinery. Actually, some studies investigated the studied area before, but it depended on the basic Gaussian equation in a simple computer programs, however, that kind of work at that time is very useful and important, but during the last two decades new largest production units were added to the Daura refinery such as, PU_3 (Power unit_3 (Boiler 11&12)), CDU_1 (Crude Distillation unit_70000 barrel_1), and CDU_2 (Crude Distillation unit_70000 barrel_2). Therefore, it is necessary to use new advanced model to study air pollution at the region for the new current years, and calculation the monthly emission rate of pollutants through actual amounts of fuel which consumed in production unit, this may be lead to accurate concentration values of pollutants and the behavior of dispersion or transport in study area. In this study to the best of author’s knowledge CALPUFF model was used and examined for first time in Iraq. CALPUFF is an advanced non-steady-state meteorological and air quality modeling system, was applied to investigate the pollutants concentration of SO2, NO2, CO, and PM1-10μm, at areas adjacent to Daura refinery which located in the center of Baghdad in Iraq. The CALPUFF modeling system includes three main components: CALMET is a diagnostic 3-dimensional meteorological model, CALPUFF (an air quality dispersion model), CALPOST is a post processing package, and an extensive set of preprocessing programs produced to interface the model to standard routinely available meteorological and geophysical datasets. The targets of this work are modeling and simulation the four pollutants (SO2, NO2, CO, and PM1-10μm) which emitted from Daura refinery within one year. Emission rates of these pollutants were calculated for twelve units includes thirty plants, and 35 stacks by using monthly average of the fuel amount consumption at this production units. Assess the performance of CALPUFF model in this study and detect if it is appropriate and get out predictions of good accuracy compared with available pollutants observation. CALPUFF model was investigated at three stability classes (stable, neutral, and unstable) to indicate the dispersion of the pollutants within deferent meteorological conditions. The simulation of the CALPUFF model showed the deferent kind of dispersion of these pollutants in this region depends on the stability conditions and the environment of the study area, monthly, and annual averages of pollutants were applied to view the dispersion of pollutants in the contour maps. High values of pollutants were noticed in this area, therefore this study recommends to more investigate and analyze of the pollutants, reducing the emission rate of pollutants by using modern techniques and natural gas, increasing the stack height of units, and increasing the exit gas velocity from stacks.

Keywords: CALPUFF, daura refinery, Iraq, pollutants

Procedia PDF Downloads 176

Authors: Neritan Shkodrani

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On November 26, 2019, an earthquake hit the central western part of Albania. It was assessed as Mw 6.4. Its epicenter was located offshore north western Durrës, about 7 km north of the city. In this paper, the consequences of settlements of very soft soils have been discussed for the case of a residential building, mentioned as “K Building”, which was suffering a significant tilting after the earthquake. “KBuilding” is an RC framed building having 12+1 (basement) storiesand a floor area of 21000 m2. The construction of the building was completed in 2012. “KBuilding”, located in Durres city, suffered severe non-structural damage during November 26, 2019, Durrës Earthquake sequences. During the in-site inspections immediately after the earthquake, the general condition of the buildings, the presence of observable settlements on the ground, and the crack situation in the structure were determined, and damage inspection were performed. It was significant to note that the “K Building” presented tilting that might be attributed, as it was believed at the beginning, partially to the failure of the columns of the ground floor and partially to liquefaction phenomena, but it did not collapse. At the first moment was not clear if the foundation had a bearing capacity failure or the foundation failed because of the soil liquefaction. Geotechnical soil investigations by using CPTU test were executed, and their data are usedto evaluatebearing capacity, consolidation settlement of the mat foundation, and soil liquefaction since they were believed to be the main reasons of this building tilting.Geotechnical soil investigation consist in 5 (five) Static Cone Penetration tests with pore pressure measurement (piezocone test). They reached a penetration depth of 20.0 m to 30.0 mand, clearly shown the presence of very soft and organic soils in the soil profile of the site. Geotechnical CPT based analysis of bearing capacity, consolidation, and secondary settlement are applied, and results are reported for each test. These results shown very small values of allowable bearing capacity and very high values of consolidation and secondary settlements. Liquefaction analysis based on the data of CPTU tests and the characteristics of ground shaking of the mentioned earthquake has shown the possibility of liquefaction for some layers of the considered soil profile, but the estimated vertical settlements are at a small range and clearly shown that the main reason of the building tilting was not related to the consequences of liquefaction, but was an existing settlement caused from the applied bearing pressure of this building. All the CPTU tests were carried out on August 2021, almost two years after the November 26, 2019, Durrës Earthquake and when the building itself was demolished. After removing the mat foundation on September 2021, it was possible to carry out CPTU tests even on the footprint of the existing building, which made possible to observe the effects of long time applied of foundation bearing pressure to the consolidation on the considered soil profile.

Keywords: bearing capacity, cone penetration test, consolidation settlement, secondary settlement, soil liquefaction, etc

Procedia PDF Downloads 86

Authors: Isobel M. Thompson, Dorian Audot, Dominic Hudson, Martin Warner, Joseph Banks

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Underwater fly kick is an essential skill in swimming, which can have a considerable impact upon overall race performance in competition, especially in sprint events. Reduced wave drags acting upon the body under the surface means that the underwater fly kick will potentially be the fastest the swimmer is travelling throughout the race. It is therefore critical to understand fly kicking techniques and determining biomechanical factors involved in the performance. Most previous studies assessing fly kick kinematics have focused on two-dimensional analysis; therefore, the three-dimensional elements of the underwater fly kick techniques are not well understood. Those studies that have investigated fly kicking techniques using three-dimensional methodologies have not reported full three-dimensional kinematics for the techniques observed, choosing to focus on one or two joints. There has not been a direct comparison completed on the results obtained using two-dimensional and three-dimensional analysis, and how these different approaches might affect the interpretation of subsequent results. The aim of this research is to quantify the differences in kinematics observed in underwater fly kicks obtained from both two and three-dimensional analyses of the same test conditions. In order to achieve this, a six-camera underwater Qualisys system was used to develop an experimental methodology suitable for assessing the kinematics of swimmer’s starts and turns. The cameras, capturing at a frequency of 100Hz, were arranged along the side of the pool spaced equally up to 20m creating a capture volume of 7m x 2m x 1.5m. Within the measurement volume, error levels were estimated at 0.8%. Prior to pool trials, participants completed a landside calibration in order to define joint center locations, as certain markers became occluded once the swimmer assumed the underwater fly kick position in the pool. Thirty-four reflective markers were placed on key anatomical landmarks, 9 of which were then removed for the pool-based trials. The fly-kick swimming conditions included in the analysis are as follows: maximum effort prone, 100m pace prone, 200m pace prone, 400m pace prone, and maximum pace supine. All trials were completed from a push start to 15m to ensure consistent kick cycles were captured. Both two-dimensional and three-dimensional kinematics are calculated from joint locations, and the results are compared. Key variables reported include kick frequency and kick amplitude, as well as full angular kinematics of the lower body. Key differences in these variables obtained from two-dimensional and three-dimensional analysis are identified. Internal rotation (up to 15º) and external rotation (up to -28º) were observed using three-dimensional methods. Abduction (5º) and adduction (15º) were also reported. These motions are not observed in the two-dimensional analysis. Results also give an indication of different techniques adopted by swimmers at various paces and orientations. The results of this research provide evidence of the strengths of both two dimensional and three dimensional motion capture methods in underwater fly kick, highlighting limitations which could affect the interpretation of results from both methods.

Keywords: swimming, underwater fly kick, performance, motion capture

Procedia PDF Downloads 113

Authors: Te Kīpa Kēpa B. Morgan, Oliver W. Mcmillan, Dylan N. Taute, Tumanako N. Fa'aui

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Epistemologies are ways of knowing. Indigenous Peoples are aware that they do not perceive and experience the world in the same way as others. So it is important when empowering Indigenous epistemologies, such as that of the New Zealand Māori, to also be able to represent a scientific understanding within the same analysis. A geothermal development assessment tool has been developed by adapting the Mauri Model Decision Making Framework. Mauri is a metric that is capable of representing the change in the life-supporting capacity of things and collections of things. The Mauri Model is a method of grouping mauri indicators as dimension averages in order to allow holistic assessment and also to conduct sensitivity analyses for the effect of worldview bias. R-shiny is the coding platform used for this Vision Mātauranga research which has created an expert decision support tool (DST) that combines a stakeholder assessment of worldview bias with an impact assessment of mauri-based indicators to determine the sustainability of proposed geothermal development. The initial intention was to develop guidelines for quantifying mātauranga Māori impacts related to geothermal resources. To do this, three typical scenarios were considered: a resource owner wishing to assess the potential for new geothermal development; another party wishing to assess the environmental and cultural impacts of the proposed development; an assessment that focuses on the holistic sustainability of the resource, including its surface features. Indicator sets and measurement thresholds were developed that are considered necessary considerations for each assessment context and these have been grouped to represent four mauri dimensions that mirror the four well-being criteria used for resource management in Aotearoa, New Zealand. Two case studies have been conducted to test the DST suitability for quantifying mātauranga Māori and other biophysical factors related to a geothermal system. This involved estimating mauri0meter values for physical features such as temperature, flow rate, frequency, colour, and developing indicators to also quantify qualitative observations about the geothermal system made by Māori. A retrospective analysis has then been conducted to verify different understandings of the geothermal system. The case studies found that the expert DST is useful for geothermal development assessment, especially where hapū (indigenous sub-tribal grouping) are conflicted regarding the benefits and disadvantages of their’ and others’ geothermal developments. These results have been supplemented with evaluations for the cumulative impacts of geothermal developments experienced by different parties using integration techniques applied to the time history curve of the expert DST worldview bias weighted plotted against the mauri0meter score. Cumulative impacts represent the change in resilience or potential of geothermal systems, which directly assists with the holistic interpretation of change from an Indigenous Peoples’ perspective.

Keywords: decision support tool, holistic geothermal assessment, indigenous knowledge, mauri model decision-making framework

Procedia PDF Downloads 168

Authors: Eiji Nakamachi, Ryota Sakiyama, Koji Yamamoto, Yusuke Morita, Hidetoshi Sakamoto

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The regeneration of injured central nerve network caused by the cerebrovascular accidents is difficult, because of poor regeneration capability of central nerve system composed of the brain and the spinal cord. Recently, new regeneration methods such as transplant of nerve cells and supply of nerve nutritional factor were proposed and examined. However, there still remain many problems with the canceration of engrafted cells and so on and it is strongly required to establish an efficacious treating method of a central nerve system. Blackman proposed the electromagnetic stimulation method to enhance the axonal nerve extension. In this study, we try to design and fabricate a new three-dimensional (3D) bio-reactor, which can load a uniform AC magnetic field stimulation on PC12 cells in the extracellular environment for enhancement of an axonal nerve extension and 3D nerve network generation. Simultaneously, we measure the morphology of PC12 cell bodies, axons, and dendrites by the multiphoton excitation fluorescence microscope (MPM) and evaluate the effectiveness of the uniform AC magnetic stimulation to enhance the axonal nerve extension. Firstly, we designed and fabricated the uniform AC magnetic field stimulation bio-reactor. For the AC magnetic stimulation system, we used the laminated silicon steel sheets for a yoke structure of 3D chamber, which had a high magnetic permeability. Next, we adopted the pole piece structure and installed similar specification coils on both sides of the yoke. We searched an optimum pole piece structure using the magnetic field finite element (FE) analyses and the response surface methodology. We confirmed that the optimum 3D chamber structure showed a uniform magnetic flux density in the PC12 cell culture area by using FE analysis. Then, we fabricated the uniform AC magnetic field stimulation bio-reactor by adopting analytically determined specifications, such as the size of chamber and electromagnetic conditions. We confirmed that measurement results of magnetic field in the chamber showed a good agreement with FE results. Secondly, we fabricated a dish, which set inside the uniform AC magnetic field stimulation of bio-reactor. PC12 cells were disseminated with collagen gel and could be 3D cultured in the dish. The collagen gel were poured in the dish. The collagen gel, which had a disk shape of 6 mm diameter and 3mm height, was set on the membrane filter, which was located at 4 mm height from the bottom of dish. The disk was full filled with the culture medium inside the dish. Finally, we evaluated the effectiveness of the uniform AC magnetic field stimulation to enhance the nurve axonal extension. We confirmed that a 6.8 increase in the average axonal extension length of PC12 under the uniform AC magnetic field stimulation at 7 days culture in our bio-reactor, and a 24.7 increase in the maximum axonal extension length. Further, we confirmed that a 60 increase in the number of dendrites of PC12 under the uniform AC magnetic field stimulation. Finally, we confirm the availability of our uniform AC magnetic stimulation bio-reactor for the nerve axonal extension and the nerve network generation.

Keywords: nerve regeneration, axonal extension , PC12 cell, magnetic field, three-dimensional bio-reactor

Procedia PDF Downloads 152

Authors: Patrick Cormier, Cesar Meylan, Matt Jensen, Dana Agar-Newman, Chloe Werle, Ming-Chang Tsai, Marc Klimstra

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Sprint-derived horizontal force-velocity-power (FVP) profiles can be developed with adequate validity and reliability with satellite (GPS/GNSS) systems. However, FVP metrics are sensitive to small nuances in data processing procedures such that minor differences in defining the onset and end of the sprint could result in different FVP metric outcomes. Furthermore, in team-sports, there is a requirement for rapid analysis and feedback of results from multiple athletes, therefore developing standardized and automated methods to improve the speed, efficiency and reliability of this process are warranted. Thus, the purpose of this study was to compare different methods of sprint end detection on the development of FVP profiles from 10Hz GPS/GNSS data through goodness-of-fit and intertrial reliability statistics. Seventeen national team female soccer players participated in the FVP protocol which consisted of 2x40m maximal sprints performed towards the end of a soccer specific warm-up in a training session (1020 hPa, wind = 0, temperature = 30°C) on an open grass field. Each player wore a 10Hz Catapult system unit (Vector S7, Catapult Innovations) inserted in a vest in a pouch between the scapulae. All data were analyzed following common procedures. Variables computed and assessed were the model parameters, estimated maximal sprint speed (MSS) and the acceleration constant τ, in addition to horizontal relative force (F₀), velocity at zero (V₀), and relative mechanical power (Pmax). The onset of the sprints was standardized with an acceleration threshold of 0.1 m/s². The sprint end detection methods were: 1. Time when peak velocity (MSS) was achieved (zero acceleration), 2. Time after peak velocity drops by -0.4 m/s, 3. Time after peak velocity drops by -0.6 m/s, and 4. When the integrated distance from the GPS/GNSS signal achieves 40-m. Goodness-of-fit of each sprint end detection method was determined using the residual sum of squares (RSS) to demonstrate the error of the FVP modeling with the sprint data from the GPS/GNSS system. Inter-trial reliability (from 2 trials) was assessed utilizing intraclass correlation coefficients (ICC). For goodness-of-fit results, the end detection technique that used the time when peak velocity was achieved (zero acceleration) had the lowest RSS values, followed by -0.4 and -0.6 velocity decay, and 40-m end had the highest RSS values. For intertrial reliability, the end of sprint detection techniques that were defined as the time at (method 1) or shortly after (method 2 and 3) when MSS was achieved had very large to near perfect ICC and the time at the 40 m integrated distance (method 4) had large to very large ICCs. Peak velocity was reached at 29.52 ± 4.02-m. Therefore, sport scientists should implement end of sprint detection either when peak velocity is determined or shortly after to improve goodness of fit to achieve reliable between trial FVP profile metrics. Although, more robust processing and modeling procedures should be developed in future research to improve sprint model fitting. This protocol was seamlessly integrated into the usual training which shows promise for sprint monitoring in the field with this technology.

Keywords: automated, biomechanics, team-sports, sprint

Procedia PDF Downloads 101

Authors: Mohamed Habireche, Nacer E. Bacha, Mohamed Djeghdjough

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In the brick industry, smooth double roll crusher is used for medium and fine crushing of soft to medium hard material. Due to opposite inward rotation of the rolls, the feed material is nipped between the rolls and crushed by compression. They are subject to intense wear, known as three-body abrasion, due to the action of abrasive products. The production downtime affecting productivity stems from two sources: the bi-monthly rectification of the roll crushers and their replacement when they are completely worn out. Choosing the right material for the roll crushers should result in longer machine cycles, and reduced repair and maintenance costs. All roll crushers are imported from outside Algeria. This results in sometimes very long delivery times which handicap the brickyards, in particular in respecting delivery times and honored the orders made by customers. The aim of this work is to investigate the effect of alloying additions on microstructure and wear behavior of grey lamellar cast iron for smooth roll crushers in brick industry. The base gray iron was melted in an induction furnace with low frequency at a temperature of 1500 °C, in which return cast iron scrap, new cast iron ingot, and steel scrap were added to the melt to generate the desired composition. The chemical analysis of the bar samples was carried out using Emission Spectrometer Systems PV 8050 Series (Philips) except for the carbon, for which a carbon/sulphur analyser Elementrac CS-i was used. Unetched microstructure was used to evaluate the graphite flake morphology using the image comparison measurement method. At least five different fields were selected for quantitative estimation of phase constituents. The samples were observed under X100 magnification with a Zeiss Axiover T40 MAT optical microscope equipped with a digital camera. SEM microscope equipped with EDS was used to characterize the phases present in the microstructure. The hardness (750 kg load, 5mm diameter ball) was measured with a Brinell testing machine for both treated and as-solidified condition test pieces. The test bars were used for tensile strength and metallographic evaluations. Mechanical properties were evaluated using tensile specimens made as per ASTM E8 standards. Two specimens were tested for each alloy. From each rod, a test piece was made for the tensile test. The results showed that the quenched and tempered alloys had best wear resistance at 400 °C for alloyed grey cast iron (containing 0.62%Mn, 0.68%Cr, and 1.09% Cu) due to fine carbides in the tempered matrix. In quenched and tempered condition, increasing Cu content in cast irons improved its wear resistance moderately. Combined addition of Cu and Cr increases hardness and wear resistance for a quenched and tempered hypoeutectic grey cast iron.

Keywords: casting, cast iron, microstructure, heat treating

Procedia PDF Downloads 87

Authors: Dan Kanmegne

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Africa will become the most populated continent by the end of the century, with around 4 billion inhabitants. Food security and climate changes will become continental issues since agricultural practices depend on climate but also contribute to global emissions and land degradation. Agroforestry has been identified as a cost-efficient and reliable strategy to address these two issues. It is defined as the integrated management of trees and crops/animals in the same land unit. Agroforestry provides benefits in terms of goods (fruits, medicine, wood, etc.) and services (windbreaks, fertility, etc.), and is acknowledged to have a great potential for carbon sequestration; therefore it can be integrated into reduction mechanisms of carbon emissions. Particularly in sub-Saharan Africa, the constraint stands in the lack of information about both areas under agroforestry and the characterization (composition, structure, and management) of each agroforestry system at the country level. This study describes and quantifies “what is where?”, earliest to the quantification of carbon stock in different systems. Remote sensing (RS) is the most efficient approach to map such a dynamic technology as agroforestry since it gives relatively adequate and consistent information over a large area at nearly no cost. RS data fulfill the good practice guidelines of the Intergovernmental Panel On Climate Change (IPCC) that is to be used in carbon estimation. Satellite data are getting more and more accessible, and the archives are growing exponentially. To retrieve useful information to support decision-making out of this large amount of data, satellite data needs to be organized so to ensure fast processing, quick accessibility, and ease of use. A new solution is a data cube, which can be understood as a multi-dimensional stack (space, time, data type) of spatially aligned pixels and used for efficient access and analysis. A data cube for Burkina Faso has been set up from the cooperation project between the international service provider WASCAL and Germany, which provides an accessible exploitation architecture of multi-temporal satellite data. The aim of this study is to map and characterize agroforestry systems using the Burkina Faso earth observation data cube. The approach in its initial stage is based on an unsupervised image classification of a normalized difference vegetation index (NDVI) time series from 2010 to 2018, to stratify the country based on the vegetation. Fifteen strata were identified, and four samples per location were randomly assigned to define the sampling units. For safety reasons, the northern part will not be part of the fieldwork. A total of 52 locations will be visited by the end of the dry season in February-March 2020. The field campaigns will consist of identifying and describing different agroforestry systems and qualitative interviews. A multi-temporal supervised image classification will be done with a random forest algorithm, and the field data will be used for both training the algorithm and accuracy assessment. The expected outputs are (i) map(s) of agroforestry dynamics, (ii) characteristics of different systems (main species, management, area, etc.); (iii) assessment report of Burkina Faso data cube.

Keywords: agroforestry systems, Burkina Faso, earth observation data cube, multi-temporal image classification

Procedia PDF Downloads 122

Authors: Malek Mahmoudi, Jonas Keruckas, Dmytro Volyniuk, Jurate Simokaitiene, Juozas V. Grazulevicius

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Host materials have been discovered as one of the most appealing methods for harvesting triplet states in organic materials for application in organic light-emitting diodes (OLEDs). The ideal host-guest system for emission in thermally delayed fluorescence OLEDs with 20% guest concentration for efficient energy transfer has been demonstrated in the present investigation. In this work, 3,3'-bis[9-(4-fluorophenyl) carbazole] (bFPC) has been used as the host, which induces balanced charge carrier transport for high-efficiency OLEDs.For providing a complete characterization of the synthesized compound, photophysical, photoelectrical, charge-transporting, and electrochemical properties of the compound have been examined. Excited-state lifetimes and singlet-triplet energy gaps were measured for characterization of photophysical properties, while thermogravimetric analysis, as well as differential scanning calorimetry measurements, were performed for probing of electrochemical and thermal properties of the compound. The electrochemical properties of this compound were investigated by cyclic voltammetry (CV) method, and ionization potential (IPCV) value of 5.68 eV was observed. UV–Vis absorption and photoluminescence spectrum of a solution of the compound in toluene (10-5 M) showed maxima at 302 and 405 nm, respectively. Photoelectron emission spectrometry was used for the characterization of charge-injection properties of the studied compound in solid. The ionization potential of this material was found to be 5.78 eV, and time-of-flight measurement was used for testing charge-transporting properties and hole mobility estimated using this technique in a vacuum-deposited layer reached 4×10-4 cm2 V-1s-1. Since the compound with high charge mobilities was tested as a host in an organic light-emitting diode. The device was fabricated by successive deposition onto a pre-cleaned indium tin oxide (ITO) coated glass substrate under a vacuum of 10-6 Torr and consisting of an indium-tin-oxide anode, hole injection and transporting layer(MoO3, NPB), emitting layer with bFPC as a host and 4CzIPN (2,4,5,6-tetra(9-carbazolyl)isophthalonitrile) which is a new highly efficient green thermally activated delayed fluorescence (TADF) material as an emitter, an electron transporting layer(TPBi) and lithium fluoride layer topped with aluminum layer as a cathode exhibited the highest maximum current efficiency and power efficiency of 33.9 cd/A and 23.5 lm/W, respectively and the electroluminescence spectrum showed only a peak at 512nm. Furthermore, the new bicarbazole-based compound was tested as a host in thermally activated delayed fluorescence organic light-emitting diodes are reaching luminance of 25300 cd m-2 and external quantum efficiency of 10.1%. Interestingly, the turn-on voltage was low enough (3.8 V), and such a device can be used for highly efficient light sources.

Keywords: thermally-activated delayed fluorescence, host material, ionization energy, charge mobility, electroluminescence

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Authors: Rajender Dahiya

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Investigation outcomes of major process incidents have been consistent for decades and validate that the causes and consequences are often identical. The debate remains as we continue to experience similar process incidents even with enormous development of new tools, technologies, industry standards, codes, regulations, and learning processes? The objective of this paper is to investigate the most common causes of major industrial incidents and reveal industry challenges and best practices to prevent such incidents. The author, in his current role, performs audits and inspections of a variety of high-hazard industries in North America, including petroleum refineries, chemicals, petrochemicals, manufacturing, etc. In this paper, he shares real life scenarios, examples, and case studies from high hazards operating facilities including key challenges and best practices. This case study will provide a clear understanding of the importance of near miss incident investigation. The incident was a Safe operating limit excursion. The case describes the deficiencies in management programs, the competency of employees, and the culture of the corporation that includes hazard identification and risk assessment, maintaining the integrity of safety-critical equipment, operating discipline, learning from process safety near misses, process safety competency, process safety culture, audits, and performance measurement. Failure to identify the hazards and manage the risks of highly hazardous materials and processes is one of the primary root-causes of an incident, and failure to learn from past incidents is the leading cause of the recurrence of incidents. Several investigations of major incidents discovered that each showed several warning signs before occurring, and most importantly, all were preventable. The author will discuss why preventable incidents were not prevented and review the mutual causes of learning failures from past major incidents. The leading causes of past incidents are summarized below. Management failure to identify the hazard and/or mitigate the risk of hazardous processes or materials. This process starts early in the project stage and continues throughout the life cycle of the facility. For example, a poorly done hazard study such as HAZID, PHA, or LOPA is one of the leading causes of the failure. If this step is performed correctly, then the next potential cause is. Management failure to maintain the integrity of safety critical systems and equipment. In most of the incidents, mechanical integrity of the critical equipment was not maintained, safety barriers were either bypassed, disabled, or not maintained. The third major cause is Management failure to learn and/or apply learning from the past incidents. There were several precursors before those incidents. These precursors were either ignored altogether or not taken seriously. This paper will conclude by sharing how a well-implemented operating management system, good process safety culture, and competent leaders and staff contributed to managing the risks to prevent major incidents.

Keywords: incident investigation, risk management, loss prevention, process safety, accident prevention

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Authors: Elissandro Voigt Beier, Cristiano Poleto

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The main objective of the research is to assess the loss through the quantification of material culture (archaeological fragments) in rural areas, sites explored economically by machining on seasonal crops, and also permanent, in a hydrographic subsystem Camaquã River in the state of Rio Grande do Sul, Brazil. The study area consists of different micro basins and differs in area, ranging between 1,000 m² and 10,000 m², respectively the largest and the smallest, all with a large number of occurrences and outcrop locations of archaeological material and high density in intense farm environment. In the first stage of the research aimed to identify the dispersion of points of archaeological material through field survey through plot points by the Global Positioning System (GPS), within each river basin, was made use of concise bibliography on the topic in the region, helping theoretically in understanding the old landscaping with preferences of occupation for reasons of ancient historical people through the settlements relating to the practice observed in the field. The mapping was followed by the cartographic development in the region through the development of cartographic products of the land elevation, consequently were created cartographic products were to contribute to the understanding of the distribution of the absolute materials; the definition and scope of the material dispersed; and as a result of human activities the development of revolving letter by mechanization of in situ material, it was also necessary for the preparation of materials found density maps, linking natural environments conducive to ancient historical occupation with the current human occupation. The third stage of the project it is for the systematic collection of archaeological material without alteration or interference in the subsurface of the indigenous settlements, thus, the material was prepared and treated in the laboratory to remove soil excesses, cleaning through previous communication methodology, measurement and quantification. Approximately 15,000 were identified archaeological fragments belonging to different periods of ancient history of the region, all collected outside of its environmental and historical context and it also has quite changed and modified. The material was identified and cataloged considering features such as object weight, size, type of material (lithic, ceramic, bone, Historical porcelain and their true association with the ancient history) and it was disregarded its principles as individual lithology of the object and functionality same. As observed preliminary results, we can point out the change of materials by heavy mechanization and consequent soil disturbance processes, and these processes generate loading of archaeological materials. Therefore, as a next step will be sought, an estimate of potential losses through a mathematical model. It is expected by this process, to reach a reliable model of high accuracy which can be applied to an archeological site of lower density without encountering a significant error.

Keywords: degradation of heritage, quantification in archaeology, watershed, use and occupation of land

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Authors: Ruijia Hu, Susanna T.Y. Tong

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Light detection and ranging (LiDAR) and four-channel red, green, blue, and near-infrared (RGBI) remote sensed imageries allow an accurate quantification and contiguous measurement of vegetation characteristics and forest structures. This information facilitates the generation of habitat structure variables for forest species distribution modelling. However, applications of remote sensing data, especially the combination of structural and spectral information, to support evidence-based decisions in forest managements and conservation practices at local scale are not widely adopted. In this study, we examined the habitat requirements of pileated woodpecker (Dryocopus pileatus) (PW) in Hamilton County, Ohio, using ecologically relevant forest structural and vegetation characteristics derived from LiDAR and RGBI data. We hypothesized that the habitat of PW is shaped by vegetation characteristics that are directly associated with the availability of food, hiding and nesting resources, the spatial arrangement of habitat patches within home range, as well as proximity to water sources. We used 186 PW presence or absence locations to model their presence and absence in generalized additive model (GAM) at two scales, representing foraging and home range size, respectively. The results confirm PW’s preference for tall and large mature stands with structural complexity, typical of late-successional or old-growth forests. Besides, the crown size of dead trees shows a positive relationship with PW occurrence, therefore indicating the importance of declining living trees or early-stage dead trees within PW home range. These locations are preferred by PW for nest cavity excavation as it attempts to balance the ease of excavation and tree security. In addition, we found that PW can adjust its travel distance to the nearest water resource, suggesting that habitat fragmentation can have certain impacts on PW. Based on our findings, we recommend that forest managers should use different priorities to manage nesting, roosting, and feeding habitats. Particularly, when devising forest management and hazard tree removal plans, one needs to consider retaining enough cavity trees within high-quality PW habitat. By mapping PW habitat suitability for the study area, we highlight the importance of riparian corridor in facilitating PW to adjust to the fragmented urban landscape. Indeed, habitat improvement for PW in the study area could be achieved by conserving riparian corridors and promoting riparian forest succession along major rivers in Hamilton County.

Keywords: deadwood detection, generalized additive model, individual tree crown delineation, LiDAR, pileated woodpecker, RGBI aerial imagery, species distribution models

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Authors: Liam Fassam, Pouria Liravi, Jacquie Bridgman

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Introduction: The way we travel is rapidly changing, car ownership and use are declining among young people and those residents in urban areas. Also, the increasing role and popularity of sharing economy companies like Uber highlight a movement towards consuming transportation solutions as a service [Mobility of a Service]. This research looks to bridge the knowledge gap that exists between city mobility, smart cities, sharing economy and social entrepreneurship business models. Understanding of this subject is crucial for smart city design, as access to affordable transport has been identified as a contributing factor to social isolation leading to issues around health and wellbeing. Methodology: To explore the current fit vis-a-vis transportation business models and social impact this research undertook a comparative analysis between a systematic literature review and a Delphi study. The systematic literature review was undertaken to gain an appreciation of the current academic thinking on ‘social entrepreneurship and smart city mobility’. The second phase of the research initiated a Delphi study across a group of 22 participants to review future opinion on ‘how social entrepreneurship can assist city mobility sharing models?’. The Delphi delivered an initial 220 results, which once cross-checked for duplication resulted in 130. These 130 answers were sent back to participants to score importance against a 5-point LIKERT scale, enabling a top 10 listing of areas for shared user transports in society to be gleaned. One further round (4) identified no change in the coefficient of variant thus no further rounds were required. Findings: Initial results of the literature review returned 1,021 journals using the search criteria ‘social entrepreneurship and smart city mobility’. Filtering allied to ‘peer review’, ‘date’, ‘region’ and ‘Chartered associated of business school’ ranking proffered a resultant journal list of 75. Of these, 58 focused on smart city design, 9 on social enterprise in cityscapes, 6 relating to smart city network design and 3 on social impact, with no journals purporting the need for social entrepreneurship to be allied to city mobility. The future inclusion factors from the Delphi expert panel indicated that smart cities needed to include shared economy models in their strategies. Furthermore, social isolation born by costs of infrastructure needed addressing through holistic A-political social enterprise models, and a better understanding of social benefit measurement is needed. Conclusion: In investigating the collaboration between key public transportation stakeholders, a theoretical model of social enterprise transportation models that positively impact upon the smart city needs of reduced transport poverty and social isolation was formed. As such, the research has identified how a revised business model of Mobility of a Service allied to a social entrepreneurship can deliver impactful measured social benefits associated to smart city design existent research.

Keywords: social enterprise, collaborative transportation, new models of ownership, transport social impact

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Authors: Fatma Refaat Ahmed, PhD, RN. Assistant Professor, Department of Nursing, College of Health Sciences, University of Sharjah, UAE. ([email protected]). Sally Mohamed Farghaly, Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt. ([email protected])

Abstract:

Context: Intensive care unit (ICU) nurses often face pressure and constraints in their work, leading to the rationing of care when demands exceed available time and resources. Observations suggest that ICU nurses are frequently distracted from their core nursing roles by non-core tasks. This study aims to provide evidence on ICU nurses' multitasking activities and explore the association between nurses' personal and clinical characteristics and their time allocation. Research Aim: The aim of this study is to quantify the time spent by ICU nurses on multitasking activities and investigate the relationship between their personal and clinical characteristics and time allocation. Methodology: A self-observation form utilizing the "Diary" recording method was used to record the number of tasks performed by ICU nurses and the time allocated to each task category. Nurses also reported on the distractions encountered during their nursing activities. A convenience sample of 60 ICU nurses participated in the study, with each nurse observed for one nursing shift (6 hours), amounting to a total of 360 hours. The study was conducted in two ICUs within a university teaching hospital in Alexandria, Egypt. Findings: The results showed that ICU nurses completed 2,730 direct patient-related tasks and 1,037 indirect tasks during the 360-hour observation period. Nurses spent an average of 33.65 minutes on ventilator care-related tasks, 14.88 minutes on tube care-related tasks, and 10.77 minutes on inpatient care-related tasks. Additionally, nurses spent an average of 17.70 minutes on indirect care tasks per hour. The study identified correlations between nursing time and nurses' personal and clinical characteristics. Theoretical Importance: This study contributes to the existing research on ICU nurses' multitasking activities and their relationship with personal and clinical characteristics. The findings shed light on the significant time spent by ICU nurses on direct care for mechanically ventilated patients and the distractions that require attention from ICU managers. Data Collection: Data were collected using self-observation forms completed by participating ICU nurses. The forms recorded the number of tasks performed, the time allocated to each task category, and any distractions encountered during nursing activities. Analysis Procedures: The collected data were analyzed to quantify the time spent on different tasks by ICU nurses. Correlations were also examined between nursing time and nurses' personal and clinical characteristics. Question Addressed: This study addressed the question of how ICU nurses allocate their time across multitasking activities and whether there is an association between nurses' personal and clinical characteristics and time allocation. Conclusion: The findings of this study emphasize the need for a lean evaluation of ICU nurses' activities to identify and address potential gaps in patient care and distractions. Implementing lean techniques can improve efficiency, safety, clinical outcomes, and satisfaction for both patients and nurses, ultimately enhancing the quality of care and organizational performance in the ICU setting.

Keywords: motion study, ICU nurse, lean, nursing time, multitasking activities

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