Search results for: center of pressure

Authors: S. Vignesh, N. Vishnu, S. Vigneshwaran, M. Vishnu Anand, Dinesh Kumar Babu, V. R. Sanal Kumar

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The study of the primary flow velocity and the self impinging secondary jet flow mixing is important from both the fundamental research and the application point of view. Real industrial configurations are more complex than simple shear layers present in idealized numerical thrust-vectoring models due to the presence of combustion, swirl and confinement. Predicting the flow features of self impinging secondary jets in a supersonic primary flow is complex owing to the fact that there are a large number of parameters involved. Earlier studies have been highlighted several key features of self impinging jets, but an extensive characterization in terms of jet interaction between supersonic flow and self impinging secondary sonic jets is still an active research topic. In this paper numerical studies have been carried out using a validated two-dimensional k-omega standard turbulence model for the design optimization of a thrust vector control system using shock induced self impinging secondary flow sonic jets using non-reacting flows. Efforts have been taken for examining the flow features of TVC system with various secondary jets at different divergent locations and jet impinging angles with the same inlet jet pressure and mass flow ratio. The results from the parametric studies reveal that in addition to the primary to the secondary mass flow ratio the characteristics of the self impinging secondary jets having bearing on an efficient thrust vectoring. We concluded that the self impinging secondary jet nozzles are better than single jet nozzle with the same secondary mass flow rate owing to the fact fixing of the self impinging secondary jet nozzles with proper jet angle could facilitate better thrust vectoring for any supersonic aerospace vehicle.

Keywords: fluidic thrust vectoring, rocket steering, supersonic to sonic jet interaction, TVC in aerospace vehicles

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Authors: Chan Eang Teng, Tang Mui Joo

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With the viral factor on social media, the sense of persuasion is generated by repetition and popularity. When users’ interest is captured, political awareness increases to spark political enthusiasm, but, the level of user’s political participation and political attitude of those active users is still questionable. An online survey on 250 youth and in-depth interview on two politicians are conducted to answer the main question in this paper. The result shows that Facebook significantly increases political awareness among youths. Social media may not be the major trigger to political activism among youths as most respondents opined that they would still vote without Facebook. Other factors could be political campaigning, political climate, age, peer pressure or others. Finding also shows that majority of respondents did not participate in online political debates or political groups. Many also wondered if the social media was the main power switch that triggers the political influx among young voters. The research finding is significant to understand how the new media, Facebook, has reshaped the political landscape in Malaysia, creating the Social Media Election that changed the rules of the political game. However, research finding does not support the ideal notion that the social media is the major trigger to youth’s political activism. This research outcome has exposed the flaws of the Social Media Election. It has revealed the less optimistic side of youth political activism. Unfortunately, results fall short of the idealistic belief that the social media have given rise to political activism among youths in the 13^th General Election in Malaysia. The research outcome also highlights an important lesson for the democratic discourse of Malaysia which is making informed and educated decisions takes more commitment, proactive and objective attitude.

Keywords: social media, political participation, political activism, democracy, political communication

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Authors: Athulya Jayakumar, M. Manjula

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Though there has been a shift in the understanding of homosexuality from being a sin, crime or pathology in the medical and legal perspectives, the acceptance of homosexuality still remains very scanty in the Indian subcontinent. The present case study is a 24-year-old female who has completed a diploma in polytechnic engineering and residing in the state of Kerala. She initially presented with her husband with complaints of lack of sexual desire and non-cooperation from the index client. After an initial few sessions, the client revealed, in an individual session, about her homosexual orientation which was unknown to her family. She has had multiple short-term relations with females and never had any heterosexual orientation/interest. During her adolescence, she was wondering if she could change herself into a male. However, currently, she accepts her gender. She never wanted a heterosexual marriage; but, had to succumb to the pressure of mother, as a result of a series of unexpected incidents at home and had to agree for the marriage, also with a hope that she may change herself into a bi-sexual. The client was able to bond with the husband emotionally but the multiple attempts at sexual intercourse, at the insistence of the husband, had always been non-pleasurable and induced a sense of disgust. Currently, for several months, there has not been any sexual activity. Also, she actively avoids any chance to have a warm communication with him so that she can avoid chances of him approaching her in a sexual manner. The case study is an attempt to highlight the culture and the struggles of a homosexual individual who comes to therapy for wanting to be a ‘normal wife’ despite having knowledge of legal rights and scenario. There is a scarcity of Indian literature that has systematically investigated issues related to homosexuality. Data on prevalence, emotional problems faced and clinical services available are sparse though it is crucial for increasing understanding of sexual behaviour, orientation and difficulties faced in India.

Keywords: case study, culture, cognitive behavior therapy, female homosexuality

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Authors: Mahmoud Moawad Mohamed Osman

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The Egyptian civilization was and still is an inspiration for many human civilizations and modern sciences. For this reason, there is still a passion for the ancient Egyptian civilization. Due to the breadth and abundance of the outputs of the ancient Egyptian civilization, many museums have been established that contribute to displaying and demonstrating the splendor of the ancient Egyptian civilization, and among those museums is the Grand Egyptian Museum (Egypt's gift to the whole world). The idea of establishing the Grand Egyptian Museum began in the nineties of the last century, and in 2002 the foundation stone was laid for the museum project to be built in a privileged location overlooking the eternal pyramids of Giza, where the Egyptian state was declared, and under the auspices of the United Nations Educational, Scientific and Cultural Organization (UNESCO) and the International Union of Architects. , for an international architectural competition for the best design for the museum. The current design submitted by Heneghan Peng Architects in Ireland won, and its design was based on the rays of the sun extending from the tops of the three pyramids when they meet to represent a conical mass, which is the Grand Egyptian Museum. The construction of the museum project began in May 2005, when the site was paved and prepared, and in 2006, the largest antiquities restoration center in the Middle East was established, dedicated to the restoration, preservation, maintenance and rehabilitation of the antiquities scheduled to be displayed in the museum halls, which was opened in 2010. The construction of the museum building, which has an area of more than 300,000 square meters, was completed during the year 2021, and includes a number of exhibition halls, each of which is considered larger than many current museums in Egypt and the world. The museum is considered one of the most important and greatest achievements of modern Egypt. It was created to be an integrated global civilizational, cultural and entertainment edifice, and to be the first destination for everyone interested in ancient Egyptian heritage, as the largest museum in the world that tells the story of the history of ancient Egyptian civilization, as it contains a large number of distinctive and unique artifacts, including the treasures of the golden king Tutankhamun, which... It is displayed for the first time in its entirety since the discovery of his tomb in November 1922, in addition to the collection of Queen Hetepheres, the guard of the mother of King Khufu, the builder of the Great Pyramid in Giza, as well as the Museum of King Khufu’s Boats, as well as various archaeological collectibles from the pre-dynastic era until the Greek and Roman eras.

Keywords: grand egyptian museum, egyptian civilization, education, museology

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Authors: O. Abramova, L. Abukova, A. Goreva, G. Isaeva

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The present work was made for the purpose of evaluating the interstitial water’s role in the mobilization of metal elements of clay deposits and occurrences in sedimentary formation in the hydro-geological basins. The experiments were performed by using a special facility, which allows adjusting the pressure, temperature, and the frequency of the acoustic vibrations. The dates for study were samples of the oil shales (Baltic career, O₂kk) and clay rocks, mainly montmorillonite composition (Borehole SG-12000, the depth of selection 1000–3600 m, the Azov-Kuban trough, N₁). After interstitial water squeezing from the rock samples, decrease in the original content of the rock forming components including trace metals V, Cr, Co, Ni, Cu, Zn, Zr, Mo, Pb, W, Ti, and others was recorded. The experiments made it possible to evaluate the ore elements output and organic matters with the interstitial waters. Calculations have shown that, in standard conditions, from each ton of the oil shales, 5-6 kg of ore elements and 9-10 kg of organic matter can be escaped. A quantity of matter, migrating from clays in the process of solidification, is changed depending on the lithogenesis stage: more recent unrealized deposits lose more ore and organic materials than the clay rocks, selected from depth over 3000 m. Each ton of clays in the depth interval 1000-1500 m is able to generate 3-5 kg of the ore elements and 6-8 kg of the organic matters. The interstitial waters are a freight forwarder over transferring these matters in the reservoir beds. It was concluded that the interstitial waters which escaped from the study samples are solutions with abnormal high concentrations of the metals and organic matters. In the discharge zones of the sediment basins, such fluids can create paragenetic associations of the sedimentary-catagenetic ore and hydrocarbon mineral resources accumulations.

Keywords: hydrocarbons, ore genesis, paragenesis, pore water

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Authors: Marvelyn F. Carolino, Charlene R. Cunanan, Gellien Faith O. Masongsong, Berlinda A. Ofrecio

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This study delves into the language usage differences among men, women, and individuals with other gender preferences. It specifically centers on the sociolinguistic aspects within the English majors at the College of Education of Rizal Technological University-Pasig, spanning from the first-year to fourth-year levels. The researchers employed a triangulation approach for data collection, utilizing a validated self-made questionnaire, interviews, and observations. The results revealed that language usage among different genders is influenced by a combination of cultural norms, social dynamics, and technological factors. Cultural norms significantly shape how respondents use language, as they conform to expected speech patterns based on their gender. Social factors, such as peer pressure, were found to impact language usage for individuals of all genders. This influence was viewed as constructive for personal development rather than inhibiting performance or communication. In terms of technological factors, respondents strongly agreed that the time spent on social media and educational applications influenced their language use. These platforms provided opportunities to expand and enhance their vocabulary. Additionally, the study employed hypothesis testing through the z-test formula to assess the impact of demographic profiles on language usage differences among genders. The results indicated that gender, economic status, locality, and ethnicity did not show statistically significant differences in language use. This lack of significant variation in findings was attributed to the relatively homogeneous demographic profile of respondents, primarily composed of females with low-income backgrounds and Tagalog ethnicity. This demographic similarity likely minimized the diversity of responses.

Keywords: gender, language, sociolinguistics, differences

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Authors: Seyed Ali Mahdipour, Maryam Shafeei Sarvestani

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Radiation pressure acceleration (RPA) and target normal sheath acceleration (TNSA) are the most important methods of Laser-accelerated proton beams (LAP) planning systems.LAP has inspired novel applications that can benefit from proton bunch properties different from conventionally accelerated proton beams. The secondary neutron and photon produced in the collision of protons with beamline components are of the important concern in proton therapy. Various published Monte Carlo researches evaluated the beamline and shielding considerations for TNSA method, but there is no studies directly address secondary neutron and photon production from RPA method in LAP. The purpose of this study is to calculate the flux distribution of neutron and photon secondary radiations on the first area ofLAP and to determine the optimize thickness and radius of the energyselector in a LAP planning system based on RPA method. Also, we present the Monte Carlo calculations to determine the appropriate beam pipe for shielding a LAP planning system. The GEANT4 Monte Carlo toolkit has been used to simulate a secondary radiation production in LAP. A section of new multifunctional LAP beamlinehas been proposed, based on the pulsed power solenoid scheme as a GEANT4 toolkit. The results show that the energy selector is the most important source of neutron and photon secondary particles in LAP beamline. According to the calculations, the pure Tungsten energy selector not be the proper case, and using of Tungsten+Polyethylene or Tungsten+Graphitecomposite selectors will reduce the production of neutron and photon intensities by approximately ~10% and ~25%, respectively. Also the optimal radiuses of energy selectors were found to be ~4 cm and ~6 cm for a 3 degree and 5 degree proton deviation angles, respectively.

Keywords: neutron, photon, flux distribution, energy selector, GEANT4 toolkit

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Authors: Pardis Abolghasemi, Benyamin Hatamsaz

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Background: Diabetic nephropathy is a serious health problem described by specific kidney structure and functional disturbance. Renoprotective effects of the stem cells secretase have been shown in many kidney diseases. The aim is to evaluate the capability of human Wharton’s jelly mesenchymal stem cells conditioned media (hWJMSCs-CM) to alleviate DN in streptozotocin (STZ)-induced diabetes. Methods: Diabetic nephropathy was induced by injection of STZ (60 mg/kg, IP) in twenty rats. Conditioned media was extracted from hWJMSCs at third passages. At week 8, diabetic rats were divided into two groups: treated (hWJMSCs-CM, 500 μl/rat for three weeks, IP) and not treated (DN). In the 11th week, three groups (control, DN and DN+hWJMSCs-CM) were kept in metabolic cages and urine was collected for 24h. Blood pressure (BP) and heart rate (HR) were continuously recorded. The serum samples were maintained for measuring BUN, Cr and angiotensin-converting enzyme (ACE) activity. The left kidney was kept at -80°C for ACE activity assessment. The right kidney and pancreas were used for histopathologic evaluation. Result: Diabetic nephropathy was detected by microalbuminuria and increased albumin/creatinine ratio, as well as the pancreas and renal structural disturbance. Glomerular filtration rate, BP and HR increased in the DN group. The ACE activity was elevated in the serum and kidneys of the DN group. Administration of hWJMSCs-CM modulated the renal functional and structural disturbance and decreased the ACE activity. Conclusion: Conditioned media was extracted from hWJMSCs may have a Renoprotective effect in diabetic nephropathy. This may happen through regulation of ACE activity and renin-angiotensin system inhibition.

Keywords: diabetic nephropathy, mesenchymal stem cells, immunomodulation, anti-inflammation

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Authors: Muhammad Zahid, Ilker S. Bayer, Athanassia Athanassiou

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Fluorinated polymers having C8 chemistry (chemicals with 8 fluorinated carbon atoms) are well renowned for their excellent low surface tension and water repelling properties. However, these polymers degrade into highly toxic heavy perfluoro acids in the environment. When the C8 chemistry is reduced to C6 chemistry, this environmental concern is eliminated at the expense of reduced liquid repellent performance. In order to circumvent this, in this study, we demonstrate pre-treatment of woven cotton fabrics with a fluorinated acrylic copolymer with C6 chemistry and subsequently with a silicone polymer to render them hydrophobic. A commercial fluorinated acrylic copolymer was blended with silica nanoparticles to form hydrophobic nano-roughness on cotton fibers and a second coating layer of polydimethylsiloxane (PDMS) was applied on the fabric. A static water contact angle (for 5µl) and rolling angle (for 12.5µl) of 147°±2° and 31° were observed, respectively. Hydrostatic head measurements were also performed to better understand the performance with 26±1 cm and 2.56kPa column height and static pressure respectively. Fabrication methods (with rod coater etc.) were kept simple, reproducible, and scalable and cost efficient. Moreover, the robustness of applied coatings was also evaluated by sonication cleaning and abrasion methods. Water contact angle (WCA), water shedding angle (WSA), hydrostatic head, droplet bouncing-rolling off and prolonged staining tests were used to characterize hydrophobicity of materials. For chemical and morphological analysis, various characterization methods were used such as attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), atomic force microscopy (AFM) and scanning electron microscopy (SEM).

Keywords: fluorinated polymer, hydrophobic, polydimethylsiloxane, water contact angle

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Authors: Foad Hassaninejadafarahani, Scott Ormiston

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Reflux condensation occurs in a vertical channels and tubes when there is an upward core flow of vapor (or gas-vapor mixture) and a downward flow of the liquid film. The understanding of this condensation configuration is crucial in the design of reflux condensers, distillation columns, and in loss-of-coolant safety analyses in nuclear power plant steam generators. The unique feature of this flow is the upward flow of the vapor-gas mixture (or pure vapor) that retards the liquid flow via shear at the liquid-mixture interface. The present model solves the full, elliptic governing equations in both the film and the gas-vapor core flow. The computational mesh is non-orthogonal and adapts dynamically the phase interface, thus produces sharp and accurate interface. Shear forces and heat and mass transfer at the interface are accounted for fundamentally. This modeling is a big step ahead of current capabilities by removing the limitations of previous reflux condensation models which inherently cannot account for the detailed local balances of shear, mass, and heat transfer at the interface. Discretisation has been done based on a finite volume method and a co-located variable storage scheme. An in-house computer code was developed to implement the numerical solution scheme. Detailed results are presented for laminar reflux condensation from steam-air mixtures flowing in vertical parallel plate channels. The results include velocity and pressure profiles, as well as axial variations of film thickness, Nusselt number and interface gas mass fraction.

Keywords: Reflux, Condensation, CFD-Two Phase, Nusselt number

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Authors: Kotomi Yamashita, Hiromi Kawasaki, Satoko Yamasaki, Susumu Fukita, Risako Sakai

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Lifestyle-related diseases develop from the long-term accumulation of health consequences from a poor lifestyle. Thus, schoolchildren, who have not accumulated long-term lifestyle habits, are believed to be at a lower risk for lifestyle-related diseases. However, schoolchildren rarely receive blood tests unless they are under treatment for a serious disease; without such data on their blood, the impacts of their young lifestyle could not be known. Blood data from physical measurements can help in the implementation of more effective health education. Therefore, we examined the correlation between body mass index (BMI) and blood sugar/serum lipid (BS/SL) levels. From 2014 to 2016, we measured the blood data of fourth-grade students living in a city in Japan. The present study reported on the results of 281 fourth-grade boys only (80.3% of total). We analyzed their BS/SL levels by comparing the blood data against the criteria of the National Center for Child Health and Development in Japan. Next, we examined the correlation between BMI and BS/SL levels. IBM SPSS Statistics for Windows, Version 25 was used for analysis. A total of 69 boys (24.6%) were within the normal range for BMI (18.5–24), whereas 193 (71.5%) and 8 boys (2.8%) had lower and higher BMI, respectively. Regarding BS levels, 280 boys were within the normal range (70–90 mg/dl); 1 boy reported a higher value. All the boys were within the normal range for glycated Hemoglobin (HbA1c) (4.6–6.2%). Regarding SL levels, 271 boys were within the normal range (125–230 mg/dl) for total cholesterol (TC), whereas 5 boys (1.8%) had lower and 5 boys (1.8%) had higher levels. A total of 243 boys (92.7%) were within the normal range (36-138mg/dL) for triglycerides (TG), whereas 19 boys (7.3%) had lower and 19 boys (7.3%) had higher levels. Regarding high-density lipoprotein cholesterol (HDL-C), 276 boys (98.2%) were within the normal range (40-mg/dl), whereas 5 boys (1.8%) reported lower values. All but one boy (280, 99.6%) were within the normal range (-170 mg/dl) for low-density lipoprotein cholesterol (LDL-C); the exception (0.4%) had a higher level. BMI and BS didn’t show a correlation. BMI and HbA1c were moderately positively correlated (r = 0.139, ｐ＝0.019). We also observed moderate positive correlations between BMI and TG (r = 0.328, p < 0.01), TC (r=0.239, p< 0.01), LDL-C (r = 0.324, p < 0.01), respectively. BMI and HDL-C were low correlated (r = -0.185, p = 0.002). Most of the boys were within the normal range for BS/SL levels. However, some boys exceeded the normal TG range. Fourth graders with a high TG may develop a lifestyle-related disease in the future. Given its relation to TG, food habits should be improved in this group. Our findings suggested a positive correlation between BMI and BS/SL levels. Fourth-grade schoolboys with a high BMI may be at high risk for developing lifestyle-related diseases. Lifestyle improvement may be recommended to lower the BS/SL levels in this group.

Keywords: blood sugar level, lifestyle-related diseases, school students, serum lipid level

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Authors: Rishabh Hans, Saksham Sharma

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Drying of a sessile droplet imbibed with colloidal solution is a complex process in many aspects. Till now, most of the work revolves around; conditions for buckling onset, post-buckling effects, nature of change of droplet shape etc. In this work, we are determining the shape of daughter cavity (DC) formed during post-buckling onset, a less explored stage, and its relationship with experimental parameters. We have introduced solid angle as a special parameter that can quantify the shape of DC at any instant. It facilitates us to compare the shape while experimenting across different substrate types, droplet sizes and particle concentration. Furthermore, the angular location of ‘weak spot’ on the periphery of droplet, which marks the initiation of cavity growth, varies in different conditions. To solve this problem, we have evaluated the deflection angle of weak spots w.r.t. the vertical axis going through the middle of droplet. Subsequently, the solid angle subtended by DC is analyzed about that inclined axis. Finally, results of analysis allude that increasing colloidal concentration has inverse effect on the growth rate of cavity’s shape. Moreover, the cap radius of DC is observed lower for high PLR which makes the capillary pressure higher and thus tougher to expedite cavity formation relatively. This analysis can be helpful in further studies to relate the shape, deflection angle, growth rate of daughter cavity to the type of droplet crust formed in the end. Examining DC stage shall add another layer to nano-colloidal research which aims to influence many industrial applications like patterning, coatings, drug delivery, food processing etc.

Keywords: buckling of sessile droplets, daughter cavity, droplet evaporation, nanoporous shell formation, solid angle

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Authors: Pornthip Seangsanga

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Sepsis or septic shock needs urgent care because it is a cause of the high mortality rate if patients do not receive timely treatment. Songkhla Hospital does not have a clear system or clinical practice guidelines for treatment of patients with severe sepsis or septic shock, which contributes to the said problem.To compare clinical outcomes based on the protocol after using the clinical guidelines between the Emergency Room, Intensive Care Unit, and the Ward. This quasi-experimental study was conducted on the population and 50 subjects who were diagnosed with severe sepsis or septic shock from December 2013 to May 2014. The data were collected using a nursing care and referring record form for patients with severe sepsis or septic shock at Songkhla Hospital. The record form had been tested for its validity by three experts, and the IOC was 1.The mortality rate in patients with severe sepsis or septic shock who were moved from the ER to the ICU was significantly lower than that of those patients moved from the Ward to the ICU within 48 hours. This was because patients with severe sepsis or septic shock who were moved from the ER to the ICU received more fluid within the first six hours according to the protocol which helped patients to have adequate tissue perfusion within the first six hours, and that helped improve blood flow to the kidneys, and the patients’ urine was found to be with a higher quantity of 0.5 cc/kg/hr, than those patients who were moved from the Ward to the ICU. This study shows that patients with severe sepsis or septic shock need to be treated immediately. Using the clinical practice guidelines along with timely diagnosis and treatment based on the sepsis bundle in giving sufficient and suitable amount of fluid to help improve blood circulation and blood pressure can clearly prevent or reduce severity of complications.

Keywords: clinical practice guidelines, caring, septic shock, sepsis bundle protocol

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Authors: Avoseh Funmilola, Osman Khalid, Wayne Nelson, Paramespri Naidoo, Deresh Ramjugernath

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The increasing global atmospheric temperature is of great concern and this has led to the development of technologies to reduce the emission of greenhouse gases into the atmosphere. Flue gas emissions from fossil fuel combustion are major sources of greenhouse gases. One of the ways to reduce the emission of CO₂ from flue gases is by post combustion capture process and this can be done by absorbing the gas into suitable chemical solvents before emitting the gas into the atmosphere. Alkanolamines are promising solvents for this capture process. Vapour liquid equilibrium of CO₂-alkanolamine systems is often represented by CO₂ loading and partial pressure of CO₂ without considering the liquid phase. The liquid phase of this system is a complex one comprising of 9 species. Online analysis of the process is important to monitor the concentrations of the liquid phase reacting and product species. Liquid phase analysis of CO₂-diethanolamine (DEA) solution was performed by attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy. A robust Calibration was performed for the CO₂-aqueous DEA system prior to an online monitoring experiment. The partial least square regression method was used for the analysis of the calibration spectra obtained. The models obtained were used for prediction of DEA and CO₂ concentrations in the online monitoring experiment. The experiment was performed with a newly built recirculating experimental set up in the laboratory. The set up consist of a 750 ml equilibrium cell and ATR-FTIR liquid flow cell. Measurements were performed at 400°C. The results obtained indicated that the FTIR spectroscopy combined with Partial least square method is an effective tool for online monitoring of speciation.

Keywords: ATR-FTIR, CO₂ capture, online analysis, PLS regression

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Authors: Somayeh Negahdari, Mohsen Ghanbarzadeh, Masoud Nikbakht, Heshmatolah Tavakol

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Asthma, obesity and overweight are the main factors causing change within the heart and respiratory airways. Asthma symptoms are normally observed during exercising. Epidemiological studies have indicated asthma symptoms occurring due to certain lifestyle habits; for example, a sedentary lifestyle. In this study, eight weeks of aerobic exercises resulted in a positive effect overall in overweight women experiencing mild chronic asthma. The quasi-experimental applied research has been done based on experimental and control groups. The experimental group (seven patients) and control group (n = 7) were graded before and after the test. According to the Borg dyspnea and fatigue Perception Index, the training intensity has determined. Participants in the study performed a sub-maximal aerobic activity schedule (45% to 80% of maximum heart rate) for two months, while the control group (n = 7) stayed away from aerobic exercise. Data evaluation and analysis of covariance compared both the pre-test and post-test with paired t-test at significance level of P≤ 0.05. After eight weeks of exercise, the results of the experimental group show a significant decrease in resting heart rate, systolic blood pressure, minute ventilation, while a significant increase in maximal oxygen uptake and tolerance activity (P ≤ 0.05). In the control group, there was no significant difference in these parameters ((P ≤ 0.05). The results indicate the aerobic activity can strengthen the respiratory muscles, while other physiological factors could result in breathing and heart recovery. Aerobic activity also resulted in favorable changes in cardiovascular parameters, and exercise tolerance of overweight women with chronic asthma.

Keywords: asthma, respiratory cardiac index, exercise tolerance, aerobic, overweight

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Authors: Ivana Scidà, Francesco Alotto, Anna Osello

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Due to the importance given today to innovation, the education sector is evolving thanks digital technologies. Virtual Reality (VR) can be a potential teaching tool offering many advantages in the field of training and education, as it allows to acquire theoretical knowledge and practical skills using an immersive experience in less time than the traditional educational process. These assumptions allow to lay the foundations for a new educational environment, involving and stimulating for students. Starting from the objective of strengthening the innovative teaching offer and the learning processes, the case study of the research concerns the digitalization of MastrLAB, High Quality Laboratory (HQL) belonging to the Department of Structural, Building and Geotechnical Engineering (DISEG) of the Polytechnic of Turin, a center specialized in experimental mechanical tests on traditional and innovative building materials and on the structures made with them. The MastrLAB-VR has been developed, a revolutionary innovative training tool designed with the aim of educating the class in total safety on the techniques of use of machinery, thus reducing the dangers arising from the performance of potentially dangerous activities. The virtual laboratory, dedicated to the students of the Building and Civil Engineering Courses of the Polytechnic of Turin, has been projected to simulate in an absolutely realistic way the experimental approach to the structural tests foreseen in their courses of study: from the tensile tests to the relaxation tests, from the steel qualification tests to the resilience tests on elements at environmental conditions or at characterizing temperatures. The research work proposes a methodology for the virtualization of technical laboratories through the application of Building Information Modelling (BIM), starting from the creation of a digital model. The process includes the creation of an independent application, which with Oculus Rift technology will allow the user to explore the environment and interact with objects through the use of joypads. The application has been tested in prototype way on volunteers, obtaining results related to the acquisition of the educational notions exposed in the experience through a virtual quiz with multiple answers, achieving an overall evaluation report. The results have shown that MastrLAB-VR is suitable for both beginners and experts and will be adopted experimentally for other laboratories of the University departments.

Keywords: building information modelling, digital learning, education, virtual laboratory, virtual reality

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Authors: Xia Luo, Cheng Zeng

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Under the promotion of the Central Committee of the Communist Party of China and the State Council in 2017, Xiong'an New Area is the third crucial new area in China established after Shenzhen and Shanghai. Its constructions' significance lies in mitigating Beijing's non-capital functions and exploring a new mode of optimizing development in densely populated and economically intensive areas. For this purpose, developing underground logistics can assume the role of goods distribution in the capital, relieve the road transport pressure in Beijing-Tianjin-Hebei Urban Agglomeration, adjust and optimize the urban layout and spatial structure of it. Firstly, the construction planning of Xiong'an New Area and underground logistics development are summarized, especially the development status abroad, the development trend, and bottlenecks of underground logistics in China. This paper explores the technicality, feasibility, and necessity of four modes of transportation. There are pneumatic capsule pipeline (PCP) technology, the CargoCap technology, cable hauled mule, and automatic guided vehicle (AGV). The above technical parameters and characteristics are introduced to relevant experts or scholars. Through establishing an indicator system, carrying out a questionnaire survey with the Delphi method, the final suggestion is obtained: China should develop logistics vehicles similar to CargoCap, adopting rail mode and driverless mode. Based on China's temporal and spatial logistics demand and the geographical pattern of Xiong'an New Area, the construction scale, technical parameters, node location, and other vital parameters of underground logistics are planned. In this way, we hope to speed up the new area's construction and the logistics industry's innovation.

Keywords: the Xiong'an new area, underground logistics, contrastive analysis, CargoCap, logistics planning

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Authors: Maryam Ghavam Sadri, Maryam Shahrooz

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Background: Nowadays the prevalence of metabolic syndrome (Mets) has taken on a growing trend. Studies have shown the relationship between vitamin D deficiency (VDD) status and Mets in children. Also studies have recorded that exerting strategies for vitamin D status improvement can help prevent Mets in children. This study investigated multiple strategies of prevention of Mets resulting from VDD in children. Methods: This review study has been done by using keywords related to the topic and 54 articles were found (2000-2015) that 25 were selected according to the indicators of Mets, supplementation and fortification of foods with vitamin D and attention to children environment and life style. Results: Studies have suggested the correlation between serum levels of vitamin D with waist circumference (p < 0.0001), systolic blood pressure (p=0.01), HOMA-IR (p=0.001) and HDL cholesterol (p < 0.0001). An inverse correlation between serum 25 (OH) D and HOMA-IR (p = 0.006) and insulin (P = 0.002) has been proved in overweight group. Higher HOMASDS and triglycerides found in vitamin D deficient obese children compared to control group without VDD (p=0.04). After supplementation with vitamin D, serum TG concentration decreases significantly (p=0.04), and improves insulin resistance (p=0.02). The prevalence of VDD is associated with time of watching TV (P < 0.01), hours of physical activity per week (P = 0.01), skipping breakfast (P < 0.001) soda intake (P < 0.001), and milk intake per day (P < 0.01). Conclusion: According to the beneficial role of vitamin D in prevention of Mets and proven relationship between serum levels of vitamin D and Mets indicators, we can prevent childhood Mets through the application of appropriate strategies such as supplementation and food fortification with vitamin D and positive changes in children life style with especial attention to physical activity in exposure of sunlight and their environment condition.

Keywords: children, metabolic syndrome, prevention strategies, vitamin D

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Authors: Teklay Gebrecherkos, Mahmud Abdulkadir

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Abstract: The emergence and subsequent rapid worldwide spread of the COVID-19 pandemic have posed a global crisis, with a tremendously increasing burden of infection, morbidity, and mortality risks. Recent studies have suggested that severe cases of COVID-19 are characterized by massive biochemical, hematological, and inflammatory alterations whose synergistic effect is estimated to progress to multiple organ damage and failure. In this regard, biochemical monitoring of COVID-19 patients, based on comprehensive laboratory assessments and findings, is expected to play a crucial role in effective clinical management and improving the survival rates of patients. However, biochemical markers that can be informative of COVID-19 patient risk stratification and predictor of clinical outcomes are currently scarcely available. The study aims to investigate the profiles of common biochemical markers and their influence on the severity of the COVID-19 infection in Tigray, Ethiopia. Methods: A laboratory-based cross-sectional study was conducted from July to August 2020 at Quiha College of Engineering, Mekelle University COVID-19 isolation and treatment center. Sociodemographic and clinical data were collected using a structured questionnaire. Whole blood was collected from each study participant, and serum samples were separated after being delivered to the laboratory. Hematological biomarkers were analyzed using FACS count, while organ tests and serum electrolytes were analyzed using ion-selective electrode methods using a Cobas-6000 series machine. Data was analyzed using SPSS Vs 20. Results: A total of 120 SARS-CoV-2 patients were enrolled during the study. The participants ranged between 18 and 91 years, with a mean age of 52 (±108.8). The majority (40%) of participants were between the ages of 60 and above. Patients with multiple comorbidities developed severe COVID-19, though not statistically significant (p=0.34). Mann-Whitney U test analysis showed that biochemical tests such as neuropile count (p=0.003), AST levels (p=0.050), serum creatinine (p=0.000), and serum sodium (p=0.015) were significantly correlated with severe COVID-19 disease as compared to non-severe disease. Conclusion: The severity of COVID-19 was associated with higher age, organ tests AST and creatinine, serum Na+, and elevated total neutrophile count. Thus, further study needs to be conducted to evaluate the alterations of biochemical biomarkers and their impact on COVID-19.

Keywords: COVID-19, biomarkers, mortality, Tigray, Ethiopia

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Authors: Stephanie Ho

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This project utilizes principles derived from the Surrealist movement to prioritize creative and critical thinking in secondary English Language Arts (ELA). The implementation of Surrealist-style pedagogies within an ELA classroom will be rooted in critical, radical pedagogy, which addresses the injustices caused by economic-oriented educational systems. The use of critical pedagogy will enable the subversive artistic and political aims of Surrealism to be transmitted to a classroom context. Through aesthetic reading strategies, appreciative questioning and dialogue, students will actively critique the power dynamics which structure (and often restrict) their lives. Within the ELA domain, cost-effective approaches often replace the actual “arts” of ELA. This research will therefore explore how Surrealist-oriented pedagogies could restore imaginative freedom and deconstruct conceptual barriers (normative standards, curricular constraints, and status quo power relations) in secondary ELA. This research will also examine how Surrealism can be used as a political and pedagogical model to treat societal problems mirrored in ELA classrooms. The stakeholders are teachers, as they experience constant pressure within their practices. Similarly, students encounter rigorous, results-based pressures. These dynamics contribute to feelings of powerlessness, thus reinforcing a formulaic model of ELA. The ELA curriculum has potential to create laboratories for critical discussion and active movement towards social change. This proposed research strategy of Surrealist-oriented pedagogies could enable students to experiment with social issues and develop senses of agency and voice that reflect awareness of contemporary society while simultaneously building their ELA skills.

Keywords: arts-informed pedagogies, language arts, literature, surrealism

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Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

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Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

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Authors: Sushma Yadav, Anil K. Saroha

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Complex industrial effluent generated from chemical industry is contaminated with toxic and hazardous organic compounds and not amenable to direct biological treatment. To effectively remove many toxic organic pollutants has made it evident that new, compact and more efficient systems are needed. Catalytic Wet Air Oxidation (CWAO) is a promising treatment technology for the abatement of organic pollutants in wastewater. A lot of information is available on using CWAO for the treatment of synthetic solution containing single organic pollutant. But the real industrial effluents containing multi-component mixture of organic compounds were less studied. The main objective of this study is to use the CWAO process for converting the organics into compounds more amenable to biological treatment; complete oxidation may be too expensive. Therefore efforts were made in the present study to explore the potential of alumina based Platinum (Pt) catalyst for the treatment of industrial organic raffinate containing toxic constituents like ammoniacal nitrogen, pyridine etc. The catalysts were prepared by incipient wetness impregnation method and characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX) and BET (Brunauer, Emmett, and Teller) surface area. CWAO experiments were performed at atmospheric pressure and (30 °C - 70 °C) temperature conditions and the results were evaluated in terms of COD removal efficiency. The biodegradability test was performed by BOD/COD ratio for checking the toxicity of the industrial wastewater as well as for the treated water. The BOD/COD ratio of treated water was significantly increased and signified that the toxicity of the organics was decreased while the biodegradability was increased, indicating the more amenability towards biological treatment.

Keywords: alumina based pt catalyst, BOD/COD ratio, catalytic wet air oxidation, COD removal efficiency, industrial organic raffinate

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Authors: Ricardo Torcato, Helder Morais

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The manufacture of crystal glass parts is based on obtaining the rough geometry by blowing and/or injection, generally followed by a set of manual finishing operations using cutting and grinding tools. The forming techniques used do not allow the obtainment, with repeatability, of parts with complex shapes and the finishing operations use intensive specialized labor resulting in high cycle times and production costs. This work aims to explore the digital manufacture of crystal glass parts by investigating new subtractive techniques for the automated, flexible finishing of these parts. Finishing operations are essential to respond to customer demands in terms of crystal feel and shine. It is intended to investigate the applicability of different computerized finishing technologies, namely milling and grinding in a CNC machining center with or without ultrasonic assistance, to crystal processing. Research in the field of grinding hard and brittle materials, despite not being extensive, has increased in recent years, and scientific knowledge about the machinability of crystal glass is still very limited. However, it can be said that the unique properties of glass, such as high hardness and very low toughness, make any glass machining technology a very challenging process. This work will measure the performance improvement brought about by the use of ultrasound compared to conventional crystal grinding. This presentation is focused on the mechanical characterization and analysis of the cutting forces in CNC machining of superior crystal glass (Pb ≥ 30%). For the mechanical characterization, the Vickers hardness test provides an estimate of the material hardness (Hv) and the fracture toughness based on cracks that appear in the indentation. Mechanical impulse excitation test estimates the Young’s Modulus, shear modulus and Poisson ratio of the material. For the cutting forces, it a dynamometer was used to measure the forces in the face grinding process. The tests were made based on the Taguchi method to correlate the input parameters (feed rate, tool rotation speed and depth of cut) with the output parameters (surface roughness and cutting forces) to optimize the process (better roughness using the cutting forces that do not compromise the material structure and the tool life) using ANOVA. This study was conducted for conventional grinding and for the ultrasonic grinding process with the same cutting tools. It was possible to determine the optimum cutting parameters for minimum cutting forces and for minimum surface roughness in both grinding processes. Ultrasonic-assisted grinding provides a better surface roughness than conventional grinding.

Keywords: CNC machining, crystal glass, cutting forces, hardness

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Authors: Dawid Przystupski, Agata Gorska, Paulina Rozborska, Weronika Bartosik, Olga Michel, Joanna Rossowska, Anna Szewczyk, Malgorzata Drag-Zalesinska, Jedrzej Gorski, Julita Kulbacka

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Researchers are still looking for an answer to the question which has been fascinating the mankind for generations, specifically – is there life beyond Earth? As long as routine flights to other planets remain beyond our reach, there is a need to find alternative ways to conduct the astrobiological research. It is worth noticing that the part of the Earth’s atmosphere, stratosphere, has been found to show subcosmic environmental conditions, namely temperatures around -50°C, very rarefied air, increased cosmic radiation and the Sun’s ultraviolet radiation. This phenomenon gives rise to the opportunity for the use of stratospheric environment as a research model for the space conditions. Therefore the idea of conducting astrobiological experiments during the stratospheric flights arose. Up to now, the preliminary work in this field included launching balloons containing solely microbiological samples into the stratosphere to figure out if they would be able to survive under the stratospheric conditions. In our study, we take this concept further, sending the human healthy and cancerous cells treated with various compounds to investigate whether these medicines are capable to protect the cells against stratospheric stress. Due to oxidative stress caused by ionizing radiation and temperature shock, we used natural compounds which display antioxidant properties. In this way, we were able to reduce the reactive oxygen species production affecting cells, which results in their death. After-flight laboratory tests of biological samples from the stratosphere have been performed and indicated the most active antioxidants as potential agents which can minimize the harmful impacts of stratospheric conditions, especially radiation and temperature.

Keywords: antioxidants, stratosphere, balloon flight, oxidative stress, cell death, radiation

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Authors: Gor Muradyan

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The paper is about friction and wear, including mechanisms, modeling, characterization, measurement and testing case in Bangladesh. Bangladesh is a country under development, A lot of people live here, approximately 145 million. The territory of this country is very small. Therefore buildings are very close to each other. As the pipe lines are very old, and people get almost dirty water, there are a lot of ongoing projects under ADB. In those projects the contractors using HDD machines (Horizontal Directional Drilling ) and grundoburst. These machines are working underground. As ground in Bangladesh is very sludge, machine can't work relevant because of big friction in the soil. When drilling works are finished machine is pulling the pipe underground. Very often the pulling of the pipes becomes very complicated because of the friction. Therefore long section of the pipe laying can’t be done because of a big friction. In that case, additional problems rise, as well as additional work must be done. As we mentioned above it is not possible to do big section of the pipe laying because of big friction in the soil, Because of this it is coming out that contractors must do more joints, more pressure test. It is always connected with additional expenditure and losing time. This machine can pull in 75 mm to 500 mm pipes connected with the soil condition. Length is possible till 500m related how much friction it will had on the puller. As less as much it can pull. Another machine grundoburst is not working at this soil condition at all. The machine is working with air compressor. This machine are using for the smaller diameter pipes, 20 mm to 63 mm. Most of the cases these machines are being used for the installing of the house connection pipes, for making service connection. To make a friction less contractors using bigger pulling had then the pipe. It is taking down the friction, But the problem of this machine is that it can't work at sludge. Because of mentioned reasons the friction has a big mining during this kind of works. There are a lot of ways to reduce the friction. In this paper we'll introduce the ways that we have researched during our practice in Bangladesh.

Keywords: Bangladesh, friction and wear, HDD machines, reducing friction

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Authors: Maria L. G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Neonatal conjunctivitis, or ophthalmia, is an infection of the conjunctiva or cornea before opening the eyelids. It is believed that immunodeficiency contributes to the development of the condition. This study aims at reporting a case of ophthalmia neonatorum in a dog, in addition to its diagnosis and treatment. A litter of five pug neonates was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, with complaints of ocular secretion. The neonates were five days old. The clinical examination revealed that three newborns presented swelling in the ocular region and a purulent secretion in the medial corner of the eye that was exerting pressure on the ocular globes, which are compatible with the description of this disease. The diagnosis was made based on the clinical signs and bacterial culture of the secretion, which revealed the presence of bacteria belonging to the genus Staphylococcus sp. The laboratory assays did not reveal any alterations. The treatment was instituted gently, opening the eyelids early and cleaning the purulent ocular secretion with saline solution. An ophthalmic ointment with retinol, amino acids, methionine, and chloramphenicol (Epitezan®) was prescribed four times a day for seven days. Blood plasma (2 mL/100 g) was administered subcutaneously because bacterial infections in neonates may represent a failure in the transference of passive immunity. A more thorough cleaning of the environment was also recommended. Neonatal conjunctivitis has a simple diagnosis and treatment. If not treated early, it can evolve to adherence of the eyelids to the cornea, ulceration, and perforation of the cornea. Therefore, the prognosis is favorable as long as the condition is diagnosed early, and the treatment is instituted quickly.

Keywords: ophthalmia neonatorum, neonatal infection, puppy, newborn

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Authors: Păcurar Diana Istina

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The indissoluble link between aesthetics and semiotics, the harmonization and semiotic understanding of the interactions between the viewer and the object being looked at, are the basis of the practical demonstration of the importance of aesthetic perception within the theater performance. The design of a theater performance includes several structures, some considered from the beginning, art forms (i.e., the text), others being represented by simple, common objects (e.g., scenographic elements), which, if reunited, can trigger a certain aesthetic perception. The audience is delivered, by the team involved in the performance, a series of auditory and visual signs with which they interact. It is necessary to explain some notions about the physiological support of the transformation of different types of stimuli at the level of the cerebral hemispheres. The cortex considered the superior integration center of extransecal and entanged stimuli, permanently processes the information received, but even if it is delivered at a constant rate, the generated response is individualized and is conditioned by a number of factors. Each changing situation represents a new opportunity for the viewer to cope with, developing feelings of different intensities that influence the generation of meanings and, therefore, the management of interactions. In this sense, aesthetic perception depends on the detection of the “correctness” of signs, the forms of which are associated with an aesthetic property. Fairness and aesthetic properties can have positive or negative values. Evaluating the emotions that generate judgment and implicitly aesthetic perception, whether we refer to visual emotions or auditory emotions, involves the integration of three areas of interest: Valence, arousal and context control. In this context, superior human cognitive processes, memory, interpretation, learning, attribution of meanings, etc., help trigger the mechanism of anticipation and, no less important, the identification of error. This ability to locate a short circuit produced in a series of successive events is fundamental in the process of forming an aesthetic perception. Our main purpose in this research is to investigate the possible conditions under which aesthetic perception and its minimum content are generated by all these structures and, in particular, by interactions with forms that are not commonly considered aesthetic forms. In order to demonstrate the quantitative and qualitative importance of the categories of signs used to construct a code for reading a certain message, but also to emphasize the importance of the order of using these indices, we have structured a mathematical analysis that has at its core the analysis of the percentage of signs used in a theater performance.

Keywords: semiology, aesthetics, theatre semiotics, theatre performance, structure, aesthetic perception

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Authors: Adam Y. Sulaiman, Donal F. Cotter, Ming J. Huang, Neil J. Hewitt

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Decarbonization of the industrial sector in developed countries has become indispensable for addressing climate change. Industrial processes including drying, distillation, and injection molding require a process heat exceeding 180°C, rendering the subcriticalHigh-Temperature heat pump(HTHP) technique unsuitable. A transcritical HTHP utilizing ecologically friendly working fluids is a highly recommended system that incorporates the features of high-energy efficiency, extended operational range, and decarbonizing the industrial sector. This paper delves into the possibility and feasibility of leveraging the HTTP system to provide up to 200°C of heat using R1233zd(E) as a working fluid. Using a steady-state model, various transcritical HTHP cycle configurations aretheoretically compared,analyzed, and evaluatedin this study. The heat transfer characteristics for the evaporator and gas cooler are investigated, as well as the cycle's energy, exergetic, and environmental performance. Using the LMTD method, the gas cooler's heat transfer coefficient, overall length, and heat transfer area were calculated. The findings indicate that the heat sink pressure level, as well as the waste heat temperature provided to the evaporator, have a significant impact on overall cycle performance. The investigation revealed the potential challenges and barriers, including the length of the gas cooler and the lubrication of the compression process. The basic transcritical HTTP cycle with additional IHX was demonstrated to be the most efficient cycle across a variety of heat source temperatures ranging from 70 to 90 °C based on theoretical energetic and exergetic performance.

Keywords: high-temperature heat pump, transcritical cycle, refrigerants, gas cooler, energy, exergy

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Authors: Arindam Chaudhuri

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Classification of data has been actively used for most effective and efficient means of conveying knowledge and information to users. The prima face has always been upon techniques for extracting useful knowledge from data such that returns are maximized. With emergence of huge datasets the existing classification techniques often fail to produce desirable results. The challenge lies in analyzing and understanding characteristics of massive data sets by retrieving useful geometric and statistical patterns. We propose a supervised parallel fuzzy rough support vector machine (PFRSVM) for data classification in cloud environment. The classification is performed by PFRSVM using hyperbolic tangent kernel. The fuzzy rough set model takes care of sensitiveness of noisy samples and handles impreciseness in training samples bringing robustness to results. The membership function is function of center and radius of each class in feature space and is represented with kernel. It plays an important role towards sampling the decision surface. The success of PFRSVM is governed by choosing appropriate parameter values. The training samples are either linear or nonlinear separable. The different input points make unique contributions to decision surface. The algorithm is parallelized with a view to reduce training times. The system is built on support vector machine library using Hadoop implementation of MapReduce. The algorithm is tested on large data sets to check its feasibility and convergence. The performance of classifier is also assessed in terms of number of support vectors. The challenges encountered towards implementing big data classification in machine learning frameworks are also discussed. The experiments are done on the cloud environment available at University of Technology and Management, India. The results are illustrated for Gaussian RBF and Bayesian kernels. The effect of variability in prediction and generalization of PFRSVM is examined with respect to values of parameter C. It effectively resolves outliers’ effects, imbalance and overlapping class problems, normalizes to unseen data and relaxes dependency between features and labels. The average classification accuracy for PFRSVM is better than other classifiers for both Gaussian RBF and Bayesian kernels. The experimental results on both synthetic and real data sets clearly demonstrate the superiority of the proposed technique.

Keywords: FRSVM, Hadoop, MapReduce, PFRSVM

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Authors: Ben Cheikh Asma, Bouafia Nabiha, Ammar Asma, Ezzi Olfa, Meddeb Khaoula, Chouchène Imed, Boussarsar Hamadi, Njah Mansour

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Background: Hospital Acquired Infection (HAI) constitutes an important worldwide health problem. It was associated with high mortality rate in intensive care units (ICU). This study aimed to determine HAI mortality rate in Tunisian intensive care units and identify its risk factors. Methods: We conducted a prospective observational cohort study over a 12 months period (September 15th 2015 to September 15 th 2016) in the adult medical ICU of University Hospital-Farhat Hached (Sousse-Tunisia). All patients admitted in the ICU for more than 48 hours were included in the study. We used an anonymous standardized survey record form to collect data by a medical hygienist assisted by an intensivist. We adopted definitions of Center for Diseases Control and prevention of Atlanta to detect HAI, Kaplan Meier survival analysis and Cox proportional hazard regression to identify independent risk factor of HAI mortality. Results: Of 171 patients, 67 developed ICU-acquired infection (global incidence rate=39.2%). The mean age of patients was 59 ± 21.2 years and 60.8% were male. The most frequently identified infections were pulmonary acquired infection (ventilator associated pneumonia (VAP) and infected atelectasis with density rates 21.4 VAP/1000 days of mechanical ventilation and 9.4 infected atelectasis /1000 days of mechanical ventilation; respectively) and central venous catheter associated infection (CVC - AI) with density rate 28.4 CVC-AI / 1000 CVC-days). HAI mortality rate was 66.7% (n=44). The median survival was 20 days 3.36, 95% Confidential Interval [13.39 – 26.60]. Specific mortality rates according to infectious site were 65.5%, 36.4% and 4.5% respectively for VAP, CVC associated infection and infected atelectasis. In univariate analysis, a significant associations between mortality and cardiovascular history (p=0.04) tracheotomy (p=0.00), peripheral venous catheterization (p=0.04), VAP (p=0.04) and infected atelectasis (p=0.04) were detected. Independent risk factors for HAI mortality were VAP with Hazard Ratio = 3.14, 95% Confidential Interval [1.63 – 6.05] (p=0.001) and tracheotomy (Hazard Ratio=0.22, 95% Confidential Interval [0.10 – 0.44], p=0.000). Conclusions: In the present study, hospital acquired infection mortality rate was relatively high. We need to intensify the fight against these infections especially ventilator-associated pneumonia that is associated with higher risk of mortality in many studies. Thus, more effective infection control interventions were necessary in our hospital.

Keywords: hospital acquired infection, intensive care unit, mortality, risk factors

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