Search results for: burn unit
1809 The Lessons Learned from Managing Malignant Melanoma During COVID-19 in a Plastic Surgery Unit in Ireland
Authors: Amenah Dhannoon, Ciaran Martin Hurley, Laura Wrafter, Podraic J. Regan
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Introduction: The COVID-19 pandemic continues to present unprecedented challenges for healthcare systems. This has resulted in the pragmatic shift in the practice of plastic surgery units worldwide. During this period, many units reported a significant fall in urgent melanoma referrals, leading to patients presenting with advanced disease requiring more extensive surgery and inferior outcomes. Our objective was to evaluate our unit's experience with both non-invasive and invasive melanoma during the COVID-19 pandemic and characterize our experience and contrast it to that experienced by our neighbors in the UK, mainland Europe and North America. Methods: a retrospective chart review was performed on all patients diagnosed with invasive and non-invasive cutaneous melanoma between March to December of 2019 (control) compared to 2020 (COVID-19 pandemic) in a single plastic surgery unit in Ireland. Patient demographics, referral source, surgical procedures, tumour characteristics, radiological findings, oncological therapies and follow-up were recorded. All data were anonymized and stored in Microsoft Excel. Results: A total of 589 patients were included in the study. Of these, 314 (53%) with invasive melanoma, compared to 275 (47%) with the non-invasive disease. Overall, more patients were diagnosed with both invasive and non-invasive melanoma in 2020 than in 2019 (p<0.05). However, significantly longer waiting times in 2020 (64 days) compared to 2019 (28 days) (p<0.05), with the majority of the referral being from GP in 2019 (83%) compared to 61% in 2020. Positive sentinel lymph node were higher in 2019 at 56% (n=28) compared to 24% (n=22) in 2020. There was no statistically significant difference in the tutor characteristics or metastasis status. Discussion: While other countries have noticed a fall in the melanoma diagnosis. Our units experienced a higher number of disease diagnoses. This can be due to multiple reasons. In Ireland, the government reached an early agreement with the private sector to continue elective surgery on an urgent basis in private hospitals. This allowed access to local anesthetic procedures and local skin cancer cases were triaged to non-COVID-19 provider centers. Our unit also adapted a fast, effective and minimal patient contact strategy for triaging skin cancer based on telemedicine. Thirdly, a skin cancer nurse specialist maintained patient follow-ups and triaging a dedicated email service. Finally, our plastic surgery service continued to maintain a virtual complex skin cancer multidisciplinary team meeting during the pandemic, ensuring local clinical governance has adhered to each clinical case. Conclusion: Our study highlights that with the prompt efficient restructuring of services, we could reserve successful management of skin cancer even in the most devastating times. It is important to reflect on the success during the pandemic and emphasize the importance of preparation for a potentially difficult futureKeywords: malignant melanoma, skin cancer, COVID-19, triage
Procedia PDF Downloads 1641808 Quality-Of-Service-Aware Green Bandwidth Allocation in Ethernet Passive Optical Network
Authors: Tzu-Yang Lin, Chuan-Ching Sue
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Sleep mechanisms are commonly used to ensure the energy efficiency of each optical network unit (ONU) that concerns a single class delay constraint in the Ethernet Passive Optical Network (EPON). How long the ONUs can sleep without violating the delay constraint has become a research problem. Particularly, we can derive an analytical model to determine the optimal sleep time of ONUs in every cycle without violating the maximum class delay constraint. The bandwidth allocation considering such optimal sleep time is called Green Bandwidth Allocation (GBA). Although the GBA mechanism guarantees that the different class delay constraints do not violate the maximum class delay constraint, packets with a more relaxed delay constraint will be treated as those with the most stringent delay constraint and may be sent early. This means that the ONU will waste energy in active mode to send packets in advance which did not need to be sent at the current time. Accordingly, we proposed a QoS-aware GBA using a novel intra-ONU scheduling to control the packets to be sent according to their respective delay constraints, thereby enhancing energy efficiency without deteriorating delay performance. If packets are not explicitly classified but with different packet delay constraints, we can modify the intra-ONU scheduling to classify packets according to their packet delay constraints rather than their classes. Moreover, we propose the switchable ONU architecture in which the ONU can switch the architecture according to the sleep time length, thus improving energy efficiency in the QoS-aware GBA. The simulation results show that the QoS-aware GBA ensures that packets in different classes or with different delay constraints do not violate their respective delay constraints and consume less power than the original GBA.Keywords: Passive Optical Networks, PONs, Optical Network Unit, ONU, energy efficiency, delay constraint
Procedia PDF Downloads 2761807 Application of Fatty Acid Salts for Antimicrobial Agents in Koji-Muro
Authors: Aya Tanaka, Mariko Era, Shiho Sakai, Takayoshi Kawahara, Takahide Kanyama, Hiroshi Morita
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Objectives: Aspergillus niger and Aspergillus oryzae are used as koji fungi in the spot of the brewing. Since koji-muro (room for making koji) was a low level of airtightness, microbial contamination has long been a concern to the alcoholic beverage production. Therefore, we focused on the fatty acid salt which is the main component of soap. Fatty acid salts have been reported to show some antibacterial and antifungal activity. So this study examined antimicrobial activities against Aspergillus and Bacillus spp. This study aimed to find the effectiveness of the fatty acid salt in koji-muro as antimicrobial agents. Materials & Methods: A. niger NBRC 31628, A. oryzae NBRC 5238, A. oryzae (Akita Konno store) and Bacillus subtilis NBRC 3335 were chosen as tested. Nine fatty acid salts including potassium butyrate (C4K), caproate (C6K), caprylate (C8K), caprate (C10K), laurate (C12K), myristate (C14K), oleate (C18:1K), linoleate (C18:2K) and linolenate (C18:3K) at 350 mM and pH 10.5 were used as antimicrobial activity. FASs and spore suspension were prepared in plastic tubes. The spore suspension of each fungus (3.0×104 spores/mL) or the bacterial suspension (3.0×105 CFU/mL) was mixed with each of the fatty acid salts (final concentration of 175 mM). The mixtures were incubated at 25 ℃. Samples were counted at 0, 10, 60, and 180 min by plating (100 µL) on potato dextrose agar. Fungal and bacterial colonies were counted after incubation for 1 or 2 days at 30 ℃. The MIC (minimum inhibitory concentration) is defined as the lowest concentration of drug sufficient for inhibiting visible growth of spore after 10 min of incubation. MICs against fungi and bacteria were determined using the two-fold dilution method. Each fatty acid salt was separately inoculated with 400 µL of Aspergillus spp. or B. subtilis NBRC 3335 at 3.0 × 104 spores/mL or 3.0 × 105 CFU/mL. Results: No obvious change was observed in tested fatty acid salts against A. niger and A. oryzae. However, C12K was the antibacterial effect of 5 log-unit incubated time for 10 min against B. subtilis. Thus, C12K suppressed 99.999 % of bacterial growth. Besides, C10K was the antibacterial effect of 5 log-unit incubated time for 180 min against B. subtilis. C18:1K, C18:2K and C18:3K was the antibacterial effect of 5 log-unit incubated time for 10 min against B. subtilis. However, compared to saturated fatty acid salts to unsaturated fatty acid salts, saturated fatty acid salts are lower cost. These results suggest C12K has potential in the field of koji-muro. It is necessary to evaluate the antimicrobial activity against other fungi and bacteria, in the future.Keywords: Aspergillus, antimicrobial, fatty acid salts, koji-muro
Procedia PDF Downloads 5471806 Synthesis, Characterization and Catecholase Study of Novel Bidentate Schiff Base Derived from Dehydroacetic Acid
Authors: Salima Tabti, Chaima Maouche, Tinhinene Louaileche, Amel Djedouani, Ismail Warad
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Novel Schiff base ligand HL has been synthesized by condensation of aromatic amine and DHA. It was characterized by UV-Vis, FT-IR, SM, NMR (1H, 13C) and also by single-crystal X-ray diffraction. The crystal structure shows that compound crystallized in a triclinic system in P-1 space group and with a two unit per cell (Z = 2).The asymmetric unit, contains one independent molecules, the conformation is determined by an intermolecular N-H…O hydrogen bond with an S(6) ring motif. The molecule have an (E) conformation about the C=N bond. The dihedral angles between the phenyl and pyran ring planes is 89.37 (1), the two plans are approximately perpendicular. The catecholase activity of is situ copper complexes of this ligand has been investigated against catechol. The progress of the oxidation reactions was closely monitored over time following the strong peak of catechol using UV-Vis. Oxidation rates were determined from the initial slope of absorbance. time plots, then analyzed by Michaelis-Menten equations. Catechol oxidation reactions were realized using different concentrations of copper acetate and ligand (L/Cu: 1/1, 1/2, 2/1). The results show that all complexes were able to catalyze the oxidation of catechol. Acetate complexes have the highest activity. Catalysis is a branch of chemical kinetics that, more generally, studies the influence of all physical or chemical factors determining reaction rates. It solves a lot of problems in the chemistry reaction process, especially for a green, economic and less polluting chemistry. For this reason, the search for new catalysts for known organic reactions, occupies a very advanced place in the themes proposed by the chemists.Keywords: dehydroacetic acid, catechol, copper, catecholase activity, x-ray
Procedia PDF Downloads 991805 Technology of Gyro Orientation Measurement Unit (Gyro Omu) for Underground Utility Mapping Practice
Authors: Mohd Ruzlin Mohd Mokhtar
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At present, most operators who are working on projects for utilities such as power, water, oil, gas, telecommunication and sewerage are using technologies e.g. Total station, Global Positioning System (GPS), Electromagnetic Locator (EML) and Ground Penetrating Radar (GPR) to perform underground utility mapping. With the increase in popularity of Horizontal Directional Drilling (HDD) method among the local authorities and asset owners, most of newly installed underground utilities need to use the HDD method. HDD method is seen as simple and create not much disturbance to the public and traffic. Thus, it was the preferred utilities installation method in most of areas especially in urban areas. HDDs were installed much deeper than exiting utilities (some reports saying that HDD is averaging 5 meter in depth). However, this impacts the accuracy or ability of existing underground utility mapping technologies. In most of Malaysia underground soil condition, those technologies were limited to maximum of 3 meter depth. Thus, those utilities which were installed much deeper than 3 meter depth could not be detected by using existing detection tools. The accuracy and reliability of existing underground utility mapping technologies or work procedure were in doubt. Thus, a mitigation action plan is required. While installing new utility using Horizontal Directional Drilling (HDD) method, a more accurate underground utility mapping can be achieved by using Gyro OMU compared to existing practice using e.g. EML and GPR. Gyro OMU is a method to accurately identify the location of HDD thus this mapping can be used or referred to avoid those cost of breakdown due to future HDD works which can be caused by inaccurate underground utility mapping.Keywords: Gyro Orientation Measurement Unit (Gyro OMU), Horizontal Directional Drilling (HDD), Ground Penetrating Radar (GPR), Electromagnetic Locator (EML)
Procedia PDF Downloads 1331804 Certain Results of a New Class of Meromorphic Multivalent Functions Involving Ruscheweyh Derivative
Authors: Kassim A. Jassim
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In the present paper, we introduce and discuss a new class Kp(λ,α) of meromorphic multivalent functions in the punctured unit disk U*={z∈¢:0<|z|<1} defined by Ruscheweyh derivative. We obtain some sufficient conditions for the functions belonging to the class Kp(λ,α).Keywords: meromorphic multivalent function, Ruscheweyh derivative, hadamard product
Procedia PDF Downloads 3341803 Performance Augmentation of a Combined Cycle Power Plant with Waste Heat Recovery and Solar Energy
Authors: Mohammed A. Elhaj, Jamal S. Yassin
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In the present time, energy crises are considered a severe problem across the world. For the protection of global environment and maintain ecological balance, energy saving is considered one of the most vital issues from the view point of fuel consumption. As the industrial sectors everywhere continue efforts to improve their energy efficiency, recovering waste heat losses provides an attractive opportunity for an emission free and less costly energy resource. In the other hand the using of solar energy has become more insistent particularly after the high gross of prices and running off the conventional energy sources. Therefore, it is essential that we should endeavor for waste heat recovery as well as solar energy by making significant and concrete efforts. For these reasons this investigation is carried out to study and analyze the performance of a power plant working by a combined cycle in which Heat Recovery System Generator (HRSG) gets its energy from the waste heat of a gas turbine unit. Evaluation of the performance of the plant is based on different thermal efficiencies of the main components in addition to the second law analysis considering the exergy destructions for the whole components. The contribution factors including the solar as well as the wasted energy are considered in the calculations. The final results have shown that there is significant exergy destruction in solar concentrator and the combustion chamber of the gas turbine unit. Other components such as compressor, gas turbine, steam turbine and heat exchangers having insignificant exergy destruction. Also, solar energy can contribute by about 27% of the input energy to the plant while the energy lost with exhaust gases can contribute by about 64% at maximum cases.Keywords: solar energy, environment, efficiency, waste heat, steam generator, performance, exergy destruction
Procedia PDF Downloads 2931802 Effects of Spent Dyebath Recycling on Pollution and Cost of Production in a Cotton Textile Industry
Authors: Dinesh Kumar Sharma, Sanjay Sharma
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Textile manufacturing industry uses a substantial amount of chemicals not only in the production processes but also in manufacturing the raw materials. Dyes are the most significant raw material which provides colour to the fabric and yarn. Dyes are produced by using a large amount of chemicals both organic and inorganic in nature. Dyes are further classified as Reactive or Vat Dyes which are mostly used in cotton textiles. In the process of application of dyes to the cotton fiber, yarn or fabric, several auxiliary chemicals are also used in the solution called dyebath to improve the absorption of dyes. There is a very little absorption of dyes and auxiliary chemicals and a residual amount of all these substances is released as the spent dye bath effluent. Because of the wide variety of chemicals used in cotton textile dyes, there is always a risk of harmful effects which may not be apparent immediately but may have an irreversible impact in the long term. Colour imparted by the dyes to the water also has an adverse effect on its public acceptability and the potability. This study has been conducted with an objective to assess the feasibility of reuse of the spent dye bath. Studies have been conducted in two independent industries manufacturing dyed cotton yarn and dyed cotton fabric respectively. These have been referred as Unit-I and Unit-II. The studies included assessment of reduction in pollution levels and the economic benefits of such reuse. The study conclusively establishes that the reuse of spent dyebath results in prevention of pollution, reduction in pollution loads and cost of effluent treatment & production. This pollution prevention technique presents a good preposition for pollution prevention in cotton textile industry.Keywords: dyes, dyebath, reuse, toxic, pollution, costs
Procedia PDF Downloads 3851801 A Vision-Based Early Warning System to Prevent Elephant-Train Collisions
Authors: Shanaka Gunasekara, Maleen Jayasuriya, Nalin Harischandra, Lilantha Samaranayake, Gamini Dissanayake
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One serious facet of the worsening Human-Elephant conflict (HEC) in nations such as Sri Lanka involves elephant-train collisions. Endangered Asian elephants are maimed or killed during such accidents, which also often result in orphaned or disabled elephants, contributing to the phenomenon of lone elephants. These lone elephants are found to be more likely to attack villages and showcase aggressive behaviour, which further exacerbates the overall HEC. Furthermore, Railway Services incur significant financial losses and disruptions to services annually due to such accidents. Most elephant-train collisions occur due to a lack of adequate reaction time. This is due to the significant stopping distance requirements of trains, as the full braking force needs to be avoided to minimise the risk of derailment. Thus, poor driver visibility at sharp turns, nighttime operation, and poor weather conditions are often contributing factors to this problem. Initial investigations also indicate that most collisions occur in localised “hotspots” where elephant pathways/corridors intersect with railway tracks that border grazing land and watering holes. Taking these factors into consideration, this work proposes the leveraging of recent developments in Convolutional Neural Network (CNN) technology to detect elephants using an RGB/infrared capable camera around known hotspots along the railway track. The CNN was trained using a curated dataset of elephants collected on field visits to elephant sanctuaries and wildlife parks in Sri Lanka. With this vision-based detection system at its core, a prototype unit of an early warning system was designed and tested. This weatherised and waterproofed unit consists of a Reolink security camera which provides a wide field of view and range, an Nvidia Jetson Xavier computing unit, a rechargeable battery, and a solar panel for self-sufficient functioning. The prototype unit was designed to be a low-cost, low-power and small footprint device that can be mounted on infrastructures such as poles or trees. If an elephant is detected, an early warning message is communicated to the train driver using the GSM network. A mobile app for this purpose was also designed to ensure that the warning is clearly communicated. A centralized control station manages and communicates all information through the train station network to ensure coordination among important stakeholders. Initial results indicate that detection accuracy is sufficient under varying lighting situations, provided comprehensive training datasets that represent a wide range of challenging conditions are available. The overall hardware prototype was shown to be robust and reliable. We envision a network of such units may help contribute to reducing the problem of elephant-train collisions and has the potential to act as an important surveillance mechanism in dealing with the broader issue of human-elephant conflicts.Keywords: computer vision, deep learning, human-elephant conflict, wildlife early warning technology
Procedia PDF Downloads 2201800 Predictors of Non-Adherence to Pharmacological Therapy in Patients with Type 2 Diabetes
Authors: Anan Jarab, Riham Almrayat, Salam Alqudah, Maher Khdour, Tareq Mukattash, Sharell Pinto
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Background: The prevalence of diabetes in Jordan is among the highest in the world, making it a particularly alarming health problem there. It has been indicated that poor adherence to the prescribed therapy lead to poor glycemic control and enhance the development of diabetes complications and unnecessary hospitalization. Purpose: To explore factors associated with medication non-adherence in patients with type 2 diabetes in Jordan. Materials and Methods: Variables including socio-demographics, disease and therapy factors, diabetes knowledge, and health-related quality of life in addition to adherence assessment were collected for 171 patients with type 2 diabetes using custom-designed and validated questionnaires. Logistic regression was performed to develop a model with variables that best predicted medication non-adherence in patients with type 2 diabetes in Jordan. Results: The majority of the patients (72.5%) were non-adherent. Patients were found four times less likely to adhere to their medications with each unit increase in the number of prescribed medications (OR = 0.244, CI = 0.08-0.63) and nine times less likely to adhere to their medications with each unit increase in the frequency of administration of diabetic medication (OR = 0.111, CI = 0.04-2.01). Patients in the present study were also approximately three times less likely (OR = 0.362, CI = 0.24-0.87) to adhere to their medications if they reported having concerns about side effects and twice more likely to adhere to medications (OR = 0.493, CI = 0.08-1.16) if they had one or more micro-vascular complication. Conclusion: The current study revealed low adherence rate to the prescribed therapy among Jordanians with type 2 diabetes. Simplifying dosage regimen, selecting treatments with lower side effects along with an emphasis on diabetes complications should be taken into account when developing care plans for patients with type 2 diabetes.Keywords: type 2 diabetes, adherence, glycemic control, clinical pharmacist, Jordan
Procedia PDF Downloads 4341799 School Partners in Initial Teacher Education: An Including or Excluding Approach When Engaging Schools
Authors: Laila Niklasson
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The aim of the study is to critically discuss how partner schools are engaged during Initial teacher education, ITE. The background is an experiment in Sweden where the practicum organization is reorganized due to a need to enhance quality during practicum. It is a national initiative from the government, supported by the National Agency of Education and lasts 2014-2019. The main features are concentration of students to school with a certain amount of mentors, mentors who have a mentor education and teachers with relevant subject areas and where there could be a mentor team with a leader at the school. An expected outcome is for example that the student teachers should be engaged in peer-learning. The schools should be supported by extra lectures from university teachers during practicum and also extra research projects where the schools should be engaged. A case study of one university based ITE was carried out to explore the consequences for the schools not selected. The result showed that from engaging x schools in a region, x was engaged. The schools are both in urban and rural areas, mainly in the latter. There is also a tendency that private schools are not engaged. On a unit level recruitment is perceived as harder for schools not engaged. In addition they cannot market themselves as ´selected school´ which can affect parent´s selection of school for their children. Also, on unit level, but with consequences for professional development, they are not selected for research project and thereby are not fully supported during school development. The conclusion is that from an earlier inclusive approach concerning professions where all teachers were perceived as possible mentors, there is a change to an exclusive approach where selected schools and selected teachers should be engaged. The change could be perceived as a change in governance mentality, but also in how professions are perceived, and development work is pursued.Keywords: initial teacher education, practicum schools, profession, quality development
Procedia PDF Downloads 1381798 Systematic Identification of Noncoding Cancer Driver Somatic Mutations
Authors: Zohar Manber, Ran Elkon
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Accumulation of somatic mutations (SMs) in the genome is a major driving force of cancer development. Most SMs in the tumor's genome are functionally neutral; however, some cause damage to critical processes and provide the tumor with a selective growth advantage (termed cancer driver mutations). Current research on functional significance of SMs is mainly focused on finding alterations in protein coding sequences. However, the exome comprises only 3% of the human genome, and thus, SMs in the noncoding genome significantly outnumber those that map to protein-coding regions. Although our understanding of noncoding driver SMs is very rudimentary, it is likely that disruption of regulatory elements in the genome is an important, yet largely underexplored mechanism by which somatic mutations contribute to cancer development. The expression of most human genes is controlled by multiple enhancers, and therefore, it is conceivable that regulatory SMs are distributed across different enhancers of the same target gene. Yet, to date, most statistical searches for regulatory SMs have considered each regulatory element individually, which may reduce statistical power. The first challenge in considering the cumulative activity of all the enhancers of a gene as a single unit is to map enhancers to their target promoters. Such mapping defines for each gene its set of regulating enhancers (termed "set of regulatory elements" (SRE)). Considering multiple enhancers of each gene as one unit holds great promise for enhancing the identification of driver regulatory SMs. However, the success of this approach is greatly dependent on the availability of comprehensive and accurate enhancer-promoter (E-P) maps. To date, the discovery of driver regulatory SMs has been hindered by insufficient sample sizes and statistical analyses that often considered each regulatory element separately. In this study, we analyzed more than 2,500 whole-genome sequence (WGS) samples provided by The Cancer Genome Atlas (TCGA) and The International Cancer Genome Consortium (ICGC) in order to identify such driver regulatory SMs. Our analyses took into account the combinatorial aspect of gene regulation by considering all the enhancers that control the same target gene as one unit, based on E-P maps from three genomics resources. The identification of candidate driver noncoding SMs is based on their recurrence. We searched for SREs of genes that are "hotspots" for SMs (that is, they accumulate SMs at a significantly elevated rate). To test the statistical significance of recurrence of SMs within a gene's SRE, we used both global and local background mutation rates. Using this approach, we detected - in seven different cancer types - numerous "hotspots" for SMs. To support the functional significance of these recurrent noncoding SMs, we further examined their association with the expression level of their target gene (using gene expression data provided by the ICGC and TCGA for samples that were also analyzed by WGS).Keywords: cancer genomics, enhancers, noncoding genome, regulatory elements
Procedia PDF Downloads 991797 COVID_ICU_BERT: A Fine-Tuned Language Model for COVID-19 Intensive Care Unit Clinical Notes
Authors: Shahad Nagoor, Lucy Hederman, Kevin Koidl, Annalina Caputo
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Doctors’ notes reflect their impressions, attitudes, clinical sense, and opinions about patients’ conditions and progress, and other information that is essential for doctors’ daily clinical decisions. Despite their value, clinical notes are insufficiently researched within the language processing community. Automatically extracting information from unstructured text data is known to be a difficult task as opposed to dealing with structured information such as vital physiological signs, images, and laboratory results. The aim of this research is to investigate how Natural Language Processing (NLP) techniques and machine learning techniques applied to clinician notes can assist in doctors’ decision-making in Intensive Care Unit (ICU) for coronavirus disease 2019 (COVID-19) patients. The hypothesis is that clinical outcomes like survival or mortality can be useful in influencing the judgement of clinical sentiment in ICU clinical notes. This paper introduces two contributions: first, we introduce COVID_ICU_BERT, a fine-tuned version of clinical transformer models that can reliably predict clinical sentiment for notes of COVID patients in the ICU. We train the model on clinical notes for COVID-19 patients, a type of notes that were not previously seen by clinicalBERT, and Bio_Discharge_Summary_BERT. The model, which was based on clinicalBERT achieves higher predictive accuracy (Acc 93.33%, AUC 0.98, and precision 0.96 ). Second, we perform data augmentation using clinical contextual word embedding that is based on a pre-trained clinical model to balance the samples in each class in the data (survived vs. deceased patients). Data augmentation improves the accuracy of prediction slightly (Acc 96.67%, AUC 0.98, and precision 0.92 ).Keywords: BERT fine-tuning, clinical sentiment, COVID-19, data augmentation
Procedia PDF Downloads 1941796 Khon Kaen University Family Health Assessment Tool Training Program on Primary Care Unit Nurses’ Skills
Authors: Suwarno, D. Jongudomkarn
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Family Health Assessment (FHA) is a key process to identify the family health needs, family health problems, and family health history. Assessing the family health is not only from the assessment tool but also from health care provider especially Nurse. Nurses’ have duties to assess the family as holistic view and they have to increase their capacities (knowledge, skills and experiences) in FHA. Thus, the continuing nursing education-training program on using the KKU FHA Tool was aimed to enhance the participant nurses’ capacities in (FHA) based on such tool. The aim of this study was to evaluate the KKU FHA Tool training program on PCU nurses’ capacity before and after training program in Primary Care Unit Bantul, Yogyakarta. The Quasi-Experiment with one group pre-, post-test design as a research design with convenient sampling technique and one group pre- post test formula for Nurses who work in Six PCU Bantul, Yogyakarta as much as fourteen respondents. The research processes were used training program with module, video and handbook KKU FHA Tool, KKU FHA tool form and capacities questionnaires. It was analyzed by descriptive data, Kolmogorov-Smirnov and Paired Sample t-test. The overall comparing analysis of paired sample t-test revealed that the mean values of pre-test were 3.35 with SD 0.417, post-test was 3.86 with SD 0.154 and post-test in later two weeks was 4.00 with SD 0.243. It was found that the p value of among the pre-test, the intermediate post-test and the post–test in later two weeks were 0.000. The p value of the intermediate post-test and post-test in later two weeks was 0.053. KKU FHA Tool training program in PCU Bantul Yogyakarta was enhanced the participant nurses’ capacities significantly. In conclusion, we are recommending KKU FHA Tool forms have to develop and implement with qualitative research as complementary data in PCU Bantul Yogyakarta by Focus Group Discussion.Keywords: family health assessment, KKU FHA tool, training program, nurses capacities
Procedia PDF Downloads 3741795 Identifying Pathogenic Mycobacterium Species Using Multiple Gene Phylogenetic Analysis
Authors: Lemar Blake, Chris Oura, Ayanna C. N. Phillips Savage
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Improved DNA sequencing technology has greatly enhanced bacterial identification, especially for organisms that are difficult to culture. Mycobacteriosis with consistent hyphema, bilateral exophthalmia, open mouth gape and ocular lesions, were observed in various fish populations at the School of Veterinary Medicine, Aquaculture/Aquatic Animal Health Unit. Objective: To identify the species of Mycobacterium that is affecting aquarium fish at the School of Veterinary Medicine, Aquaculture/Aquatic Animal Health Unit. Method: A total of 13 fish samples were collected and analyzed via: Ziehl-Neelsen, conventional polymerase chain reaction (PCR) and real-time PCR. These tests were carried out simultaneously for confirmation. The following combination of conventional primers: 16s rRNA (564 bp), rpoB (396 bp), sod (408 bp) were used. Concatenation of the gene fragments was carried out to phylogenetically classify the organism. Results: Acid fast non-branching bacilli were detected in all samples from homogenized internal organs. All 13 acid fast samples were positive for Mycobacterium via real-time PCR. Partial gene sequences using all three primer sets were obtained from two samples and demonstrated a novel strain. A strain 99% related to Mycobacterium marinum was also confirmed in one sample, using 16srRNA and rpoB genes. The two novel strains were clustered with the rapid growers and strains that are known to affect humans. Conclusions: Phylogenetic analysis demonstrated two novel Mycobacterium strains with the potential of being zoonotic and one strain 99% related to Mycobacterium marinum.Keywords: polymerase chain reaction, phylogenetic, DNA sequencing, zoonotic
Procedia PDF Downloads 1351794 Lighting Consumption Analysis in Retail Industry: Comparative Study
Authors: Elena C. Tamaş, Grațiela M. Țârlea, Gianni Flamaropol, Dragoș Hera
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This article is referring to a comparative study regarding the electrical energy consumption for lighting on diverse types of big sizes commercial buildings built in Romania after 2007, having 3, 4, 5 versus 8, 9, 10 operational years. Some buildings have installed building management systems (BMS) to monitor also the lighting performances starting with the opening days till the present days but some have chosen only local meters to implement. Firstly, for each analyzed building, the total required energy power and the energy power consumption for lighting were calculated depending on the lamps number, the unit power and the average daily running hours. All objects and installations were chosen depending on the destination/location of the lighting (exterior parking or access, interior or covering parking, building interior and building perimeter). Secondly, to all lighting objects and installations, mechanical counters were installed, and to the ones linked to BMS there were installed the digital meters as well for a better monitoring. Some efficient solutions are proposed to improve the power consumption, for example the 1/3 lighting functioning for the covered and exterior parking lighting to those buildings if can be done. This type of lighting share can be performed on each level, especially on the night shifts. Another example is to use the dimmers to reduce the light level, depending on the executed work in the respective area, and a 30% power energy saving can be achieved. Using the right BMS to monitor, the energy consumption depending on the average operational daily hours and changing the non-performant unit lights with the ones having LED technology or economical ones might increase significantly the energy performances and reduce the energy consumption of the buildings.Keywords: commercial buildings, energy performances, lightning consumption, maintenance
Procedia PDF Downloads 2541793 Thermal Performance of an Air Heating Storing System
Authors: Mohammed A. Elhaj, Jamal S. Yassin
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Owing to the lack of synchronization between the solar energy availability and the heat demands in a specific application, the energy storing sub-system is necessary to maintain the continuity of thermal process. The present work is dealing with an active solar heating storing system in which an air solar collector is connected to storing unit where this energy is distributed and provided to the heated space in a controlled manner. The solar collector is a box type absorber where the air flows between a number of vanes attached between the collector absorber and the bottom plate. This design can improve the efficiency due to increasing the heat transfer area exposed to the flowing air, as well as the heat conduction through the metal vanes from the top absorbing surface. The storing unit is a packed bed type where the air is coming from the air collector and circulated through the bed in order to add/remove the energy through the charging / discharging processes, respectively. The major advantage of the packed bed storage is its high degree of thermal stratification. Numerical solution of the packed bed energy storage is considered through dividing the bed into a number of equal segments for the bed particles and solved the energy equation for each segment depending on the neighbor ones. The studied design and performance parameters in the developed simulation model including, particle size, void fraction, etc. The final results showed that the collector efficiency was fluctuated between 55%-61% in winter season (January) under the climatic conditions of Misurata in Libya. Maximum temperature of 52ºC is attained at the top of the bed while the lower one is 25ºC at the end of the charging process of hot air into the bed. This distribution can satisfy the required load for the most house heating in Libya.Keywords: solar energy, thermal process, performance, collector, packed bed, numerical analysis, simulation
Procedia PDF Downloads 3221792 The Validation of RadCalc for Clinical Use: An Independent Monitor Unit Verification Software
Authors: Junior Akunzi
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In the matter of patient treatment planning quality assurance in 3D conformational therapy (3D-CRT) and volumetric arc therapy (VMAT or RapidArc), the independent monitor unit verification calculation (MUVC) is an indispensable part of the process. Concerning 3D-CRT treatment planning, the MUVC can be performed manually applying the standard ESTRO formalism. However, due to the complex shape and the amount of beams in advanced treatment planning technic such as RapidArc, the manual independent MUVC is inadequate. Therefore, commercially available software such as RadCalc can be used to perform the MUVC in complex treatment planning been. Indeed, RadCalc (version 6.3 LifeLine Inc.) uses a simplified Clarkson algorithm to compute the dose contribution for individual RapidArc fields to the isocenter. The purpose of this project is the validation of RadCalc in 3D-CRT and RapidArc for treatment planning dosimetry quality assurance at Antoine Lacassagne center (Nice, France). Firstly, the interfaces between RadCalc and our treatment planning systems (TPS) Isogray (version 4.2) and Eclipse (version13.6) were checked for data transfer accuracy. Secondly, we created test plans in both Isogray and Eclipse featuring open fields, wedges fields, and irregular MLC fields. These test plans were transferred from TPSs according to the radiotherapy protocol of DICOM RT to RadCalc and the linac via Mosaiq (version 2.5). Measurements were performed in water phantom using a PTW cylindrical semiflex ionisation chamber (0.3 cm³, 31010) and compared with the TPSs and RadCalc calculation. Finally, 30 3D-CRT plans and 40 RapidArc plans created with patients CT scan were recalculated using the CT scan of a solid PMMA water equivalent phantom for 3D-CRT and the Octavius II phantom (PTW) CT scan for RapidArc. Next, we measure the doses delivered into these phantoms for each plan with a 0.3 cm³ PTW 31010 cylindrical semiflex ionisation chamber (3D-CRT) and 0.015 cm³ PTW PinPoint ionisation chamber (Rapidarc). For our test plans, good agreements were found between calculation (RadCalc and TPSs) and measurement (mean: 1.3%; standard deviation: ± 0.8%). Regarding the patient plans, the measured doses were compared to the calculation in RadCalc and in our TPSs. Moreover, RadCalc calculations were compared to Isogray and Eclispse ones. Agreements better than (2.8%; ± 1.2%) were found between RadCalc and TPSs. As for the comparison between calculation and measurement the agreement for all of our plans was better than (2.3%; ± 1.1%). The independent MU verification calculation software RadCal has been validated for clinical use and for both 3D-CRT and RapidArc techniques. The perspective of this project includes the validation of RadCal for the Tomotherapy machine installed at centre Antoine Lacassagne.Keywords: 3D conformational radiotherapy, intensity modulated radiotherapy, monitor unit calculation, dosimetry quality assurance
Procedia PDF Downloads 2091791 Effect of Irrigation Regime and Plant Density on Chickpea (Cicer arietinum L.) Yield in a Semi-Arid Environment
Authors: Atif Naim, Faisal E. Ahmed, Sershen
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A field experiment was conducted for two consecutive winter seasons at the Demonstration Farm of the Faculty of Agriculture, University of Khartoum, Sudan, to study effects of different levels of irrigation regime and plant density on yield of introduced small seeded (desi type) chickpea cultivar (ILC 482). The experiment was laid out in a 3X3 factorial split-plot design with 4 replications. The treatments consisted of three irrigation regimes (designated as follows: I1 = optimum irrigation, I2 = moderate stress and I3 = severe stress; this corresponded with irrigation after drainage of 50%, 75% and 100% of available water based on 70%, 60% and 50% of field capacity, respectively) assigned as main plots and three plant densities (D₁=20, D₂= 40 and D₃= 60 plants/m²) assigned as subplots. The results indicated that the yield components (number of pods per plant, number of seeds per pod, 100 seed weight), seed yield per plant, harvest index and yield per unit area of chickpea were significantly (p < 0.05) affected by irrigation regime. Decreasing irrigation regime significantly (p < 0.05) decreased all measured parameters. Alternatively, increasing plant density significantly (p < 0.05) decreased the number of pods and seed yield per plant and increased seed yield per unit area. While number of seeds per pod and harvest index were not significantly (p > 0.05) affected by plant density. Interaction between irrigation regime and plant density was also significantly (p < 0.05) affected all measured parameters of yield, except for harvest index. It could be concluded that the best irrigation regime was full irrigation (after drainage of 50% available water at 70% field capacity) and the optimal plant density was 20 plants/m² under conditions of semi-arid regions.Keywords: irrigation regime, Cicer arietinum, chickpea, plant density
Procedia PDF Downloads 2181790 A Study on the Microbilogical Profile and Antibiotic Sensitivity Pattern of Bacterial Isolates Causing Urinary Tract Infection in Intensive Care Unit Patients in a Tertiary Care Hospital in Eastern India
Authors: Pampita Chakraborty, Sukumar Mukherjee
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The study was done to determine the microbiological profile and changing pattern of the pathogens causing UTI in the ICU patients. All the patients admitted to the ICU with urinary catheter insertion for more than 48hours were included in the study. Urine samples were collected in a sterile container with aseptic precaution using disposable syringe and was processed as per standards. Antimicrobial susceptibility test was done by Disc Diffusion method as per CLSI guidelines. A total of 100 urine samples were collected from ICU patients, out of which 30% showed significant bacterial growth and 7% showed growth of candida spp. Prevalence of UTI was more in female (73%) than male (27.%). Gram-negative bacilli 26(86.67%) were more common in our study followed by gram-positive cocci 4(13.33%). The most common uropathogens isolated were Escherichia coli 14 (46.67%), followed by Klebsiella spp 7(23.33%), Staphylococcus aureus 4(13.33%), Acinetobacter spp 3(10%), Enterococcus faecalis 1(3.33%) and Pseudomonas aeruginosa 1(3.33%). Most of the Gram-negative bacilli were sensitive to amikacin (80%) and nitrofurantoin (80%), where as all gram-positive organisms were sensitive to Vancomycin. A large number ESBL producers were also observed in this study. The study finding showed that E.coli is the predominant pathogen and has increasing resistance pattern to the commonly used antibiotics. The study proposes that the adherence to antibiotic policy is the key ingredients for successful outcome in ICU patients and also emphasizes that repeated evaluation of microbial characteristics and continuous surveillance of resistant bacteria is required for selection of appropriate antibiotic therapy.Keywords: antimicrobial sensitivity, intensive care unit, nosocomial infection, urinary tract infection
Procedia PDF Downloads 2611789 A Multi-Stage Learning Framework for Reliable and Cost-Effective Estimation of Vehicle Yaw Angle
Authors: Zhiyong Zheng, Xu Li, Liang Huang, Zhengliang Sun, Jianhua Xu
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Yaw angle plays a significant role in many vehicle safety applications, such as collision avoidance and lane-keeping system. Although the estimation of the yaw angle has been extensively studied in existing literature, it is still the main challenge to simultaneously achieve a reliable and cost-effective solution in complex urban environments. This paper proposes a multi-stage learning framework to estimate the yaw angle with a monocular camera, which can deal with the challenge in a more reliable manner. In the first stage, an efficient road detection network is designed to extract the road region, providing a highly reliable reference for the estimation. In the second stage, a variational auto-encoder (VAE) is proposed to learn the distribution patterns of road regions, which is particularly suitable for modeling the changing patterns of yaw angle under different driving maneuvers, and it can inherently enhance the generalization ability. In the last stage, a gated recurrent unit (GRU) network is used to capture the temporal correlations of the learned patterns, which is capable to further improve the estimation accuracy due to the fact that the changes of deflection angle are relatively easier to recognize among continuous frames. Afterward, the yaw angle can be obtained by combining the estimated deflection angle and the road direction stored in a roadway map. Through effective multi-stage learning, the proposed framework presents high reliability while it maintains better accuracy. Road-test experiments with different driving maneuvers were performed in complex urban environments, and the results validate the effectiveness of the proposed framework.Keywords: gated recurrent unit, multi-stage learning, reliable estimation, variational auto-encoder, yaw angle
Procedia PDF Downloads 1341788 Reducing Falls in Memory Care through Implementation of the Stopping Elderly Accidents, Deaths, and Injuries Program
Authors: Cory B. Lord
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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.Keywords: dementia, elderly, falls, STEADI
Procedia PDF Downloads 1191787 A Study on the Effectiveness of Alternative Commercial Ventilation Inlets That Improve Energy Efficiency of Building Ventilation Systems
Authors: Brian Considine, Aonghus McNabola, John Gallagher, Prashant Kumar
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Passive air pollution control devices known as aspiration efficiency reducers (AER) have been developed using aspiration efficiency (AE) concepts. Their purpose is to reduce the concentration of particulate matter (PM) drawn into a building air handling unit (AHU) through alterations in the inlet design improving energy consumption. In this paper an examination is conducted into the effect of installing a deflector system around an AER-AHU inlet for both a forward and rear-facing orientations relative to the wind. The results of the study found that these deflectors are an effective passive control method for reducing AE at various ambient wind speeds over a range of microparticles of varying diameter. The deflector system was found to induce a large wake zone at low ambient wind speeds for a rear-facing AER-AHU, resulting in significantly lower AE in comparison to without. As the wind speed increased, both contained a wake zone but have much lower concentration gradients with the deflectors. For the forward-facing models, the deflector system at low ambient wind speed was preferred at higher Stokes numbers but there was negligible difference as the Stokes number decreased. Similarly, there was no significant difference at higher wind speeds across the Stokes number range tested. The results demonstrate that a deflector system is a viable passive control method for the reduction of ventilation energy consumption.Keywords: air handling unit, air pollution, aspiration efficiency, energy efficiency, particulate matter, ventilation
Procedia PDF Downloads 1141786 Home-Based Care with Follow-Up at Outpatient Unit or Community-Follow-Up Center with/without Food Supplementation and/or Psychosocial Stimulation of Children with Moderate Acute Malnutrition in Bangladesh
Authors: Md Iqbal Hossain, Tahmeed Ahmed, Kenneth H. Brown
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Objective: To assess the effect of community-based follow up, with or without food-supplementation and/or psychosocial stimulation, as an alternative to current hospital-based follow-up of children with moderate-acute-malnutrition (WHZ < -2 to -3) (MAM). Design/methods: The study was conducted at the ICDDR,B Dhaka Hospital and in four urban primary health care centers of Dhaka, Bangladesh during 2005-2007. The efficacy of five different randomly assigned interventions was compared with respect to the rate of completion of follow-up, growth and morbidity in 227 MAM children aged 6-24 months who were initially treated at ICDDR,B for diarrhea and/or other morbidities. The interventions were: 1) Fortnightly follow-up care (FFC) at the ICDDR,B’s outpatient-unit, including growth monitoring, health education, and micro-nutrient supplementation (H-C, n=49). 2) FFC at community follow-up unit (CNFU) [established in the existing urban primary health-care centers close to the residence of the child] but received the same regimen as H-C (C-C, n=53). 3) As per C-C plus cereal-based supplementary food (SF) (C-SF, n=49). The SF packets were distributed on recruitment and at every visit in CNFU [@1 packet/day for 6–11 and 2 packets/day for 12-24 month old children. Each packet contained 20g toasted rice-powder, 10g toasted lentil-powder, 5g molasses, and 3g soy bean oil, to provide a total of ~ 150kcal with 11% energy from protein]. 4) As per C-C plus psychosocial stimulation (PS) (C-PS, n=43). PS consisted of child-stimulation and parental-counseling conducted by trained health workers. 5) As per C-C plus both SF+PS (C-SF+PS, n=33). Results: A total of 227children (48.5% female), with a mean ± SD age of 12.6 ±3.8 months, and WHZ of - 2.53±0.28 enrolled. Baseline characteristics did not differ by treatment group. The rate of spontaneous attendance at scheduled follow-up visits gradually decreased in all groups. Follow-up attendance and gain in weight and length were greater in groups C-SF, C-SF+PS, and C-PS than C-C, and these indicators were observed least in H-C. Children in the H-C group more often suffered from diarrhea (25 % vs. 4-9%) and fever (28% vs. 8-11%) than other groups (p < 0.05). Children who attended at least five of the total six scheduled follow-up visits gained more in weight (median: 0.86 vs. 0.62 kg, p=0.002), length (median: 2.4 vs. 2.0 cm, p=0.009) than those who attended fewer. Conclusions: Community-based service delivery, especially including supplementary food with or without psychosocial stimulation, permits better rehabilitation of children with MAM compared to current hospital outpatients-based care. By scaling the community-based follow-up including food supplementation with or without psychosocial stimulation, it will be possible to rehabilitate a greater number of MAM children in a better way.Keywords: community-based management, moderate acute malnutrition, psychosocial stimulation, supplementary food
Procedia PDF Downloads 4321785 The Impact of Hospital Intensive Care Unit Window Design on Daylighting and Energy Performance in Desert Climate
Authors: A. Sherif, H. Sabry, A. Elzafarany, M. Gadelhak, R. Arafa, M. Aly
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This paper addresses the design of hospital Intensive Care Unit windows for the achievement of visual comfort and energy savings. The aim was to identify the window size and shading system configurations that could fulfill daylighting adequacy, avoid glare and reduce energy consumption. The study focused on addressing the effect of utilizing different shading systems in association with a range of Window-to-Wall Ratios (WWR) in different orientations under the desert clear-sky of Cairo, Egypt. The results of this study demonstrated that solar penetration is a critical concern affecting the design of ICU windows in desert locations, as in Cairo, Egypt. Use of shading systems was found to be essential in providing acceptable daylight performance and energy saving. Careful positioning of the ICU window towards a proper orientation can dramatically improve performance. It was observed that ICU windows facing the north direction enjoyed the widest range of successful window configuration possibilities at different WWRs. ICU windows facing south enjoyed a reasonable number of configuration options as well. By contrast, the ICU windows facing the east orientation had a very limited number of options that provide acceptable performance. These require additional local shading measures at certain times due to glare incidence. Moreover, use of horizontal sun breakers and solar screens to protect the ICU windows proved to be more successful than the other alternatives in a wide range of Window to Wall Ratios. By contrast, the use of light shelves and vertical shading devices seemed questionable.Keywords: daylighting, desert, energy efficiency, shading
Procedia PDF Downloads 4281784 Machine Learning Based Anomaly Detection in Hydraulic Units of Governors in Hydroelectric Power Plants
Authors: Mehmet Akif Bütüner, İlhan Koşalay
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Hydroelectric power plants (HEPPs) are renewable energy power plants with the highest installed power in the world. While the control systems operating in these power plants ensure that the system operates at the desired operating point, it is also responsible for stopping the relevant unit safely in case of any malfunction. While these control systems are expected not to miss signals that require stopping, on the other hand, it is desired not to cause unnecessary stops. In traditional control systems including modern systems with SCADA infrastructure, alarm conditions to create warnings or trip conditions to put relevant unit out of service automatically are usually generated with predefined limits regardless of different operating conditions. This approach results in alarm/trip conditions to be less likely to detect minimal changes which may result in serious malfunction scenarios in near future. With the methods proposed in this research, routine behavior of the oil circulation of hydraulic governor of a HEPP will be modeled with machine learning methods using historical data obtained from SCADA system. Using the created model and recently gathered data from control system, oil pressure of hydraulic accumulators will be estimated. Comparison of this estimation with the measurements made and recorded instantly by the SCADA system will help to foresee failure before becoming worse and determine remaining useful life. By using model outputs, maintenance works will be made more planned, so that undesired stops are prevented, and in case of any malfunction, the system will be stopped or several alarms are triggered before the problem grows.Keywords: hydroelectric, governor, anomaly detection, machine learning, regression
Procedia PDF Downloads 841783 A Review of the Handling and Disposal of Botulinum Toxin in a Maxillofacial Unit
Authors: Ashana Gupta
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Aim: In the UK, Botulinum Toxin (botox) is authorised for treating chronic myofascial pain secondary to masseter muscle hypertrophy (Fedorowicz et al. 2013). This audit aimed to ensure the Maxillofacial Unit is meeting the trust guidelines for the safe storage and disposal of botox. Method: The trust upholds a strict policy for botox handling. The audit was designed to optimise several elements including Staff awareness of regulations around botox handling A questionnaire was designed to test knowledge of advised storage temperatures, reporting of adverse events, disposal procedures and regulatory authorities. Steps taken to safely delivertoxin and eliminate unused toxin. A checklist was completed. These include marks for storagetemperature, identification checks, disposal of sharps, deactivation of toxin, and disposal. Results: All staff correctly stated storage requirements for toxin. 75% staff (n=8) were unsure about reporting and regulations. Whilst all staff knew how to dispose of vials, 0% staff showed awareness for the crucial step of deactivating toxin. All checklists (n=20) scored 100% for adequate storage, ID checks, and toxin disposal. However, there were no steps taken to deactivate toxin in any cases. Staff training took place with revision to clinical protocols. In line with Trust guidelines, an additional clinical step has been introduced including use of 0.5% sodium hypochlorite to deactivate botox. Conclusion: Deactivation is crucial to ensure residual toxin is not misused. There are cases of stolen botox within South-Tees Hospital (Woodcock, 2014). This audit was successful in increasing compliance to safe handling and disposal of botox by 100% and ensured our hospitalmeets Trust guidance.Keywords: botulinum toxin, aesthetics, handling, disposal
Procedia PDF Downloads 2011782 Comparison of Clinical Profiles of Patients Seen in a Women and Children Protection Unit in a Local Government Hospital in Makati, Philippines Before and During the COVID-19 Pandemic Between January 2018 to February 2020 and March 2020 to December 2021
Authors: Margaret Denise P. Del Rosario, Geraldine Alcantara
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Background: The declaration of the COVID-19 pandemic has impacted hospital visits of child abuse cases with less consults but more severe injuries. Objective: The study aims to identify the clinical profiles of patients seen in the hospital ng Makati Women and Children Protection Unit before and during the pandemic. Design: A cross-sectional analytic study design through review of records that underwent quantitative analysis. Results: 264 cases pre-pandemic and 208 cases during the pandemic were reviewed. Most reported cases were neglect comprising of 47% of the pre-pandemic cases and 68% of cases during the pandemic. Supervisory neglect was most commonly reported. An equal distribution between males and females were seen among victims and alleged perpetrators. The age group of both victims and alleged perpetrators during the pandemic was significantly younger compared to the pre-pandemic period. Children belonging to larger family groups were commonly encountered with most of them being the eldest amongst siblings. Alleged perpetrators were mostly secondary graduates for both time periods. A significant increase of cases during the pandemic occurred at home. More patients required hospitalization during the pandemic period with 37% compared to the 23% of admissions prior to the pandemic. Furthermore, a three-fold increase of injuries sustained during the pandemic required intensive care. Conclusion: The study reflects increased severity of injuries related to abuse during the pandemic compared to pre-pandemic times. A significant increase in injuries requiring intensive care were also seen despite less reported cases.Keywords: child abuse, COVID-19, violence against children, WCPU, neglect
Procedia PDF Downloads 471781 A Zero-Flaring Flowback Solution to Revive Liquid Loaded Gas Wells
Authors: Elsayed Amer, Tarek Essam, Abdullah Hella, Mohammed Al-Ajmi
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Hydrocarbon production decline in mature gas fields is inevitable, and mitigating these circumstances is essential to ensure a longer production period. Production decline is not only influenced by reservoir pressure and wellbore integrity; however, associated liquids in the reservoir rock have a considerable impact on the production process. The associated liquid may result in liquid loading, near wellbore damage, condensate banking, fine sand migration, and wellhead pressure depletion. Consequently, the producing well will suffocate, and the liquid column will seize the well from flowing. A common solution in such circumstances is reducing the surface pressure by opening the well to the atmospheric pressure and flaring the produced liquids. This practice may not be applicable to many cases since the atmospheric pressure is not low enough to create a sufficient driving force to flow the well. In addition, flaring the produced hydrocarbon is solving the issue on account of the environment, which is against the world's efforts to mitigate the impact of climate change. This paper presents a novel approach and a case study that utilizes a multi-phase mobile wellhead gas compression unit (MMWGC) to reduce surface pressure to the sub-atmospheric level and transfer the produced hydrocarbons to the sales line. As a result, the liquid column will unload in a zero-flaring manner, and the life of the producing well will extend considerably. The MMWGC unit was able to successfully kick off a dead well to produce up to 10 MMSCFD after reducing the surface pressure for 3 hours. Applying such novelty on a broader scale will not only extend the life of the producing wells yet will also provide a zero-flaring, economically and environmentally preferred solution.Keywords: petroleum engineering, zero-flaring, liquid loading, well revival
Procedia PDF Downloads 961780 Reliability of Social Support Measurement Modification of the BC-SSAS among Women with Breast Cancer Who Undergone Chemotherapy in Selected Hospital, Central Java, Indonesia
Authors: R. R. Dewi Rahmawaty Aktyani Putri, Earmporn Thongkrajai, Dedy Purwito
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There were many instruments have been developed to assess social support which has the different dimension in breast cancer patients. The Issue of measurement is a challenge to determining the component of dimensional concept, defining the unit of measurement, and establishing the validity and reliability of the measurement. However, the instruments where need to know how much support which obtained and perceived among women with breast cancer who undergone chemotherapy which it can help nurses to prevent of non-adherence in chemotherapy. This study aimed to measure the reliability of BC-SSAS instrument among 30 Indonesian women with breast cancer aged 18 years and above who undergone chemotherapy for six cycles in the oncological unit of Outpatient Department (OPD), Margono Soekardjo Hospital, Central Java, Indonesia. Data were collected during October to December 2015 by using modified the Breast Cancer Social Support Assessment (BC-SSAS). The Cronbach’s alpha analysis was carried out to measure internal consistency for reliability test of BC-SSAS instrument. This study used five experts for content validity index. The results showed that for content validity, I-CVI was 0.98 and S-CVI was 0.98; Cronbach’s alpha value was 0.971 and the Cronbach’s alpha coefficients for the subscales were high, with 0.903 for emotional support, 0.865 for informational support, 0.901 for tangible support, 0.897 for appraisal support and 0.884 for positive interaction support. The results confirmed that the BC-SSAS instrument has high reliability. BC-SSAS instruments were reliable and can be used in health care services to measure the social support received and perceived among women with breast cancer who undergone chemotherapy so that preventive interventions can be developed and the quality of health services can be improved.Keywords: BC-SSAS, women with breast cancer, chemotherapy, Indonesia
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