Search results for: diesel-generator unit
Commenced in January 2007
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Edition: International
Paper Count: 2159

Search results for: diesel-generator unit

1649 Multiscale Analysis of Shale Heterogeneity in Silurian Longmaxi Formation from South China

Authors: Xianglu Tang, Zhenxue Jiang, Zhuo Li

Abstract:

Characterization of shale multi scale heterogeneity is an important part to evaluate size and space distribution of shale gas reservoirs in sedimentary basins. The origin of shale heterogeneity has always been a hot research topic for it determines shale micro characteristics description and macro quality reservoir prediction. Shale multi scale heterogeneity was discussed based on thin section observation, FIB-SEM, QEMSCAN, TOC, XRD, mercury intrusion porosimetry (MIP), and nitrogen adsorption analysis from 30 core samples in Silurian Longmaxi formation. Results show that shale heterogeneity can be characterized by pore structure and mineral composition. The heterogeneity of shale pore is showed by different size pores at nm-μm scale. Macropores (pore diameter > 50 nm) have a large percentage of pore volume than mesopores (pore diameter between 2~ 50 nm) and micropores (pore diameter < 2nm). However, they have a low specific surface area than mesopores and micropores. Fractal dimensions of the pores from nitrogen adsorption data are higher than 2.7, what are higher than 2.8 from MIP data, showing extremely complex pore structure. This complexity in pore structure is mainly due to the organic matter and clay minerals with complex pore network structures, and diagenesis makes it more complicated. The heterogeneity of shale minerals is showed by mineral grains, lamina, and different lithology at nm-km scale under the continuous changing horizon. Through analyzing the change of mineral composition at each scale, random arrangement of mineral equal proportion, seasonal climate changes, large changes of sedimentary environment, and provenance supply are considered to be the main reasons that cause shale minerals heterogeneity from microcosmic to macroscopic. Due to scale effect, the change of shale multi scale heterogeneity is a discontinuous process, and there is a transformation boundary between homogeneous and in homogeneous. Therefore, a shale multi scale heterogeneity changing model is established by defining four types of homogeneous unit at different scales, which can be used to guide the prediction of shale gas distribution from micro scale to macro scale.

Keywords: heterogeneity, homogeneous unit, multiscale, shale

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1648 Password Cracking on Graphics Processing Unit Based Systems

Authors: N. Gopalakrishna Kini, Ranjana Paleppady, Akshata K. Naik

Abstract:

Password authentication is one of the widely used methods to achieve authentication for legal users of computers and defense against attackers. There are many different ways to authenticate users of a system and there are many password cracking methods also developed. This paper is mainly to propose how best password cracking can be performed on a CPU-GPGPU based system. The main objective of this work is to project how quickly a password can be cracked with some knowledge about the computer security and password cracking if sufficient security is not incorporated to the system.

Keywords: GPGPU, password cracking, secret key, user authentication

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1647 Design Optimisation of a Novel Cross Vane Expander-Compressor Unit for Refrigeration System

Authors: Y. D. Lim, K. S. Yap, K. T. Ooi

Abstract:

In recent years, environmental issue has been a hot topic in the world, especially the global warming effect caused by conventional non-environmentally friendly refrigerants has increased. Several studies of a more energy-efficient and environmentally friendly refrigeration system have been conducted in order to tackle the issue. In search of a better refrigeration system, CO2 refrigeration system has been proposed as a better option. However, the high throttling loss involved during the expansion process of the refrigeration cycle leads to a relatively low efficiency and thus the system is impractical. In order to improve the efficiency of the refrigeration system, it is suggested by replacing the conventional expansion valve in the refrigeration system with an expander. Based on this issue, a new type of expander-compressor combined unit, named Cross Vane Expander-Compressor (CVEC) was introduced to replace the compressor and the expansion valve of a conventional refrigeration system. A mathematical model was developed to calculate the performance of CVEC, and it was found that the machine is capable of saving the energy consumption of a refrigeration system by as much as 18%. Apart from energy saving, CVEC is also geometrically simpler and more compact. To further improve its efficiency, optimization study of the device is carried out. In this report, several design parameters of CVEC were chosen to be the variables of optimization study. This optimization study was done in a simulation program by using complex optimization method, which is a direct search, multi-variables and constrained optimization method. It was found that the main design parameters, which was shaft radius was reduced around 8% while the inner cylinder radius was remained unchanged at its lower limit after optimization. Furthermore, the port sizes were increased to their upper limit after optimization. The changes of these design parameters have resulted in reduction of around 12% in the total frictional loss and reduction of 4% in power consumption. Eventually, the optimization study has resulted in an improvement in the mechanical efficiency CVEC by 4% and improvement in COP by 6%.

Keywords: complex optimization method, COP, cross vane expander-compressor, CVEC, design optimization, direct search, energy saving, improvement, mechanical efficiency, multi variables

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1646 Sexual Dimorphism in the Sensorial Structures of the Antenna of Thygater aethiops (Hymenoptera: Apidae) and Its Relation with Some Corporal Parameters

Authors: Wendy Carolina Gomez Ramirez, Rodulfo Ospina Torres

Abstract:

Thygater aethiops is a species of solitary bee with a neotropical distribution that has been adapted to live in urban environments. This species of bee presents a marked sexual dimorphism since the males have antenna almost as long as their body different from the females that present antenna with smaller size. In this work, placoid sensilla were studied, which are structures that appear in the antenna and are involved in the detection of substances both, for reproduction and for the search of food. The aim of this study was to evaluate the differences between these sensory structures in the different sexes, for which males and females were captured. Later some body measures were taken such as fresh weight with abdomen and without it, since the weight could be modified by the stomach content; other measures were taken as the total antenna length and length of the flagellum and flagelomere. After negative imprints of the antenna were made using nail polish, the imprint was cut with a microblade and mounted onto a microscope slide. The placoid sensilla were visible on the imprint, so they were counted manually on the 100x objective lens of the optical microscope. Initially, the males presented a specific distribution pattern in two types of sensilla: trichoid and placoid, the trichoid were found aligned in the dorsal face of the antenna and the placoid were distributed along the entire antenna; that was different to the females since they did not present a distribution pattern the sensilla were randomly organized. It was obtained that the males, because they have a longer antenna, have a greater number of sensilla in relation to the females. Additionally, it was found that there was no relationship between the weight and the number of sensilla, but there was a positive relationship between the length of the antenna, the length of the flagellum and the number of sensilla. The relationship between the number of sensilla per unit area in each of the sexes was also calculated, which showed that, on average, males have 4.2 ± 0.38 sensilla per unit area and females present 2.2 ± 0.20 and likewise a significant difference between sexes. This dimorphism found may be related to the sexual behavior of the species, since it has been demonstrated that males are more adapted to the perception of substances related to reproduction than to the search of food.

Keywords: antenna, olfactory organ, sensilla, sexual dimorphism, solitary bees

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1645 The Study of Cost Accounting in S Company Based on TDABC

Authors: Heng Ma

Abstract:

Third-party warehousing logistics has an important role in the development of external logistics. At present, the third-party logistics in our country is still a new industry, the accounting system has not yet been established, the current financial accounting system of third-party warehousing logistics is mainly in the traditional way of thinking, and only able to provide the total cost information of the entire enterprise during the accounting period, unable to reflect operating indirect cost information. In order to solve the problem of third-party logistics industry cost information distortion, improve the level of logistics cost management, the paper combines theoretical research and case analysis method to reflect cost allocation by building third-party logistics costing model using Time-Driven Activity-Based Costing(TDABC), and takes S company as an example to account and control the warehousing logistics cost. Based on the idea of “Products consume activities and activities consume resources”, TDABC put time into the main cost driver and use time-consuming equation resources assigned to cost objects. In S company, the objects focuses on three warehouse, engaged with warehousing and transportation (the second warehouse, transport point) service. These three warehouse respectively including five departments, Business Unit, Production Unit, Settlement Center, Security Department and Equipment Division, the activities in these departments are classified by in-out of storage forecast, in-out of storage or transit and safekeeping work. By computing capacity cost rate, building the time-consuming equation, the paper calculates the final operation cost so as to reveal the real cost. The numerical analysis results show that the TDABC can accurately reflect the cost allocation of service customers and reveal the spare capacity cost of resource center, verifies the feasibility and validity of TDABC in third-party logistics industry cost accounting. It inspires enterprises focus on customer relationship management and reduces idle cost to strengthen the cost management of third-party logistics enterprises.

Keywords: third-party logistics enterprises, TDABC, cost management, S company

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1644 Anaesthetic Management of Congenitally Corrected Transposition of Great Arteries with Complete Heart Block in a Parturient for Emergency Caesarean Section

Authors: Lokvendra S. Budania, Yogesh K Gaude, Vamsidhar Chamala

Abstract:

Introduction: Congenitally corrected transposition of great arteries (CCTGA) is a complex congenital heart disease where there are both atrioventricular and ventriculoarterial discordances, usually accompanied by other cardiovascular malformations. Case Report: A 24-year-old primigravida known case of CCTGA at 37 weeks of gestation was referred to our hospital for safe delivery. Her electrocardiogram showed HR-40/pm, echocardiography showed Ejection Fraction of 65% and CCTGA. Temporary pacemaker was inserted by cardiologist in catheterization laboratory, before giving trial of labour in view of complete heart block. She was planned for normal delivery, but emergency Caesarean section was planned due to non-reassuring foetal Cardiotocography Pre-op vitals showed PR-50 bpm with temporary pacemaker, Blood pressure-110/70 mmHg, SpO2-99% on room air. Nil per oral was inadequate. Patency of two peripheral IV cannula checked and left radial arterial line secured. Epidural Anaesthesia was planned, and catheter was placed at L2-L3. Test dose was given, Anaesthesia was provided with 5ml + 5ml of 2% Lignocaine with 25 mcg Fentanyl and further 2.5Ml of 0.5% Bupivacaine was given to achieve a sensory level of T6. Cesarean section was performed and baby was delivered. Cautery was avoided during this procedure. IV Oxytocin (15U) was added to 500 mL of ringer’s lactate. Hypotension was treated with phenylephrine boluses. Patient was shifted to post-operative care unit and later to high dependency unit for monitoring. Post op vitals remained stable. Temporary pacemaker was removed after 24 hours of surgery. Her post-operative period was uneventful and discharged from hospital. Conclusion: Rare congenital cardiac disorders require detail knowledge of pathophysiology and associated comorbidities with the disease. Meticulously planned and carefully titrated neuraxial techniques will be beneficial for such cases.

Keywords: congenitally corrected transposition of great arteries, complete heart block, emergency LSCS, epidural anaesthesia

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1643 Typification and Determination of Antibiotic Resistance Rates of Stenotrophomonas Maltophilia Strains Isolated from Intensive Care Unit Patients in a University Practice and Research Hospital

Authors: Recep Kesli, Gulsah Asik, Cengiz Demir, Onur Turkyilmaz

Abstract:

Objective: Stenotrophomonas maltophilia (S. maltophilia) has recently emerged as an important nosocomial microorganism. Treatment of invasive infections caused by this organism is problematic because this microorganism is usually resistant to a wide range of commonly used antimicrobials. We aimed to evaluate clinical isolates of S. maltophilia in respect to sampling sites and antimicrobial resistant. Method: During a two years period (October 2013 and September 2015) eighteen samples collected from the intensive care unit (ICU) patients hospitalized in Afyon Kocatepe University, ANS Practice and Research Hospital. Identification of the bacteria was determined by conventional methods and automated identification system-VITEK 2 (bio-Mérieux, Marcy l’toile, France). Antibacterial resistance tests were performed by Kirby Bauer disc (Oxoid, England) diffusion method following the recommendations of CLSI. Results: Eighteen S. maltophilia strains were identified as the causative agents of different infections. The main type of infection was lower respiratory tract infection (83,4 %); three patients (16,6 %) had bloodstream infection. While, none of the 18 S. maltophilia strains were found to be resistant against to trimethoprim sulfametaxasole (TMP-SXT) and levofloxacine, eight strains 66.6 % were found to be resistant against ceftazidim. Conclusion: The isolation of S.maltophilia starains resistant to TMP-SXT is vital. In order to prevent or minimize infections due to S. maltophilia such precuations should be utilized: Avoidance of inappropriate antibiotic use, prolonged implementation of foreign devices, reinforcement of hand hygiene practices and the application of appropriate infection control practices. Microbiology laboratories also may play important roles in controlling S. maltophilia infections by monitoring the prevalence, continuously, the provision of local antibiotic resistance paterns data and the performance of synergistic studies also may help to guide appropirate antimicrobial therapy choices.

Keywords: Stenotrophomonas maltophilia, trimethoprim-sulfamethoxazole, antimicrobial resistance, Stenotrophomonas spp.

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1642 Enhanced Performance of Supercapacitor Based on Boric Acid Doped Polyvinyl Alcohol-H₂SO₄ Gel Polymer Electrolyte System

Authors: Hamide Aydin, Banu Karaman, Ayhan Bozkurt, Umran Kurtan

Abstract:

Recently, Proton Conducting Gel Polymer Electrolytes (GPEs) have drawn much attention in supercapacitor applications due to their physical and electrochemical characteristics and stability conditions for low temperatures. In this research, PVA-H2SO4-H3BO3 GPE has been used for electric-double layer capacitor (EDLCs) application, in which electrospun free-standing carbon nanofibers are used as electrodes. Introduced PVA-H2SO4-H3BO3 GPE behaves as both separator and the electrolyte in the supercapacitor. Symmetric Swagelok cells including GPEs were assembled via using two electrode arrangements and the electrochemical properties were searched. Electrochemical performance studies demonstrated that PVA-H2SO4-H3BO3 GPE had a maximum specific capacitance (Cs) of 134 F g-1 and showed great capacitance retention (%100) after 1000 charge/discharge cycles. Furthermore, PVA-H2SO4-H3BO3 GPE yielded an energy density of 67 Wh kg-1 with a corresponding power density of 1000 W kg-1 at a current density of 1 A g-1. PVA-H2SO4 based polymer electrolyte was produced according to following procedure; Firstly, 1 g of commercial PVA was dissolved in distilled water at 90°C and stirred until getting transparent solution. This was followed by addition of the diluted H2SO4 (1 g of H2SO4 in a distilled water) to the solution to obtain PVA-H2SO4. PVA-H2SO4-H3BO3 based polymer electrolyte was produced by dissolving H3BO3 in hot distilled water and then inserted into the PVA-H2SO4 solution. The mole fraction was arranged to ¼ of the PVA repeating unit. After the stirring 2 h at RT, gel polymer electrolytes were obtained. The final electrolytes for supercapacitor testing included 20% of water in weight. Several blending combinations of PVA/H2SO4 and H3BO3 were studied to observe the optimized combination in terms of conductivity as well as electrolyte stability. As the amount of boric acid increased in the matrix, excess sulfuric acid was excluded due to cross linking, especially at lower solvent content. This resulted in the reduction of proton conductivity. Therefore, the mole fraction of H3BO3 was chosen as ¼ of PVA repeating unit. Within this optimized limits, the polymer electrolytes showed better conductivities as well as stability.

Keywords: electrical double layer capacitor, energy density, gel polymer electrolyte, ultracapacitor

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1641 The Sustainability of Public Debt in Taiwan

Authors: Chiung-Ju Huang

Abstract:

This study examines whether the Taiwan’s public debt is sustainable utilizing an unrestricted two-regime threshold autoregressive (TAR) model with an autoregressive unit root. The empirical results show that Taiwan’s public debt appears as a nonlinear series and is stationary in regime 1 but not in regime 2. This result implies that while Taiwan’s public debt was mostly sustainable over the 1996 to 2013 period examined in the study, it may no longer be sustainable in the most recent two years as the public debt ratio has increased cumulatively to 3.618%.

Keywords: nonlinearity, public debt, sustainability, threshold autoregressive model

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1640 Comparison of Peri- and Post-Operative Outcomes of Three Left Atrial Incisions: Conventional Direct, Transseptal and Superior Septal Left Atriotomy

Authors: Estelle Démoulin, Dionysios Adamopoulos, Tornike Sologashvili, Mathieu Van Steenberghe, Jalal Jolou, Haran Burri, Christoph Huber, Mustafa Cikirikcioglu

Abstract:

Background & objective: Mitral valve surgeries are mainly performed by median sternotomy with conventional direct atriotomy. Good exposure to the mitral valve is challenging, especially for acute pathologies, where left atrium dilation does not occur. Other atriotomies, such as transseptal or superior septal, are used as they allow better access and visualization. Peri- and postoperative outcomes of these three different left atriotomies were compared. Methods: Patients undergoing mitral valve surgery between January 2010 and December 2020 were included and divided into three groups: group 1 (conventional direct, n=115), group 2 (transseptal, n=33) and group 3 (superior septal, n=59). To improve the sampling size, all patients underwent mitral valve surgery with or without associated procedures (CABG, aortic-tricuspid surgery, Maze procedure). The study protocol was approved by SwissEthics. Results: No difference was shown for the etiology of mitral valve disease, except endocarditis, which was more frequent in group 3 (p = 0.014). Elective surgeries and isolated mitral valve surgery were more frequent in group 1 (p = 0.008, p = 0.011) and aortic clamping and cardiopulmonary bypass were shorter (p = 0.002, p<0.001). Group 3 had more emergency procedures (p = 0.011) and longer lengths of intensive care unit and hospital stay (p = 0.000, p = 0.003). There was no difference in permanent pacemaker implantation, postoperative complications and mortality between the groups. Conclusion: Mitral valve surgeries can be safely performed using those three left atriotomies. Conventional direct may lead to shorter aortic clamping and cardiopulmonary bypass times. Superior septal is mostly used for acute pathologies, and it does not increase postoperative arrhythmias and permanent pacemaker implantation. However, intensive care unit and hospital lengths of stay were found to be longer in this group. In our opinion, this outcome is more related to the pathology and type of surgery than the incision itself.

Keywords: Mitral valve surgery, cardiac surgery, atriotomy, Operative outcomes

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1639 Analyzing the Heat Transfer Mechanism in a Tube Bundle Air-PCM Heat Exchanger: An Empirical Study

Authors: Maria De Los Angeles Ortega, Denis Bruneau, Patrick Sebastian, Jean-Pierre Nadeau, Alain Sommier, Saed Raji

Abstract:

Phase change materials (PCM) present attractive features that made them a passive solution for thermal comfort assessment in buildings during summer time. They show a large storage capacity per volume unit in comparison with other structural materials like bricks or concrete. If their use is matched with the peak load periods, they can contribute to the reduction of the primary energy consumption related to cooling applications. Despite these promising characteristics, they present some drawbacks. Commercial PCMs, as paraffines, offer a low thermal conductivity affecting the overall performance of the system. In some cases, the material can be enhanced, adding other elements that improve the conductivity, but in general, a design of the unit that optimizes the thermal performance is sought. The material selection is the departing point during the designing stage, and it does not leave plenty of room for optimization. The PCM melting point depends highly on the atmospheric characteristics of the building location. The selection must relay within the maximum, and the minimum temperature reached during the day. The geometry of the PCM container and the geometrical distribution of these containers are designing parameters, as well. They significantly affect the heat transfer, and therefore its phenomena must be studied exhaustively. During its lifetime, an air-PCM unit in a building must cool down the place during daytime, while the melting of the PCM occurs. At night, the PCM must be regenerated to be ready for next uses. When the system is not in service, a minimal amount of thermal exchanges is desired. The aforementioned functions result in the presence of sensible and latent heat storage and release. Hence different types of mechanisms drive the heat transfer phenomena. An experimental test was designed to study the heat transfer phenomena occurring in a circular tube bundle air-PCM exchanger. An in-line arrangement was selected as the geometrical distribution of the containers. With the aim of visual identification, the containers material and a section of the test bench were transparent. Some instruments were placed on the bench for measuring temperature and velocity. The PCM properties were also available through differential scanning calorimeter (DSC) tests. An evolution of the temperature during both cycles, melting and solidification were obtained. The results showed some phenomena at a local level (tubes) and on an overall level (exchanger). Conduction and convection appeared as the main heat transfer mechanisms. From these results, two approaches to analyze the heat transfer were followed. The first approach described the phenomena in a single tube as a series of thermal resistances, where a pure conduction controlled heat transfer was assumed in the PCM. For the second approach, the temperature measurements were used to find some significant dimensionless numbers and parameters as Stefan, Fourier and Rayleigh numbers, and the melting fraction. These approaches allowed us to identify the heat transfer phenomena during both cycles. The presence of natural convection during melting might have been stated from the influence of the Rayleigh number on the correlations obtained.

Keywords: phase change materials, air-PCM exchangers, convection, conduction

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1638 Identification and Antibiotic Resistance Rates of Acinetobacter baumannii Strains Isolated from the Respiratory Tract Samples, Obtained from the Different Intensive Care Units

Authors: Recep Kesli, Gulşah Asik, Cengiz Demir, Onur Turkyilmaz

Abstract:

Objective: Acinetobacter baumannii (A. baumannii) can cause health-care associated infections, such as bacteremia, urinary tract and wound infections, endocarditis, meningitis, and pneumonia, particularly in intensive care unit patients. In this study, we aimed to evaluate A. baumannii production in sputum and bronchoalveolar lavage and susceptibilities for antibiotics in a 24 months period. Methods: Between October 2013 and September 2015, Acinetobacter baumannii isolated from respiratory tract speciments were evaluated retrospectively. The strains were isolated from the different intensive care units patients. A. baumannii strains were identified by both the conventional methods and aoutomated identification system -VITEK 2 (bio-Merieux, Marcy l’etoile, France). Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria. Results: All the ninety isolates included in the study were from respiratory tract specimens. While of all the isolated 90 Acinetobacter baumannii strains were found to be resistant (100%), against ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam, resistance rates against other tested antibiotics found as follows; meropenem 77, 86%, imipenem 75, 83%, trimethoprim-sulfamethoxazole (TMP-STX) 69, 76,6%, gentamicin 51, 56,6% and amikacin 48, 53,3%. Colistin was found as the most effective antibiotic against Acinetobacter baumannii, and there were not found any resistant (0%) strain against colistin. Conclusion: This study demonstrated that the no resistance was found in Acinetobacter baumannii against to colistin. High rates of resistance to carbapenems (imipenem and meropenem) and other tested antibiotics (ceftiaxone, ceftazidime, ciprofloxacine, piperacilline-tazobactam, TMP-STX gentamicin and amikacin) also have remarkable resistance rates. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay with resistance rates. High resistance rates against antibiotics require implementation of the infection control program and rational use of antibiotics. In the present study, while there were not found colistin resistance, panresistance were found against to ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam.

Keywords: acinetobacter baumannii, antibiotic resistance, multi drug resistance, intensive care unit

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1637 A Clinical Study of Placenta Previa and Its Effect on Fetomaternal Outcome in Scarred and Unscarred Uterus at a Tertiary Care Hospital

Authors: Sharadha G., Suresh Kanakkanavar

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Background: Placenta previa is a condition characterized by partial or complete implantation of the placenta in the lower uterine segment. It is one of the main causes of vaginal bleeding in the third trimester and a significant cause of maternal and perinatal morbidity and mortality. Materials and Methods: This is an observational study involving 130 patients diagnosed with placenta previa and satisfying inclusion criteria. The demographic data, clinical, surgical, and treatment, along with maternal and neonatal outcome parameters, were noted in proforma. Results: The incidence of placenta previa among scarred uterus was 1.32%, and in unscarred uterus was 0.67%. The mean age of the study population was 27.12±4.426years. High parity, high abortion rate, multigravida status, and less gestational age at delivery were commonly seen in scarred uterus compared to unscarred uterus. Complete placenta previa, anterior placental position, and adherent placenta were significantly associated with a scarred uterus compared to an unscarred uterus. The rate of caesarean hysterectomy was higher in the scarred uterus, along with statistical association to previous lower-segment caesarean sections. Intraoperative procedures like uterine artery ligation, bakri balloon insertion, and iliac artery ligation were higher in the scarred group. The maternal intensive care unit admission rate was higher in the scarred group and also showed its statistical association with previous lower segment caesarean section. Neonatal outcomes in terms of pre-term birth, still birth, neonatal intensive care unit admission, and neonatal death, though higher in the scarred group, did not differ statistically among the groups. Conclusion: Advancing maternal age, multiparity, prior uterine surgeries, and abortions are independent risk factors for placenta previa. Maternal morbidity is higher in the scarred uterus group compared to the unscarred group. Neonatal outcomes did not differ statistically among the groups. This knowledge would help the obstetricians to take measures to reduce the incidence of placenta previa and scarred uterus which would improve the fetomaternal outcome of placenta previa.

Keywords: placenta previa, scarred uterus, unscarred uterus, adherent placenta

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1636 Factors That Determine International Competitiveness of Agricultural Products in Latin America 1990-2020

Authors: Oluwasefunmi Eunice Irewole, Enrique Armas Arévalos

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Agriculture has played a crucial role in the economy and the development of many countries. Moreover, the basic needs for human survival are; food, shelter, and cloth are link on agricultural production. Most developed countries see that agriculture provides them with food and raw materials for different goods such as (shelter, medicine, fuel and clothing) which has led to an increase in incomes, livelihoods and standard of living. This study aimed at analysing the relationship between International competitiveness of agricultural products, with the area, fertilizer, labour force, economic growth, foreign direct investment, exchange rate and inflation rate in Latin America during the period of 1991-to 2019. In this study, panel data econometric methods were used, as well as cross-section dependence (Pesaran test), unit root (cross-section Augumented Dickey Fuller and Cross-sectional Im, Pesaran, and Shin tests), cointergration (Pedroni and Fisher-Johansen tests), and heterogeneous causality (Pedroni and Fisher-Johansen tests) (Hurlin and Dumitrescu test). The results reveal that the model has cross-sectional dependency and that they are integrated at one I. (1). The "fully modified OLS and dynamic OLS estimators" were used to examine the existence of a long-term relationship, and it was found that a long-term relationship existed between the selected variables. The study revealed a positive significant relationship between International Competitiveness of the agricultural raw material and area, fertilizer, labour force, economic growth, and foreign direct investment, while international competitiveness has a negative relationship with the advantages of the exchange rate and inflation. The economy policy recommendations deducted from this investigation is that Foreign Direct Investment and the labour force have a positive contribution to the increase of International Competitiveness of agricultural products.

Keywords: revealed comparative advantage, agricultural products, area, fertilizer, economic growth, granger causality, panel unit root

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1635 Foreign Literature at the Lessons of Individual Reading: Contemporary Methods of Phraseological Units Teaching

Authors: Diana Davletbaeva, Elena Pankratova

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This article observes some current questions of use of foreign literature in a process of phraseological units teaching in schools. It reveals and establishes different advantages of literary read at the lessons of individual reading and gives some core points of arrangements and organizational work. The article touches upon some essential keys concerning successful phraseological units mastering and improvement of students’ knowledge in a sphere of phraseology.

Keywords: foreign languages teaching, literary read, individual reading, phraseological unit, complex of exercises

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1634 Electricity Consumption and Economic Growth: The Case of Mexico

Authors: Mario Gómez, José Carlos Rodríguez

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The causal relationship between energy consumption and economic growth has been an important issue in the economic literature. This paper studies the causal relationship between electricity consumption and economic growth in Mexico for the period of 1971-2011. In so doing, unit root tests and causality test are applied. The results show that the series are stationary in levels and that there is causality running from economic growth to energy consumption. The energy conservation policies have little or no impact on economic growth in México.

Keywords: causality, economic growth, energy consumption, Mexico

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1633 Oestrogen Replacement In Post-Oophorectomy Women

Authors: Joana Gato, Ahmed Abotabekh, Panayoti Bachkangi

Abstract:

Introduction: Oestrogen is an essential gonadal hormone that plays a vital role in the reproductive system of women1. The average age of menopause in the UK is 512. Women who go through premature menopause should be offered Hormone replacement therapy (HRT). Similarly, women who undergo surgical menopause should be offered HRT, unless contraindicated, depending on the indication of their surgery2,3. Aim: To assess if the patients in our department are counselled regarding HRT after surgical treatment and if HRT was prescribed. Methodology: A retrospective audit in a busy district hospital, examining all the patients who had a hysterectomy. The audit examined if HRT was discussed pre-operatively, prescribed on discharge and if a follow up was arranged. For women with contraindication to HRT, the audit assessed if the reasons were discussed pre-operatively and communicated to the Inclusion criteria: woman having a total or subtotal hysterectomy, with or without bilateral salpingo-ophorectomy (BSO), between April and September 2022. Exclusion criteria: woman having a vaginal hysterectomy. Results: 40 patients in total had hysterectomy; 27 (68%) were under the age of 51. 15 out of 27 patients bad BSO. 9 women were prescribed HRT, but 8 were offered HRT immediately, and 1 of them were offered a follow up. Of women who underwent surgical menopause, 7 were not given any HRT. The HRT choice was diverse, however, the majority was prescribed oral HRT. 40% of women undergoing surgical menopause did not have a discussion about HRT prior to their surgery. In postmenopausal women (n=13; 33%), still two were given HRT for preexisting menopausal symptoms. Discussion: Only 59% of the pre-menopausal patients had oophorectomy, therefore undergoing surgical menopause. Of these, 44% were not given any HRT, and 40% had no discussion about HRT prior to surgery. Interestingly, the majority of these women have no obvious contraindication to HRT. The choice of HRT was diverse, but the majority was commenced on oral HRT. Our unit is still working towards meeting all the NICE guidance standards of offering HRT and information prior to surgery to women planning to undergo surgical menopause. Conclusion: Starting HRT at the onset of menopause has been shown to improve quality of life and reduce the risk of cardiovascular disease and osteoporotic fractures4. Our unit still has scope for improvement to comply with the current NICE guidance. All pre-menopausal women undergoing surgical menopause should have a discussion regarding HRT prior to surgery and be offered it if there are no contraindications. This discussion should be clearly documented in the notes. At the time of this report, some of the patients have not yet had a follow up, which we recognize as a limitation to our audit.

Keywords: hormone replacement therapy, menopause, premature ovarian insufficiency, surgical management

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1632 Mediterranean Diet, Duration of Admission and Mortality in Elderly, Hospitalized Patients: A Cross-Sectional Study

Authors: Christos Lampropoulos, Maria Konsta, Ifigenia Apostolou, Vicky Dradaki, Tamta Sirbilatze, Irini Dri, Christina Kordali, Vaggelis Lambas, Kostas Argyros, Georgios Mavras

Abstract:

Objectives: Mediterranean diet has been associated with lower incidence of cardiovascular disease and cancer. The purpose of our study was to examine the hypothesis that Mediterranean diet may protect against mortality and reduce admission duration in elderly, hospitalized patients. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). The following data were taken into account in analysis: anthropometric and laboratory data, dietary habits (MedDiet score), patients’ nutritional status [Mini Nutritional Assessment (MNA) score], physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and admission duration difference respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 30% per each unit increase of MedDiet score (OR=0.7, 95% CI:0.6-0.8, p < 0.0001). Patients with cancer-related admission were 37.7 times more likely to die, compared to those with infection (OR=37.7, 95% CI:4.4-325, p=0.001). According to multivariate linear regression analysis, admission duration was inversely related to Mediterranean diet, since it is decreased 0.18 days on average for each unit increase of MedDiet score (b:-0.18, 95% CI:-0.33 - -0.035, p=0.02). Additionally, the duration of current admission increased on average 0.83 days for each previous hospital admission (b:0.83, 95% CI:0.5-1.16, p<0.0001). The admission duration of patients with cancer was on average 4.5 days higher than the patients who admitted due to infection (b:4.5, 95% CI:0.9-8, p=0.015). Conclusion: Mediterranean diet adequately protects elderly, hospitalized patients against mortality and reduces the duration of hospitalization.

Keywords: Mediterranean diet, malnutrition, nutritional status, prognostic factors for mortality

Procedia PDF Downloads 289
1631 Sharp Estimates of Oscillatory Singular Integrals with Rough Kernels

Authors: H. Al-Qassem, L. Cheng, Y. Pan

Abstract:

In this paper, we establish sharp bounds for oscillatory singular integrals with an arbitrary real polynomial phase P. Our kernels are allowed to be rough both on the unit sphere and in the radial direction. We show that the bounds grow no faster than log (deg(P)), which is optimal and was first obtained by Parissis and Papadimitrakis for kernels without any radial roughness. Our results substantially improve many previously known results. Among key ingredients of our methods are an L¹→L² sharp estimate and using extrapolation.

Keywords: oscillatory singular integral, rough kernel, singular integral, orlicz spaces, block spaces, extrapolation, L^{p} boundedness

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1630 Passive Aeration of Wastewater: Analytical Model

Authors: Ayman M. El-Zahaby, Ahmed S. El-Gendy

Abstract:

Aeration for wastewater is essential for the proper operation of aerobic treatment units where the wastewater normally has zero dissolved oxygen. This is due to the need of oxygen by the aerobic microorganisms to grow and survive. Typical aeration units for wastewater treatment require electric energy for their operation such as mechanical aerators or diffused aerators. The passive units are units that operate without the need of electric energy such as cascade aerators, spray aerators and tray aerators. In contrary to the cascade aerators and spray aerators, tray aerators require much smaller area foot print for their installation as the treatment stages are arranged vertically. To the extent of the authors knowledge, the design of tray aerators for the aeration purpose has not been presented in the literature. The current research concerns with an analytical study for the design of tray aerators for the purpose of increasing the dissolved oxygen in wastewater treatment systems, including an investigation on different design parameters and their impact on the aeration efficiency. The studied aerator shall act as an intermediate stage between an anaerobic primary treatment unit and an aerobic treatment unit for small scale treatment systems. Different free falling flow regimes were investigated, and the thresholds for transition between regimes were obtained from the literature. The study focused on the jetting flow regime between trays. Starting from the two film theory, an equation that relates the dissolved oxygen concentration effluent from the system was derived as a function of the flow rate, number of trays, tray area, spacing between trays, number and diameter of holes and the water temperature. A MATLab ® model was developed for the derived equation. The expected aeration efficiency under different tray configurations and operating conditions were illustrated through running the model with varying the design parameters. The impact of each parameter was illustrated. The overall system efficiency was found to increase by decreasing the hole diameter. On the other side, increasing the number of trays, tray area, flow rate per hole or tray spacing had positive effect on the system efficiency.

Keywords: aeration, analytical, passive, wastewater

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1629 Administrative Traits and Capabilities of Mindanao State University Heads of Office as Perceived by Their Subordinates

Authors: Johanida L. Etado

Abstract:

The study determined the Administrative traits and capabilities of Mindanao State University Heads of office as perceived by their respondents. Specifically, this study attempted to find out: To get the primary data, a self- constructed survey questionnaire which was validated by a panel of experts, including the adviser. Most of the MSU head of office were aware of their duties and responsibilities as a manager. Considering their vast knowledge and expertise on the technical or task aspects of the job, it is not surprising that respondents perceived them to a high degree as work or task oriented. MSU head of office were knowledgeable and capable in performing field-specific, specialized tasks and enabling them to coordinate work, solve problems, communicate effectively, and also understand the big picture in light of the front-line work that must be performed. The significance of coaching or mentoring in this instance may be explained by the less number of Master’s or Doctorate degree holder among employees resulting to close supervision and mentorship of head of office towards the latter; Without comparison, interpersonal or human relation capabilities is a very effective way in dealing with people as it gives them the opportunity to influence their employees. In the case of MSU head of office, the best way of dealing with problematic employees is by establishing trust and allowing them to partake in the decision making even on setting organizational goals as it would make them feel part of the organization; Thus, it is recommended that the success of an organization depends largely with the effectiveness of the head of unit. In this case, being development oriented would mean encouraging both head officers & employees to know not only the technical know hoe of the organisation but also the visions, missions, goals & the latter’s aspirations to establish cooperation & harmonious working environment; hence, orientation & reorientation time to time would enable them to be more development oriented; With respect to human relations, effective interpersonal relationship between head of unit & employee is of paramount importance. In order to strengthen the relationship between the two, the management should establish an upward & downward communication where two parties will have to establish an open & transparent communication, either through verbal & non-verbal one.

Keywords: administrator, administrative traits, leadership traits, work orientation

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1628 Development of a Nursing Care Program Based on Anthroposophic External Therapy for the Pediatric Hospital in Brazil and Germany

Authors: Karina Peron, Ricardo Ghelman, Monica Taminato, Katia R. Oliveira, Debora C. A. Rodrigues, Juliana R. C. Mumme, Olga K. M. Sunakozaua, Georg Seifert, Vicente O. Filho

Abstract:

The nurse is the most available health professional for the interventions of support in the integrative approach in hospital environment, therefore a professional group key to changes in the model of care. The central components in the performance of anthroposophic nursing procedures are direct physical contact, promotion of proper rhythm, thermal regulation and the construction of a calm and empathic atmosphere, safe for patients and their caregivers. The procedures of anthroposophic external therapies (AET), basically composed of the application of compresses and the use of natural products, provide an opportunity to intensify the therapeutic results through an innovative, complementary and integrative model in the university hospital. The objective of this work is to report the implementation of a program of nursing techniques (AET) through a partnership between the Pediatric Oncology Sector of the Department of Pediatrics of the Faculty of Medicine of the University of Sao Paulo and Charite University of Berlin, with lecturers from Berlin's Integrative Hospital Havelhöhe and Witten-Herdecke Integrative Hospital, both in Germany. Intensive training activities of the Hospital's nursing staff and a survey on AET needs were developed based on the most prevalent complaints in pediatric oncology patients in the three environments of the Hospital of Pediatric Oncology: Bone Marrow Transplantation Unit, Intensive Care Unit and Division of Internal Patients. We obtained the approval of the clinical protocol of external anthroposophic therapies for nursing care by the Ethics Committee and the Academic Council of the Hospital. With this project, we highlight the key AET needs that will be part of the standard program of pediatric oncology care with appropriate scientific support. The results of the prevalent symptoms were: vomiting, nausea, pain, difficulty in starting sleep, constipation, cold extremities, mood disorder and psychomotor agitation. This project was the pioneer within the Integrative Pediatrics Program, as an innovative concept of Medicine and Integrative Health presented at scientific meetings.

Keywords: integrative health care, integrative nursing, pediatric nursing, pediatric oncology

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1627 A Collaborative Application of Six Sigma and Value Engineering in Supply Chain and Logistics

Authors: Arun Raja, Kevin Thomas, Sreyas Tribhu, S. P. Anbuudayasankar

Abstract:

This paper deals with the application of six sigma methodology in supply chain (SC) and logistics. A detailed cram about how the SC can be improved and its impact on the organization are dealt with and also how the quality plays a vital role in improving SC and logistics are identified. A simulation has been performed using the ARENA software to determine the process efficiency of a bottle manufacturing unit. Further, a Value Stream Mapping (VSM) analysis has been executed on the manufacturing process flow model and the manner by which Value Engineering (VE) holds a significant importance for quality assertion on the products is also studied.

Keywords: supply chain, six sigma, value engineering, logistics, quality

Procedia PDF Downloads 655
1626 Durability Analysis of a Knuckle Arm Using VPG System

Authors: Geun-Yeon Kim, S. P. Praveen Kumar, Kwon-Hee Lee

Abstract:

A steering knuckle arm is the component that connects the steering system and suspension system. The structural performances such as stiffness, strength, and durability are considered in its design process. The former study suggested the lightweight design of a knuckle arm considering the structural performances and using the metamodel-based optimization. The six shape design variables were defined, and the optimum design was calculated by applying the kriging interpolation method. The finite element method was utilized to predict the structural responses. The suggested knuckle was made of the aluminum Al6082, and its weight was reduced about 60% in comparison with the base steel knuckle, satisfying the design requirements. Then, we investigated its manufacturability by performing foraging analysis. The forging was done as hot process, and the product was made through two-step forging. As a final step of its developing process, the durability is investigated by using the flexible dynamic analysis software, LS-DYNA and the pre and post processor, eta/VPG. Generally, a car make does not provide all the information with the part manufacturer. Thus, the part manufacturer has a limit in predicting the durability performance with the unit of full car. The eta/VPG has the libraries of suspension, tire, and road, which are commonly used parts. That makes a full car modeling. First, the full car is modeled by referencing the following information; Overall Length: 3,595mm, Overall Width: 1,595mm, CVW (Curve Vehicle Weight): 910kg, Front Suspension: MacPherson Strut, Rear Suspension: Torsion Beam Axle, Tire: 235/65R17. Second, the road is selected as the cobblestone. The road condition of the cobblestone is almost 10 times more severe than that of usual paved road. Third, the dynamic finite element analysis using the LS-DYNA is performed to predict the durability performance of the suggested knuckle arm. The life of the suggested knuckle arm is calculated as 350,000km, which satisfies the design requirement set up by the part manufacturer. In this study, the overall design process of a knuckle arm is suggested, and it can be seen that the developed knuckle arm satisfies the design requirement of the durability with the unit of full car. The VPG analysis is successfully performed even though it does not an exact prediction since the full car model is very rough one. Thus, this approach can be used effectively when the detail to full car is not given.

Keywords: knuckle arm, structural optimization, Metamodel, forging, durability, VPG (Virtual Proving Ground)

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1625 Vancomycin Resistance Enterococcus and Implications to Trauma and Orthopaedic Care

Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

Abstract:

Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

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1624 Study on Runoff Allocation Responsibilities of Different Land Uses in a Single Catchment Area

Authors: Chuan-Ming Tung, Jin-Cheng Fu, Chia-En Feng

Abstract:

In recent years, the rapid development of urban land in Taiwan has led to the constant increase of the areas of impervious surface, which has increased the risk of waterlogging during heavy rainfall. Therefore, in recent years, promoting runoff allocation responsibilities has often been used as a means of reducing regional flooding. In this study, the single catchment area covering both urban and rural land as the study area is discussed. Based on Storm Water Management Model, urban and rural land in a single catchment area was explored to develop the runoff allocation responsibilities according to their respective control regulation on land use. The impacts of runoff increment and reduction in sub-catchment area were studied to understand the impact of highly developed urban land on the reduction of flood risk of rural land at the back end. The results showed that the rainfall with 1 hour short delay of 2 years, 5 years, 10 years, and 25 years return period. If the study area was fully developed, the peak discharge at the outlet would increase by 24.46% -22.97% without runoff allocation responsibilities. The front-end urban land would increase runoff from back-end of rural land by 76.19% -46.51%. However, if runoff allocation responsibilities were carried out in the study area, the peak discharge could be reduced by 58.38-63.08%, which could make the front-end to reduce 54.05% -23.81% of the peak flow to the back-end. In addition, the researchers found that if it was seen from the perspective of runoff allocation responsibilities of per unit area, the residential area of urban land would benefit from the relevant laws and regulations of the urban system, which would have a better effect of reducing flood than the residential land in rural land. For rural land, the development scale of residential land was generally small, which made the effect of flood reduction better than that of industrial land. Agricultural land requires a large area of land, resulting in the lowest share of the flow per unit area. From the point of the planners, this study suggests that for the rural land around the city, its responsibility should be assigned to share the runoff. And setting up rain water storage facilities in the same way as urban land, can also take stock of agricultural land resources to increase the ridge of field for flood storage, in order to improve regional disaster reduction capacity and resilience.

Keywords: runoff allocation responsibilities, land use, flood mitigation, SWMM

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1623 Cluster Analysis and Benchmarking for Performance Optimization of a Pyrochlore Processing Unit

Authors: Ana C. R. P. Ferreira, Adriano H. P. Pereira

Abstract:

Given the frequent variation of mineral properties throughout the Araxá pyrochlore deposit, even if a good homogenization work has been carried out before feeding the processing plants, an operation with quality and performance’s high variety standard is expected. These results could be improved and standardized if the blend composition parameters that most influence the processing route are determined, and then the types of raw materials are grouped by them, finally presenting a great reference with operational settings for each group. Associating the physical and chemical parameters of a unit operation through benchmarking or even an optimal reference of metallurgical recovery and product quality reflects in the reduction of the production costs, optimization of the mineral resource, and guarantee of greater stability in the subsequent processes of the production chain that uses the mineral of interest. Conducting a comprehensive exploratory data analysis to identify which characteristics of the ore are most relevant to the process route, associated with the use of Machine Learning algorithms for grouping the raw material (ore) and associating these with reference variables in the process’ benchmark is a reasonable alternative for the standardization and improvement of mineral processing units. Clustering methods through Decision Tree and K-Means were employed, associated with algorithms based on the theory of benchmarking, with criteria defined by the process team in order to reference the best adjustments for processing the ore piles of each cluster. A clean user interface was created to obtain the outputs of the created algorithm. The results were measured through the average time of adjustment and stabilization of the process after a new pile of homogenized ore enters the plant, as well as the average time needed to achieve the best processing result. Direct gains from the metallurgical recovery of the process were also measured. The results were promising, with a reduction in the adjustment time and stabilization when starting the processing of a new ore pile, as well as reaching the benchmark. Also noteworthy are the gains in metallurgical recovery, which reflect a significant saving in ore consumption and a consequent reduction in production costs, hence a more rational use of the tailings dams and life optimization of the mineral deposit.

Keywords: mineral clustering, machine learning, process optimization, pyrochlore processing

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1622 A Multi Cordic Architecture on FPGA Platform

Authors: Ahmed Madian, Muaz Aljarhi

Abstract:

Coordinate Rotation Digital Computer (CORDIC) is a unique digital computing unit intended for the computation of mathematical operations and functions. This paper presents a multi-CORDIC processor that integrates different CORDIC architectures on a single FPGA chip and allows the user to select the CORDIC architecture to proceed with based on what he wants to calculate and his/her needs. Synthesis show that radix 2 CORDIC has the lowest clock delay, radix 8 CORDIC has the highest LUT usage and lowest register usage while Hybrid Radix 4 CORDIC had the highest clock delay.

Keywords: multi, CORDIC, FPGA, processor

Procedia PDF Downloads 447
1621 Demand-Side Financing for Thai Higher Education: A Reform Towards Sustainable Development

Authors: Daral Maesincee, Jompol Thongpaen

Abstract:

Thus far, most of the decisions made within the walls of Thai higher education (HE) institutions have primarily been supply-oriented. With the current supply-driven, itemized HE financing systems, the nation is struggling to systemically produce high-quality manpower that serves the market’s needs, often resulting in education mismatches and unemployment – particularly in science, technology, and innovation (STI)-related fields. With the COVID-19 pandemic challenges widening the education inequality (accessibility and quality) gap, HE becomes even more unobtainable for underprivileged students, permanently leaving some out of the system. Therefore, Thai HE needs a new financing system that produces the “right people” for the “right occupations” through the “right ways,” regardless of their socioeconomic backgrounds, and encourages the creation of non-degree courses to tackle these ongoing challenges. The “Demand-Side Financing for Thai Higher Education” policy aims to do so by offering a new paradigm of HE resource allocation via two main mechanisms: i) standardized formula-based unit-cost subsidizations that is specific to each study field and ii) student loan programs that respond to the “demand signals” from the labor market and the students, that are in line with the country’s priorities. Through in-dept reviews, extensive studies, and consultations with various experts, education committees, and related agencies, i) the method of demand signal analysis is identified, ii) the unit-cost of each student in the sample study fields is approximated, iii) the method of budget analysis is formulated, iv) the interagency workflows are established, and v) a supporting information database is created to suggest the number of graduates each HE institution can potentially produce, the study fields and skillsets that are needed by the labor market, the employers’ satisfaction with the graduates, and each study field’s employment rates. By responding to the needs of all stakeholders, this policy is expected to steer Thai HE toward producing more STI-related manpower in order to uplift Thai people’s quality of life and enhance the nation’s global competitiveness. This policy is currently in the process of being considered by the National Education Transformation Committee and the Higher Education Commission.

Keywords: demand-side financing, higher education resource, human capital, higher education

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1620 Factors Associated with Commencement of Non-Invasive Ventilation

Authors: Manoj Kumar Reddy Pulim, Lakshmi Muthukrishnan, Geetha Jayapathy, Radhika Raman

Abstract:

Introduction: In the past two decades, noninvasive positive pressure ventilation (NIPPV) emerged as one of the most important advances in the management of both acute and chronic respiratory failure in children. In the acute setting, it is an alternative to intubation with a goal to preserve normal physiologic functions, decrease airway injury, and prevent respiratory tract infections. There is a need to determine the clinical profile and parameters which point towards the need for NIV in the pediatric emergency setting. Objectives: i) To study the clinical profile of children who required non invasive ventilation and invasive ventilation, ii) To study the clinical parameters common to children who required non invasive ventilation. Methods: All children between one month to 18 years, who were intubated in the pediatric emergency department and those for whom decision to commence Non Invasive Ventilation was made in Emergency Room were included in the study. Children were transferred to the Paediatric Intensive Care Unit and started on Non Invasive Ventilation as per our hospital policy and followed up in the Paediatric Intensive Care Unit. Clinical profile of all children which included age, gender, diagnosis and indication for intubation were documented. Clinical parameters such as respiratory rate, heart rate, saturation, grunting were documented. Parameters obtained were subject to statistical analysis. Observations: Airway disease (Bronchiolitis 25%, Viral induced wheeze 22%) was a common diagnosis in 32 children who required Non Invasive Ventilation. Neuromuscular disorder was the common diagnosis in 27 children (78%) who were Intubated. 17 children commenced on Non Invasive Ventilation who later needed invasive ventilation had Neuromuscular disease. High frequency nasal cannula was used in 32, and mask ventilation in 17 children. Clinical parameters common to the Non Invasive Ventilation group were age < 1 year (17), tachycardia n = 7 (22%), tachypnea n = 23 (72%) and severe respiratory distress n = 9 (28%), grunt n = 7 (22%), SPO2 (80% to 90%) n = 16. Children in the Non Invasive Ventilation + INTUBATION group were > 3 years (9), had tachycardia 7 (41%), tachypnea 9(53%) with a male predominance n = 9. In statistical comparison among 3 groups,'p' value was significant for pH, saturation, and use of Ionotrope. Conclusion: Invasive ventilation can be avoided in the paediatric Emergency Department in children with airway disease, by commencing Non Invasive Ventilation early. Intubation in the pediatric emergency department has a higher association with neuromuscular disorders.

Keywords: clinical parameters, indications, non invasive ventilation, paediatric emergency room

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