Search results for: post processing kinematics
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7705

Search results for: post processing kinematics

2275 Development of Broad Spectrum Nitrilase Biocatalysts and Bioprocesses for Nitrile Biotransformation

Authors: Avinash Vellore Sunder, Shikha Shah, Pramod P. Wangikar

Abstract:

The enzymatic conversion of nitriles to carboxylic acids by nitrilases has gained significance in the green synthesis of several pharmaceutical precursors and fine chemicals. While nitrilases have been characterized from different sources, the industrial application requires the identification of nitrilases that possess higher substrate tolerance, wider specificity and better thermostability, along with the development of an efficient bioprocess for producing large amounts of nitrilase. To produce large amounts of nitrilase, we developed a fed-batch fermentation process on defined media for the high cell density cultivation of E. coli cells expressing the well-studied nitrilase from Alcaligenes fecalis. A DO-stat feeding approach was employed combined with an optimized post-induction strategy to achieve nitrilase titer of 2.5*105 U/l and 78 g/l dry cell weight. We also identified 16 novel nitrilase sequences from genome mining and analysis of substrate binding residues. The nitrilases were expressed in E. coli and their biocatalytic potential was evaluated on a panel of 22 industrially relevant nitrile substrates using high-throughput screening and HPLC analysis. Nine nitrilases were identified to exhibit high activity on structurally diverse nitriles including aliphatic and aromatic dinitriles, heterocyclic, -hydroxy and -keto nitriles. With fed-batch biotransformation, whole-cell Zobelia galactanivorans nitrilase achieved yields of 2.4 M nicotinic acid and 1.8 M isonicotinic acid from 3-cyanopyridine and 4-cyanopyridine respectively within 5 h, while Cupravidus necator nitrilase enantioselectively converted 740 mM mandelonitrile to (R)–mandelic acid. The nitrilase from Achromobacter insolitus could hydrolyze 542 mM iminodiacetonitrile in 1 h. The availability of highly active nitrilases along with bioprocesses for enzyme production expands the toolbox for industrial biocatalysis.

Keywords: biocatalysis, isonicotinic acid, iminodiacetic acid, mandelic acid, nitrilase

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2274 Adaptability of Steel-Framed Industrialized Building System In Post-Service Life

Authors: Alireza Taghdiri, Sara Ghanbarzade Ghomi

Abstract:

Existing buildings are permanently subjected to change, continuously renovated and repaired in their long service life. Old buildings are destroyed and their material and components are recycled or reused for constructing new ones. In this process, the importance of sustainability principles for building construction is obviously known and great significance must be attached to the consumption of resources, resulting effects on the environment and economic costs. Utilization strategies for extending buildings service life and delay in destroying have a positive effect on environment protection. In addition, simpler alterability or expandability of buildings’ structures and reducing energy and natural resources consumption have benefits for users, producers and the environment. To solve these problems, by applying theories of open building, structural components of some conventional building systems have been analyzed and then, a new geometry adaptive building system is developed which can transform and support different imposed loads. In order to achieve this goal, various research methods and tools such as professional and scientific literatures review, comparative analysis, case study and computer simulation were applied and data interpretation was implemented using descriptive statistics and logical arguments. Therefore, hypothesis and proposed strategies were evaluated and an adaptable and reusable 2-dimensional building system was presented which can respond appropriately to dwellers and end-users needs and provide reusability of structural components of building system in new construction or function. Investigations showed that this incremental building system can be successfully applied in achieving the architectural design objectives and by small modifications on components and joints, it is easy to obtain different and adaptable load-optimized component alternatives for flexible spaces.

Keywords: adaptability, durability, open building, service life, structural building system

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2273 Transcriptional Evidence for the Involvement of MyD88 in Flagellin Recognition: Genomic Identification of Rock Bream MyD88 and Comparative Analysis

Authors: N. Umasuthan, S. D. N. K. Bathige, W. S. Thulasitha, I. Whang, J. Lee

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The MyD88 is an evolutionarily conserved host-expressed adaptor protein that is essential for proper TLR/ IL1R immune-response signaling. A previously identified complete cDNA (1626 bp) of OfMyD88 comprised an ORF of 867 bp encoding a protein of 288 amino acids (32.9 kDa). The gDNA (3761 bp) of OfMyD88 revealed a quinquepartite genome organization composed of 5 exons (with the sizes of 310, 132, 178, 92 and 155 bp) separated by 4 introns. All the introns displayed splice signals consistent with the consensus GT/AG rule. A bipartite domain structure with two domains namely death domain (24-103) coded by 1st exon, and TIR domain (151-288) coded by last 3 exons were identified through in silico analysis. Moreover, homology modeling of these two domains revealed a similar quaternary folding nature between human and rock bream homologs. A comprehensive comparison of vertebrate MyD88 genes showed that they possess a 5-exonic structure. In this structure, the last three exons were strongly conserved, and this suggests that a rigid structure has been maintained during vertebrate evolution. A cluster of TATA box-like sequences were found 0.25 kb upstream of cDNA starting position. In addition, putative 5'-flanking region of OfMyD88 was predicted to have TFBS implicated with TLR signaling, including copies of NFB1, APRF/ STAT3, Sp1, IRF1 and 2 and Stat1/2. Using qPCR technique, a ubiquitous mRNA expression was detected in liver and blood. Furthermore, a significantly up-regulated transcriptional expression of OfMyD88 was detected in head kidney (12-24 h; >2-fold), spleen (6 h; 1.5-fold), liver (3 h; 1.9-fold) and intestine (24 h; ~2-fold) post-Fla challenge. These data suggest a crucial role for MyD88 in antibacterial immunity of teleosts.

Keywords: MyD88, innate immunity, flagellin, genomic analysis

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2272 Intraoperative Inter Pectoral and Sub Serratus Nerve Blocks Reduce Post Operative Opiate Requirements in Breast Augmentation Surgery

Authors: Conor Mccartney, Mark Lee

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Background: An essential component in ambulatory breast augmentation surgery is good analgesia. The demographic undergoing this operation is usually fit, low risk with few comorbidities. These patients do not require long-term hospitalization and do not want to spend excessive time in the hospital for financial reasons. Opiate analgesia can have significant side effects such as nausea, vomiting and sedation. Reducing volumes of postoperative opiates allows faster ambulation and discharge from day surgery. We have developed two targeted nerve blocks that can be applied by the operating surgeon in a matter of seconds under direct vision, not requiring imaging. Anecdotally we found that these targeted nerve blocks reduced opiate requirements and allowed accelerated discharge and faster return to normal activities. This was then tested in a prospective randomized, double-blind trial. Methods: 20 patients were randomized into saline (n = 10) or Ropivicaine adrenaline solution (n = 10). The operating surgeon and anesthetist were blinded to the solution. All patients were closely followed up and morphine equivalents were accurately recorded. Follow-up pain scores were recorded using the Overall Benefit of Analgesia pain questionnaire. Findings: The Ropivicaine nerve blocks significantly reduced opiate requirements postoperatively (p<0.05). Pain scores were significantly decreased in the study group (p<0.05). There were no side effects attributable to the nerve blocks. Conclusions: Intraoperative targeted nerve blocks significantly reduce postoperative opiate requirements in breast augmentation surgery. This results in faster recovery and higher patient satisfaction.

Keywords: breast augmentation, nerve block, postoperative recovery, opiate analgesia, inter pectoral block, sub serratus block

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2271 Influence of Sr(BO2)2 Doping on Superconducting Properties of (Bi,Pb)-2223 Phase

Authors: N. G. Margiani, I. G. Kvartskhava, G. A. Mumladze, Z. A. Adamia

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Chemical doping with different elements and compounds at various amounts represents the most suitable approach to improve the superconducting properties of bismuth-based superconductors for technological applications. In this paper, the influence of partial substitution of Sr(BO2)2 for SrO on the phase formation kinetics and transport properties of (Bi,Pb)-2223 HTS has been studied for the first time. Samples with nominal composition Bi1.7Pb0.3Sr2-xCa2Cu3Oy[Sr(BO2)2]x, x=0, 0.0375, 0.075, 0.15, 0.25, were prepared by the standard solid state processing. The appropriate mixtures were calcined at 845 oC for 40 h. The resulting materials were pressed into pellets and annealed at 837 oC for 30 h in air. Superconducting properties of undoped (reference) and Sr(BO2)2-doped (Bi,Pb)-2223 compounds were investigated through X-ray diffraction (XRD), resistivity (ρ) and transport critical current density (Jc) measurements. The surface morphology changes in the prepared samples were examined by scanning electron microscope (SEM). XRD and Jc studies have shown that the low level Sr(BO2)2 doping (x=0.0375-0.075) to the Sr-site promotes the formation of high-Tc phase and leads to the enhancement of current carrying capacity in (Bi,Pb)-2223 HTS. The doped sample with x=0.0375 has the best performance compared to other prepared samples. The estimated volume fraction of (Bi,Pb)-2223 phase increases from ~25 % for reference specimen to ~70 % for x=0.0375. Moreover, strong increase in the self-field Jc value was observed for this dopant amount (Jc=340 A/cm2), compared to an undoped sample (Jc=110 A/cm2). Pronounced enhancement of superconducting properties of (Bi,Pb)-2223 superconductor can be attributed to the acceleration of high-Tc phase formation as well as the improvement of inter-grain connectivity by small amounts of Sr(BO2)2 dopant.

Keywords: bismuth-based superconductor, critical current density, phase formation, Sr(BO₂)₂ doping

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2270 Floor Response Spectra of RC Frames: Influence of the Infills on the Seismic Demand on Non-Structural Components

Authors: Gianni Blasi, Daniele Perrone, Maria Antonietta Aiello

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The seismic vulnerability of non-structural components is nowadays recognized to be a key issue in performance-based earthquake engineering. Recent loss estimation studies, as well as the damage observed during past earthquakes, evidenced how non-structural damage represents the highest rate of economic loss in a building and can be in many cases crucial in a life-safety view during the post-earthquake emergency. The procedures developed to evaluate the seismic demand on non-structural components have been constantly improved and recent studies demonstrated how the existing formulations provided by main Standards generally ignore features which have a sensible influence on the definition of the seismic acceleration/displacements subjecting non-structural components. Since the influence of the infills on the dynamic behaviour of RC structures has already been evidenced by many authors, it is worth to be noted that the evaluation of the seismic demand on non-structural components should consider the presence of the infills as well as their mechanical properties. This study focuses on the evaluation of time-history floor acceleration in RC buildings; which is a useful mean to perform seismic vulnerability analyses of non-structural components through the well-known cascade method. Dynamic analyses are performed on an 8-storey RC frame, taking into account the presence of the infills; the influence of the elastic modulus of the panel on the results is investigated as well as the presence of openings. Floor accelerations obtained from the analyses are used to evaluate the floor response spectra, in order to define the demand on non-structural components depending on the properties of the infills. Finally, the results are compared with formulations provided by main International Standards, in order to assess the accuracy and eventually define the improvements required according to the results of the present research work.

Keywords: floor spectra, infilled RC frames, non-structural components, seismic demand

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2269 Robotic Mini Gastric Bypass Surgery

Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

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Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

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2268 The Use of Spirulina during Aerobic Exercise on the Performance of Immune and Consumption Indicators (A Case Study: Young Men After Physical Training)

Authors: Vahab Behmanesh

Abstract:

One of the topics that has always attracted the attention of sports medicine and sports science experts is the positive or negative effect of sports activities on the functioning of the body's immune system. In the present research, a course of aerobic running with spirulina consumption has been studied on the maximum oxygen consumption and the performance of some indicators of the immune system of men who have trained after one session of physical activity. In this research, 50 trained students were studied randomly in four groups, spirulina- aerobic, spirulina, placebo- aerobic, and control. In order to test the research hypotheses, one-way statistical method of variance (ANOVA) was used considering the significance level of a=0.005 and post hoc test (LSD). A blood sample was taken from the participants in the first stage test in fasting and resting state immediately after Bruce's maximal test on the treadmill until complete relaxation was reached, and their Vo2max value was determined through the aforementioned test. The subjects of the spirulina-aerobic running and placebo-aerobic running groups took three 500 mg spirulina and 500 mg placebo pills a day for six weeks and ran three times a week for 30 minutes at the threshold of aerobic stimulation. The spirulina and placebo groups also consumed spirulina and placebo tablets in the above method for six weeks. Then they did the same first stage test as the second stage test. Blood samples were taken to measure the number of CD4+, CD8+, NK, and the ratio of CD4+ to CD8+ on four occasions before and after the first and second stage tests. The analysis of the findings showed that: aerobic running and spirulina supplement alone increase Vo2max. Aerobic running and consumption of spirulina increases Vo2max more than other groups (P<0.05), +CD4 and hemoglobin of the spirulina-aerobic running group was significantly different from other groups (P=0.002), +CD4 of the groups together There was no significant difference, NK increased in all groups, the ratio of CD4+ to CD8+ between the groups had a significant difference (P=0.002), the ratio of CD4+ to CD8+ in the spirulina- aerobic group was lower than the spirulina and placebo groups. All in all, it can be concluded that the supplement of spirulina and aerobic exercise may increase Vo2max and improve safety indicators.

Keywords: spirulina (Q2), hemoglobin (Q3), aerobic exercise (Q3), residual activity (Q2), CD4+ to CD8+ ratio (Q3)

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2267 Improving Trainings of Mineral Processing Operators Through Gamification and Modelling and Simulation

Authors: Pedro A. S. Bergamo, Emilia S. Streng, Jan Rosenkranz, Yousef Ghorbani

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Within the often-hazardous mineral industry, simulation training has speedily gained appreciation as an important method of increasing site safety and productivity through enhanced operator skill and knowledge. Performance calculations related to froth flotation, one of the most important concentration methods, is probably the hardest topic taught during the training of plant operators. Currently, most training teach those skills by traditional methods like slide presentations and hand-written exercises with a heavy focus on memorization. To optimize certain aspects of these pieces of training, we developed “MinFloat”, which teaches the operation formulas of the froth flotation process with the help of gamification. The simulation core based on a first-principles flotation model was implemented in Unity3D and an instructor tutoring system was developed, which presents didactic content and reviews the selected answers. The game was tested by 25 professionals with extensive experience in the mining industry based on a questionnaire formulated for training evaluations. According to their feedback, the game scored well in terms of quality, didactic efficacy and inspiring character. The feedback of the testers on the main target audience and the outlook of the mentioned solution is presented. This paper aims to provide technical background on the construction of educational games for the mining industry besides showing how feedback from experts can more efficiently be gathered thanks to new technologies such as online forms.

Keywords: training evaluation, simulation based training, modelling, and simulation, froth flotation

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2266 Hindi Speech Synthesis by Concatenation of Recognized Hand Written Devnagri Script Using Support Vector Machines Classifier

Authors: Saurabh Farkya, Govinda Surampudi

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Optical Character Recognition is one of the current major research areas. This paper is focussed on recognition of Devanagari script and its sound generation. This Paper consists of two parts. First, Optical Character Recognition of Devnagari handwritten Script. Second, speech synthesis of the recognized text. This paper shows an implementation of support vector machines for the purpose of Devnagari Script recognition. The Support Vector Machines was trained with Multi Domain features; Transform Domain and Spatial Domain or Structural Domain feature. Transform Domain includes the wavelet feature of the character. Structural Domain consists of Distance Profile feature and Gradient feature. The Segmentation of the text document has been done in 3 levels-Line Segmentation, Word Segmentation, and Character Segmentation. The pre-processing of the characters has been done with the help of various Morphological operations-Otsu's Algorithm, Erosion, Dilation, Filtration and Thinning techniques. The Algorithm was tested on the self-prepared database, a collection of various handwriting. Further, Unicode was used to convert recognized Devnagari text into understandable computer document. The document so obtained is an array of codes which was used to generate digitized text and to synthesize Hindi speech. Phonemes from the self-prepared database were used to generate the speech of the scanned document using concatenation technique.

Keywords: Character Recognition (OCR), Text to Speech (TTS), Support Vector Machines (SVM), Library of Support Vector Machines (LIBSVM)

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2265 Levels of Digital Health Literacy in Culturally and Linguistically Diverse Females in Regional Australia and its Association with Demographics

Authors: Usma Iftikhar, Khorshed Alam

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Background: Digital health platforms and digital health interventions are gaining increasing importance with the shift to online health-seeking behaviour, especially post-Covid. Subsequently, the importance of digital health literacy is increasingly being recognized. With the surge in culturally and linguistically diverse populations in First World countries, especially females, the predictors of digital health access in this population remain elusive. Keeping in view the inadequate digital infrastructure in rural and remote Australia, with lack of specialist services, the determinants of digital access gain even more importance. Objectives: The objective of this research are to measure the digital health literacy levels in this population, including the predictors of digital health literacy like sociodemographics and the correlation between the predictors and digital health literacy levels. Methods: A population-based quantitative survey was carried out in Regional Queensland from Jan 2022- Dec 2023 on culturally and linguistically diverse adult females. Sociodemographics like age, literacy levels, socioeconomic status, access to digital devices were recorded after informed consent. Digital health literacy levels were measured by specially designed questionnaires. The relationship between sociodemographics and digital health literacy levels was estimated by Pearson correlation. Results: Mean DHL was 2.66 + 0.35. There was a negative significant relationship (p<0.005) between demographics like age and access to a digital device with digital health literacy levels. Also observed was a positive significant relationship between literacy levels and proficiency in English. Conclusion: Age, literacy levels and English proficiency are some of the highest predictors of digital health access. This is important because remote areas rely on digital health access due to less developed health infrastructure, including specialist services. Guide for Policy makers to focus on the populations most in need.

Keywords: digital health literacy, eHealth literacy, culturally and linguistically diverse, ethnic minorities, regional areas, rural and remote areas

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2264 Improving Graduate Student Writing Skills: Best Practices and Outcomes

Authors: Jamie Sundvall, Lisa Jennings

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A decline in writing skills and abilities of students entering graduate school has become a focus for university systems within the United States. This decline has become a national trend that requires reflection on the intervention strategies used to address the deficit and unintended consequences as outcomes in the profession. Social work faculty is challenged to increase written scholarship within the academic setting. However, when a large number of students in each course have writing deficits, there is a shift from focus on content, ability to demonstrate competency, and application of core social work concepts. This qualitative study focuses on the experiences of online faculty who support increasing scholarship through writing and are following best practices preparing students academically to see improvements in written presentation in classroom work. This study outlines best practices to improve written academic presentation, especially in an online setting. The research also highlights how a student’s ability to show competency and application of concepts may be overlooked in the online setting. This can lead to new social workers who are prepared academically, but may unable to effectively advocate and document thought presentation in their writing. The intended progression of writing across all levels of higher education moves from summary, to application, and into abstract problem solving. Initial findings indicate that it is important to reflect on practices used to address writing deficits in terms of academic writing, competency, and application. It is equally important to reflect on how these methods of intervention impact a student post-graduation. Specifically, for faculty, it is valuable to assess a social worker’s ability to engage in continuity of documentation and advocacy at micro, mezzo, macro, and international levels of practice.

Keywords: intervention, professional impact, scholarship, writing

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2263 Consequential Effects of Coal Utilization on Urban Water Supply Sources – a Study of Ajali River in Enugu State Nigeria

Authors: Enebe Christian Chukwudi

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Water bodies around the world notably underground water, ground water, rivers, streams, and seas, face degradation of their water quality as a result of activities associated with coal utilization including coal mining, coal processing, coal burning, waste storage and thermal pollution from coal plants which tend to contaminate these water bodies. This contamination results from heavy metals, presence of sulphate and iron, dissolved solids, mercury and other toxins contained in coal ash, sludge, and coal waste. These wastes sometimes find their way to sources of urban water supply and contaminate them. A major problem encountered in the supply of potable water to Enugu municipality is the contamination of Ajali River, the source of water supply to Enugu municipal by coal waste. Hydro geochemical analysis of Ajali water samples indicate high sulphate and iron content, high total dissolved solids(TDS), low pH (acidity values) and significant hardness in addition to presence of heavy metals, mercury, and other toxins. This is indicative of the following remedial measures: I. Proper disposal of mine wastes at designated disposal sites that are suitably prepared. II. Proper water treatment and III. Reduction of coal related contaminants taking advantage of clean coal technology.

Keywords: effects, coal, utilization, water quality, sources, waste, contamination, treatment

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2262 Aircraft Components, Manufacturing and Design: Opportunities, Bottlenecks, and Challenges

Authors: Ionel Botef

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Aerospace products operate in very aggressive environments characterized by high temperature, high pressure, large stresses on individual components, the presence of oxidizing and corroding atmosphere, as well as internally created or externally ingested particulate materials that induce erosion and impact damage. Consequently, during operation, the materials of individual components degrade. In addition, the impact of maintenance costs for both civil and military aircraft was estimated at least two to three times greater than initial purchase values, and this trend is expected to increase. As a result, for viable product realisation and maintenance, a spectrum of issues regarding novel processing technologies, innovation of new materials, performance, costs, and environmental impact must constantly be addressed. One of these technologies, namely the cold-gas dynamic-spray process has enabled a broad range of coatings and applications, including many that have not been previously possible or commercially practical, hence its potential for new aerospace applications. Therefore, the purpose of this paper is to summarise the state of the art of this technology alongside its theoretical and experimental studies, and explore how the cold-gas dynamic-spray process could be integrated within a framework that finally could lead to more efficient aircraft maintenance. Based on the paper's qualitative findings supported by authorities, evidence, and logic essentially it is argued that the cold-gas dynamic-spray manufacturing process should not be viewed in isolation, but should be viewed as a component of a broad framework that finally leads to more efficient aerospace operations.

Keywords: aerospace, aging aircraft, cold spray, materials

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2261 Importance of Developing a Decision Support System for Diagnosis of Glaucoma

Authors: Murat Durucu

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Glaucoma is a condition of irreversible blindness, early diagnosis and appropriate interventions to make the patients able to see longer time. In this study, it addressed that the importance of developing a decision support system for glaucoma diagnosis. Glaucoma occurs when pressure happens around the eyes it causes some damage to the optic nerves and deterioration of vision. There are different levels ranging blindness of glaucoma disease. The diagnosis at an early stage allows a chance for therapies that slows the progression of the disease. In recent years, imaging technology from Heidelberg Retinal Tomography (HRT), Stereoscopic Disc Photo (SDP) and Optical Coherence Tomography (OCT) have been used for the diagnosis of glaucoma. This better accuracy and faster imaging techniques in response technique of OCT have become the most common method used by experts. Although OCT images or HRT precision and quickness, especially in the early stages, there are still difficulties and mistakes are occurred in diagnosis of glaucoma. It is difficult to obtain objective results on diagnosis and placement process of the doctor's. It seems very important to develop an objective decision support system for diagnosis and level the glaucoma disease for patients. By using OCT images and pattern recognition systems, it is possible to develop a support system for doctors to make their decisions on glaucoma. Thus, in this recent study, we develop an evaluation and support system to the usage of doctors. Pattern recognition system based computer software would help the doctors to make an objective evaluation for their patients. It is intended that after development and evaluation processes of the software, the system is planning to be serve for the usage of doctors in different hospitals.

Keywords: decision support system, glaucoma, image processing, pattern recognition

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2260 The Effect of Deformation Activation Volume, Strain Rate Sensitivity and Processing Temperature of Grain Size Variants

Authors: P. B. Sob, A. A. Alugongo, T. B. Tengen

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The activation volume of 6082T6 aluminum is investigated at different temperatures on grain size variants. The deformation activation volume was computed on the basis of the relationship between the Boltzmann’s constant k, the testing temperatures, the material strain rate sensitivity and the material yield stress of grain size variants. The material strain rate sensitivity is computed as a function of yield stress and strain rate of grain size variants. The effect of the material strain rate sensitivity and the deformation activation volume of 6082T6 aluminum at different temperatures of 3-D grain are discussed. It is shown that the strain rate sensitivities and activation volume are negative for the grain size variants during the deformation of nanostructured materials. It is also observed that the activation volume vary in different ways with the equivalent radius, semi minor axis radius, semi major axis radius and major axis radius. From the obtained results it is shown that the variation of activation volume increased and decreased with the testing temperature. It was revealed that, increased in strain rate sensitivity led to decrease in activation volume whereas increased in activation volume led to decrease in strain rate sensitivity.

Keywords: nanostructured materials, grain size variants, temperature, yield stress, strain rate sensitivity, activation volume

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2259 A Review of the Nutritional, Health and Medicinal Benefits of Selected Endangered Food Spice Crops in South Eastern Nigeria

Authors: Poly-Mbah C. P., Offor J. I., Onyeneke E. N., Poly-Mbah J. C.

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Many food spice crops are being endangered into extinction in Nigeria because of climate change as well as deforestation occasioned by population pressure and urbanization and also due to neglect of research and agronomic attention. This review was aimed at identifying the nutritional and health benefits of these endangered aromatic food spice crops. The findings of this review will help to popularize their cultivation and increase research efforts made in the agronomy of these food spice species. Nine aromatic food spice crop species identified to be facing the danger of extinction include: Guinea pepper ( Piper guineensis), Utazi ( Gongronema latifolium), Hoary or Thai lemon basil ( Ocimum africanum), Mint basil ( Ocimum gratissimum), Whole country onions( Afrostyrax lepidophyllus), Jansa ( Cussonia bateri), Negro pepper ( Xylopia aethiopica), Ataiko or Orima (Afromomium Danielle), Aidan (Tetrapleura tetraptera). Findings from this review revealed that these species are capable of improving the nutrition and health of the rural dwellers but yet, are minimally cultivated. This paper also reviewed research made in the agronomy of these identified threatened food spice crops in the semi-urban Southeastern Nigeria environment and discovered that there is little research attention on them. The availability of these food spice crop species was discovered to come from collections made from nearby bushes and forests. This paper therefore recommends that agronomic packages such as pre-planting, planting and post-planting requirements be investigated and recommended in order to initiate and increase the cultivation of the selected endangered food spice crops as well as their productivity.

Keywords: review, endangered, food spice crops, South Eastern Nigeria

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2258 Feature Analysis of Predictive Maintenance Models

Authors: Zhaoan Wang

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Research in predictive maintenance modeling has improved in the recent years to predict failures and needed maintenance with high accuracy, saving cost and improving manufacturing efficiency. However, classic prediction models provide little valuable insight towards the most important features contributing to the failure. By analyzing and quantifying feature importance in predictive maintenance models, cost saving can be optimized based on business goals. First, multiple classifiers are evaluated with cross-validation to predict the multi-class of failures. Second, predictive performance with features provided by different feature selection algorithms are further analyzed. Third, features selected by different algorithms are ranked and combined based on their predictive power. Finally, linear explainer SHAP (SHapley Additive exPlanations) is applied to interpret classifier behavior and provide further insight towards the specific roles of features in both local predictions and global model behavior. The results of the experiments suggest that certain features play dominant roles in predictive models while others have significantly less impact on the overall performance. Moreover, for multi-class prediction of machine failures, the most important features vary with type of machine failures. The results may lead to improved productivity and cost saving by prioritizing sensor deployment, data collection, and data processing of more important features over less importance features.

Keywords: automated supply chain, intelligent manufacturing, predictive maintenance machine learning, feature engineering, model interpretation

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2257 The Effect of a Saturated Kink on the Dynamics of Tungsten Impurities in the Plasma Core

Authors: H. E. Ferrari, R. Farengo, C. F. Clauser

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Tungsten (W) will be used in ITER as one of the plasma facing components (PFCs). The W could migrate to the plasma center. This could have a potentially deleterious effect on plasma confinement. Electron cyclotron resonance heating (ECRH) can be used to prevent W accumulation. We simulated a series of H mode discharges in ASDEX U with PFC containing W, where central ECRH was used to prevent W accumulation in the plasma center. The experiments showed that the W density profiles were flat after a sawtooth crash, and become hollow in between sawtooth crashes when ECRH has been applied. It was also observed that a saturated kink mode was active in these conditions. We studied the effect of saturated kink like instabilities on the redistribution of W impurities. The kink was modeled as the sum of a simple analytical equilibrium (large aspect ratio, circular cross section) plus the perturbation produced by the kink. A numerical code that follows the exact trajectories of the impurity ions in the total fields and includes collisions was employed. The code is written in Cuda C and runs in Graphical Processing Units (GPUs), allowing simulations with a large number of particles with modest resources. Our simulations show that when the W ions have a thermal velocity distribution, the kink has no effect on the W density. When we consider the plasma rotation, the kink can affect the W density. When the average passing frequency of the W particles is similar to the frequency of the kink mode, the expulsion of W ions from the plasma core is maximum, and the W density shows a hollow structure. This could have implications for the mitigation of W accumulation.

Keywords: impurity transport, kink instability, tungsten accumulation, tungsten dynamics

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2256 Reality Shock Affecting the Motivation to Work of New Flight Attendants: An Exploratory Qualitative Study of Flight Attendants Who Left Their Jobs Early

Authors: Hiromi Takafuji

Abstract:

Flight attendant:FA is one of popular occupation, especially in Asian countries, and the decision to be hired is made after clearing a high multiplier. On the other hand, immediately after joining the company, they experience unique stress due to the fact that the organization requires them to perform security and customer service duties in a highly specialized and limited space and time. As a result, despite the high level of difficulty in joining the company, many new recruits retire early at a high rate. It is commonly said that 30% of new graduates leave the company within three years in Japan and speculated that Reality Shock:RS is one of the causes of this. RS is that newcomers experience refers to the stress caused by the difference between pre-employment expectations and post-employment reality. The purpose of this study was to elucidate the mechanism by which the expertise required of new FA and the expectation of expertise held by each of them cause reality shock, which affects motivation and the decision to leave. This study identified the professionalism required of new FA and the impact of that expectation for professionalism on RS through an exploratory study of the experiences and psychological processes of FA who left within three years. Semi-structured in-depth interviews were conducted with five FA who left a major Japanese airline at an early stage, and their experiences were categorized, integrated, and classified by qualitative content analysis. They were chosen under a number of controlled conditions. Then two major findings emerged: first, that pre-employment expectations defining RS were hierarchical, and second, that training amplified expectations of professionalism, which strongly influenced early turnover. From these, this study generated a model of RS generative process model of FA that expectations are hierarchical and influential. This could contribute to the prevention of mental health deterioration by reality shock among new FA.

Keywords: reality shock, flight attendant, early turnover, qualitative study

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2255 Dispersions of Carbon Black in Microemulsions

Authors: Mohamed Youssry, Dominique Guyomard, Bernard Lestriez

Abstract:

In order to enhance the energy and power densities of electrodes for energy storage systems, the formulation and processing of electrode slurries proved to be a critical issue in determining the electrode performance. In this study, we introduce novel approach to formulate carbon black slurries based on microemulsion and lyotropic liquid crystalline phases (namely, lamellar phase) composed of non-ionic surfactant (Triton X100), decanol and water. Simultaneous measurements of electrical properties of slurries under shear flow (rheology) have been conducted to elucidate the microstructure evolution with the surfactant concentration and decanol/water ratio at rest, as well as, the structural transition under steady-shear which has been confirmed by rheo-microscopy. Interestingly, the carbon black slurries at low decanol/water ratio are weak-gel (flowable) with higher electrical conductivity than those at higher ratio which behave strong-gel viscoelastic response. In addition, the slurries show recoverable electrical behaviour under shear flow in tandem with the viscosity trend. It is likely that oil-in-water microemulsion enhances slurries’ stability without affecting on the percolating network of carbon black. On the other hand, the oil-in-water analogous and bilayer structure of lamellar phase cause the slurries less conductive as a consequence of losing the network percolation. These findings are encouraging to formulate microemulsion-based electrodes for energy storage system (lithium-ion batteries).

Keywords: electrode slurries, microemulsion, microstructure transition, rheo-electrical properties

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2254 Hematological Profiles of Visceral Leishmaniasis Patients before and after Treatment of Anti-Leishmanial Drugs at University of Gondar Leishmania Research and Treatment Center Northwest, Ethiopia

Authors: Fitsumbrhan Tajebe, Fadil Murad, Mitikie Tigabie, Mareye Abebaw, Tadele Alemu, Sefanit Abate, Rezika Mohammedw, Arega Yeshanew, Elias Shiferaw

Abstract:

Background: Visceral leshimaniasis is a parasitic disease characterized by a systemic infection of phagocytic cells. Hematological parameters of these patients may be affected by the progress of the disease or treatment. Thus, the current study aimed to assess the hematological profiles of visceral leishmaniasis patients before and after treatment. Method: An institutional based retrospective cohort study was conducted among visceral leishmaniasis patients at University of Gondar Comprehensive Specialized Referral Hospital Leishmaniasis Research and Treatment Center from 2013 to 2018. Hematological profiles before initiation and after completion of treatment were extracted from registration book. Descriptive statics was presented using frequency and percentage. Paired t-test and Wilcoxon Signed rank test were used for comparing mean difference for normally and non- normally distributed data, respectively. Spearman and Pearson correlation analysis was used to describe the correlation of hematological parameters with different variables. P value < 0.05 was considered as statistically significant. Result: Except absolute nerutrophil count, post treatment hematological parameters show a significant increment compared to pretreatment one. The prevalence of anemia, leucopenia and thrombocytopenia was 85.5%, 83.4% and 75.8% prior to treatment and it was 58.3%, 38.2% and 19.2% after treatment, respectively. Moreover, parasite load of the disease showed statistically significant negative correlation with hematological profiles mainly with white blood cell and red blood cell. Conclusion: Majority of hematological profiles of patients with active VL have been restored after treatment, which might be associated with treatment effect on parasite proliferation and concentration of parasite in visceral organ, which directly affect hematological profiles.

Keywords: visceral leshimaniasis, hematological profile, anti-leshimanial drug, Gondar

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2253 Thermomechanical Deformation Response in Cold Sprayed SiCp/Al Composites: Strengthening, Microstructure Characterization, and Thermomechanical Properties

Authors: L. Gyansah, Yanfang Shen, Jiqiang Wang, Tianying Xiong

Abstract:

SiCₚ/ pure Al composites with different SiC fractions (20 wt %, 30 wt %, and 40 wt %) were precisely cold sprayed, followed by hot axial-compression tests at deformation temperatures of 473 K to 673 K, leading to failure of specimens through routine crack propagation in their multiphase. The plastic deformation behaviour with respect to the SiCₚ contents and the deformation temperatures were studied at strain rate 1s-1.As-sprayed and post-failure specimens were analyzed by X-ray computed tomography (XCT), transmission electron microscopy (TEM), and scanning electron microscopy (SEM). Quasi-static thermomechanical testing results revealed that compressive strength (UTS = 228 MPa and 30.4 %) was the highest in the composites that was thermomechanically compressed at 473 K compared to those of the as-sprayed, while the as-sprayed exhibited a compressive strength of 182.8 MPa related to the increment in SiC fraction. Strength—plasticity synergy was promoted by dynamic recrystallization (DRX) through strengthening and refinement of the grains. The DRX degree depends relevantly on retainment of the uniformly ultrafine SiCₚ particulates, the pinning effects of the interfaces promoted by the ultrafine grain structures (UFG), and the higher deformation temperature. Reconstructed X-ray computed tomography data revealed different crack propagation mechanisms. A single-plane shear crack with multi-laminates fracture morphology yields relatively through the as-sprayed and as-deformed at 473 K deposits, while a multiphase plane shear cracks preeminently existed in high temperature deformed deposits resulting in multiphase-interface delaminations. Three pertinent strengthening mechanisms, videlicet, SiCp dispersed strengthening, refined grain strengthening, and dislocation strengthening, existed in the gradient microstructure, and their detailed contributions to the thermomechanical properties were discussed.

Keywords: cold spraying, hot deformation, deformation temperature, thermomechancal properties, SiC/Al composite

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2252 An Exploration Survival Risk Factors of Stroke Patients at a General Hospital in Northern Taiwan

Authors: Hui-Chi Huang, Su-Ju Yang, Ching-Wei Lin, Jui-Yao Tsai, Liang-Yiang

Abstract:

Background: The most common serious complication following acute stroke is pneumonia. It has been associated with the increased morbidity, mortality, and medical cost after acute stroke in elderly patients. Purpose: The aim of this retrospective study was to investigate the relationship between stroke patients, risk factors of pneumonia, and one-year survival rates in a group of patients, in a tertiary referal center in Northern Taiwan. Methods: From January 2012 to December 2013, a total of 1730 consecutively administered stroke patients were recruited. The Survival analysis and multivariate regression analyses were used to examine the predictors for the one-year survival in stroke patients of a stroke registry database from northern Taiwan. Results: The risk of stroke mortality increased with age≧ 75 (OR=2.305, p < .0001), cancer (OR=3.221, p=<.0001), stayed in intensive care unit (ICU) (OR=2.28, p <.0006), dysphagia (OR=5.026, p<.0001), without speech therapy(OR=0.192, p < .0001),serum albumin < 2.5(OR=0.322, p=.0053) , eGFR > 60(OR=0.438, p <. 0001), admission NIHSS >11(OR=1.631, p=.0196), length of hospitalization (d) > 30(OR=0.608, p=.0227), and stroke subtype (OR=0.506, p=.0032). After adjustment of confounders, pneumonia was not significantly associated with the risk of mortality. However, it is most likely to develop in patients who are age ≧ 75, dyslipidemia , coronary artery disease , albumin < 2.5 , eGFR <60 , ventilator use , stay in ICU , dysphagia, without speech therapy , urinary tract infection , Atrial fibrillation , Admission NIHSS > 11, length of hospitalization > 30(d) , stroke severity (mRS=3-5) ,stroke Conclusion: In this study, different from previous research findings, we found that elderly age, severe neurological deficit and rehabilitation therapy were significantly associated with Post-stroke Pneumonia. However, specific preventive strategies are needed to target the high risk groups to improve their long-term outcomes after acute stroke. These findings could open new avenues in the management of stroke patients.

Keywords: stroke, risk, pneumonia, survival

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2251 The Effect of Second Victim-Related Distress on Work-Related Outcomes in Tertiary Care, Kelantan, Malaysia

Authors: Ahmad Zulfahmi Mohd Kamaruzaman, Mohd Ismail Ibrahim, Ariffin Marzuki Mokhtar, Maizun Mohd Zain, Saiful Nazri Satiman, Mohd Najib Majdi Yaacob

Abstract:

Background: Aftermath any patient safety incidents, the involved healthcare providers possibly sustained second victim-related distress (second victim distress and reduced their professional efficacy), with subsequent negative work-related outcomes or vice versa cultivating resilience. This study aimed to investigate the factors affecting negative work-related outcomes and resilience, with the triad of support; colleague, supervisor, and institutional support as the hypothetical mediators. Methods: This was a cross sectional study recruiting a total of 733 healthcare providers from three tertiary care in Kelantan, Malaysia. Three steps of hierarchical linear regression were developed for each outcome; negative work-related outcomes and resilience. Then, four multiple mediator models of support triad were analyzed. Results: Second victim distress, professional efficacy, and the support triad contributed significantly for each regression model. In the pathway of professional efficacy on each negative work-related outcomes and resilience, colleague support partially mediated the relationship. As for second victim distress on negative work related outcomes, colleague and supervisor support were the partial mediator, and on resilience; all support triad also produced a similar effect. Conclusion: Second victim distress, professional efficacy, and the support triad influenced the relationship with the negative work-related outcomes and resilience. Support triad as the mediators ameliorated the effect in between and explained the urgency of having good support for recovery post encountering patient safety incidents.

Keywords: second victims, patient safety incidents, hierarchical linear regression, mediation, support

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2250 The Effect of Antibiotic Use on Blood Cultures: Implications for Future Policy

Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

Abstract:

Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

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2249 Comparative Analysis of Yield before and after Access to Extension Services among Crop Farmers in Bauchi Local Government Area of Bauchi State, Nigeria

Authors: U. S. Babuga, A. H. Danwanka, A. Garba

Abstract:

The research was carried out to compare the yield of respondents before and after access to extension services on crop production technologies in the study area. Data were collected from the study area through questionnaires administered to seventy-five randomly selected respondents. Data were analyzed using descriptive statistics, t-test and regression models. The result disclosed that majority (97%) of the respondent attended one form of school or the other. The majority (78.67%) of the respondents had farm size ranging between 1-3 hectares. The majority of the respondent adopt improved variety of crops, plant spacing, herbicide, fertilizer application, land preparation, crop protection, crop processing and storage of farm produce. The result of the t-test between the yield of respondents before and after access to extension services shows that there was a significant (p<0.001) difference in yield before and after access to extension. It also indicated that farm size was significant (p<0.001) while household size, years of farming experience and extension contact were significant at (p<0.005). The major constraint to adoption of crop production technologies were shortage of extension agents, high cost of technology and lack of access to credit facility. The major pre-requisite for the improvement of extension service are employment of more extension agents or workers and adequate training. Adequate agricultural credit to farmers at low interest rates will enhance their adoption of crop production technologies.

Keywords: comparative, analysis, yield, access, extension

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2248 Using Audio-Visual Aids and Computer-Assisted Language Instruction to Overcome Learning Difficulties of Reading in Students of Special Needs

Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

Abstract:

Background & aims: Reading is a receptive skill whose importance could involve abilities' variance from linguistic standard. Several evidences support the hypothesis stating that the more you read the better you write, with a different impact for speech language therapists (SLTs) who use audio-visual aids and computer-assisted language instruction (CALI) and those who do not. Methods: Here we made use of audio-visual aids and CALI for teaching reading skill to a group of 40 students of special needs of both sexes (range between 8 and 18 years old) at al-Malādh school for teaching students of special needs in Dhamar (Yemen) while another group of the same number is taught using ordinary teaching methods. Pre-and-posttests have been administered at the beginning and the end of the semester (Before and after teaching the reading course). The purpose was to understand the differences between the levels of the students of special needs to see to what extent audio-visual aids and CALI are useful for them. The two groups were taught by the same instructor under the same circumstances in the same school. Both quantitative and qualitative procedures were used to analyze the data. Results: The overall findings revealed that audio-visual aids and CALI are very useful for teaching reading to students of special needs and this can be seen in the scores of the treatment group’s subjects (7.0%, in post-test vs.2.5% in pre-test). In comparison to the scores of the second group’s subjects (where audio-visual aids and CALI were not used) (2.2% in both pre-and-posttests), the first group subjects have overcome reading tasks and this can be observed in their performance in the posttest. Compared with males, females’ performance was better (1466 scores (7.3%) vs. 1371 scores (6.8%). Qualitative and statistical analyses showed that such comprehension is absolutely due to the use of audio-visual aids and CALI and nothing else. These outcomes confirm the evidence of the significance of using audio-visual aids and CALI as effective means for teaching receptive skills in general and reading skill in particular.

Keywords: reading, receptive skills, audio-visual aids, CALI, students, special needs, SLTs

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2247 Rheological and Computational Analysis of Crude Oil Transportation

Authors: Praveen Kumar, Satish Kumar, Jashanpreet Singh

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Transportation of unrefined crude oil from the production unit to a refinery or large storage area by a pipeline is difficult due to the different properties of crude in various areas. Thus, the design of a crude oil pipeline is a very complex and time consuming process, when considering all the various parameters. There were three very important parameters that play a significant role in the transportation and processing pipeline design; these are: viscosity profile, temperature profile and the velocity profile of waxy crude oil through the crude oil pipeline. Knowledge of the Rheological computational technique is required for better understanding the flow behavior and predicting the flow profile in a crude oil pipeline. From these profile parameters, the material and the emulsion that is best suited for crude oil transportation can be predicted. Rheological computational fluid dynamic technique is a fast method used for designing flow profile in a crude oil pipeline with the help of computational fluid dynamics and rheological modeling. With this technique, the effect of fluid properties including shear rate range with temperature variation, degree of viscosity, elastic modulus and viscous modulus was evaluated under different conditions in a transport pipeline. In this paper, two crude oil samples was used, as well as a prepared emulsion with natural and synthetic additives, at different concentrations ranging from 1,000 ppm to 3,000 ppm. The rheological properties was then evaluated at a temperature range of 25 to 60 °C and which additive was best suited for transportation of crude oil is determined. Commercial computational fluid dynamics (CFD) has been used to generate the flow, velocity and viscosity profile of the emulsions for flow behavior analysis in crude oil transportation pipeline. This rheological CFD design can be further applied in developing designs of pipeline in the future.

Keywords: surfactant, natural, crude oil, rheology, CFD, viscosity

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2246 Using Multi-Specialist Team to Care for a Breast Cancer Patient Who Received Total Mastectomy during Pregnancy

Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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