Search results for: solar radiation pressure
1083 'Get the DNR': Exploring the Impact of an Educational eModule on Internal Medicine Residents' Attitudes and Approaches to Goals of Care Conversations
Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong
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Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.Keywords: goals of care conversations, communication skills, emodule, medical education
Procedia PDF Downloads 1351082 Catalytic Wet Air Oxidation as a Pretreatment Option for Biodegradability Enhancement of Industrial Effluent
Authors: Sushma Yadav, Anil K. Saroha
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Complex industrial effluent generated from chemical industry is contaminated with toxic and hazardous organic compounds and not amenable to direct biological treatment. To effectively remove many toxic organic pollutants has made it evident that new, compact and more efficient systems are needed. Catalytic Wet Air Oxidation (CWAO) is a promising treatment technology for the abatement of organic pollutants in wastewater. A lot of information is available on using CWAO for the treatment of synthetic solution containing single organic pollutant. But the real industrial effluents containing multi-component mixture of organic compounds were less studied. The main objective of this study is to use the CWAO process for converting the organics into compounds more amenable to biological treatment; complete oxidation may be too expensive. Therefore efforts were made in the present study to explore the potential of alumina based Platinum (Pt) catalyst for the treatment of industrial organic raffinate containing toxic constituents like ammoniacal nitrogen, pyridine etc. The catalysts were prepared by incipient wetness impregnation method and characterized by scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX) and BET (Brunauer, Emmett, and Teller) surface area. CWAO experiments were performed at atmospheric pressure and (30 °C - 70 °C) temperature conditions and the results were evaluated in terms of COD removal efficiency. The biodegradability test was performed by BOD/COD ratio for checking the toxicity of the industrial wastewater as well as for the treated water. The BOD/COD ratio of treated water was significantly increased and signified that the toxicity of the organics was decreased while the biodegradability was increased, indicating the more amenability towards biological treatment.Keywords: alumina based pt catalyst, BOD/COD ratio, catalytic wet air oxidation, COD removal efficiency, industrial organic raffinate
Procedia PDF Downloads 3031081 Friction and Wear, Including Mechanisms, Modeling,Characterization, Measurement and Testing (Bangladesh Case)
Authors: Gor Muradyan
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The paper is about friction and wear, including mechanisms, modeling, characterization, measurement and testing case in Bangladesh. Bangladesh is a country under development, A lot of people live here, approximately 145 million. The territory of this country is very small. Therefore buildings are very close to each other. As the pipe lines are very old, and people get almost dirty water, there are a lot of ongoing projects under ADB. In those projects the contractors using HDD machines (Horizontal Directional Drilling ) and grundoburst. These machines are working underground. As ground in Bangladesh is very sludge, machine can't work relevant because of big friction in the soil. When drilling works are finished machine is pulling the pipe underground. Very often the pulling of the pipes becomes very complicated because of the friction. Therefore long section of the pipe laying can’t be done because of a big friction. In that case, additional problems rise, as well as additional work must be done. As we mentioned above it is not possible to do big section of the pipe laying because of big friction in the soil, Because of this it is coming out that contractors must do more joints, more pressure test. It is always connected with additional expenditure and losing time. This machine can pull in 75 mm to 500 mm pipes connected with the soil condition. Length is possible till 500m related how much friction it will had on the puller. As less as much it can pull. Another machine grundoburst is not working at this soil condition at all. The machine is working with air compressor. This machine are using for the smaller diameter pipes, 20 mm to 63 mm. Most of the cases these machines are being used for the installing of the house connection pipes, for making service connection. To make a friction less contractors using bigger pulling had then the pipe. It is taking down the friction, But the problem of this machine is that it can't work at sludge. Because of mentioned reasons the friction has a big mining during this kind of works. There are a lot of ways to reduce the friction. In this paper we'll introduce the ways that we have researched during our practice in Bangladesh.Keywords: Bangladesh, friction and wear, HDD machines, reducing friction
Procedia PDF Downloads 3171080 Magnetron Sputtered Thin-Film Catalysts with Low Noble Metal Content for Proton Exchange Membrane Water Electrolysis
Authors: Peter Kus, Anna Ostroverkh, Yurii Yakovlev, Yevheniia Lobko, Roman Fiala, Ivan Khalakhan, Vladimir Matolin
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Hydrogen economy is a concept of low-emission society which harvests most of its energy from renewable sources (e.g., wind and solar) and in case of overproduction, electrochemically turns the excess amount into hydrogen, which serves as an energy carrier. Proton exchange membrane water electrolyzers (PEMWE) are the backbone of this concept. By fast-response electricity to hydrogen conversion, the PEMWEs will not only stabilize the electrical grid but also provide high-purity hydrogen for variety of fuel cell powered devices, ranging from consumer electronics to vehicles. Wider commercialization of PEMWE technology is however hindered by high prices of noble metals which are necessary for catalyzing the redox reactions within the cell. Namely, platinum for hydrogen evolution reaction (HER), running on cathode, and iridium for oxygen evolution reaction (OER) on anode. Possible way of how to lower the loading of Pt and Ir is by using conductive high-surface nanostructures as catalyst supports in conjunction with thin-film catalyst deposition. The presented study discusses unconventional technique of membrane electron assembly (MEA) preparation. Noble metal catalysts (Pt and Ir) were magnetron sputtered in very low loadings onto the surface of porous sublayers (located on gas diffusion layer or directly on membrane), forming so to say localized three-phase boundary. Ultrasonically sprayed corrosion resistant TiC-based sublayer was used as a support material on anode, whereas magnetron sputtered nanostructured etched nitrogenated carbon (CNx) served the same role on cathode. By using this configuration, we were able to significantly decrease the amount of noble metals (to thickness of just tens of nanometers), while keeping the performance comparable to that of average state-of-the-art catalysts. Complex characterization of prepared supported catalysts includes in-cell performance and durability tests, electrochemical impedance spectroscopy (EIS) as well as scanning electron microscopy (SEM) imaging and X-ray photoelectron spectroscopy (XPS) analysis. Our research proves that magnetron sputtering is a suitable method for thin-film deposition of electrocatalysts. Tested set-up of thin-film supported anode and cathode catalysts with combined loading of just 120 ug.cm⁻² yields remarkable values of specific current. Described approach of thin-film low-loading catalyst deposition might be relevant when noble metal reduction is the topmost priority.Keywords: hydrogen economy, low-loading catalyst, magnetron sputtering, proton exchange membrane water electrolyzer
Procedia PDF Downloads 1631079 UV-Cured Thiol-ene Based Polymeric Phase Change Materials for Thermal Energy Storage
Authors: M. Vezir Kahraman, Emre Basturk
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Energy storage technology offers new ways to meet the demand to obtain efficient and reliable energy storage materials. Thermal energy storage systems provide the potential to acquire energy savings, which in return decrease the environmental impact related to energy usage. For this purpose, phase change materials (PCMs) that work as 'latent heat storage units' which can store or release large amounts of energy are preferred. Phase change materials (PCMs) are being utilized to absorb, collect and discharge thermal energy during the cycle of melting and freezing, converting from one phase to another. Phase Change Materials (PCMs) can generally be arranged into three classes: organic materials, salt hydrates and eutectics. Many kinds of organic and inorganic PCMs and their blends have been examined as latent heat storage materials. PCMs have found different application areas such as solar energy storage and transfer, HVAC (Heating, Ventilating and Air Conditioning) systems, thermal comfort in vehicles, passive cooling, temperature controlled distributions, industrial waste heat recovery, under floor heating systems and modified fabrics in textiles. Ultraviolet (UV)-curing technology has many advantages, which made it applicable in many different fields. Low energy consumption, high speed, room-temperature operation, low processing costs, high chemical stability, and being environmental friendly are some of its main benefits. UV-curing technique has many applications. One of the many advantages of UV-cured PCMs is that they prevent the interior PCMs from leaking. Shape-stabilized PCM is prepared by blending the PCM with a supporting material, usually polymers. In our study, this problem is minimized by coating the fatty alcohols with a photo-cross-linked thiol-ene based polymeric system. Leakage is minimized because photo-cross-linked polymer acts a matrix. The aim of this study is to introduce a novel thiol-ene based shape-stabilized PCM. Photo-crosslinked thiol-ene based polymers containing fatty alcohols were prepared and characterized for the purpose of phase change materials (PCMs). Different types of fatty alcohols were used in order to investigate their properties as shape-stable PCMs. The structure of the PCMs was confirmed by ATR-FTIR techniques. The phase transition behaviors, thermal stability of the prepared photo-crosslinked PCMs were investigated by differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). This work was supported by Marmara University, Commission of Scientific Research Project.Keywords: differential scanning calorimetry (DSC), Polymeric phase change material, thermal energy storage, UV-curing
Procedia PDF Downloads 2281078 A Case Report on Neonatal Conjunctivitis in Pugs
Authors: Maria L. G. Lourenco, Viviane Y. Hibaru, Keylla H. N. P. Pereira, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado
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Neonatal conjunctivitis, or ophthalmia, is an infection of the conjunctiva or cornea before opening the eyelids. It is believed that immunodeficiency contributes to the development of the condition. This study aims at reporting a case of ophthalmia neonatorum in a dog, in addition to its diagnosis and treatment. A litter of five pug neonates was admitted to the Sao Paulo State University (UNESP) Veterinary Hospital, Botucatu, Sao Paulo, Brazil, with complaints of ocular secretion. The neonates were five days old. The clinical examination revealed that three newborns presented swelling in the ocular region and a purulent secretion in the medial corner of the eye that was exerting pressure on the ocular globes, which are compatible with the description of this disease. The diagnosis was made based on the clinical signs and bacterial culture of the secretion, which revealed the presence of bacteria belonging to the genus Staphylococcus sp. The laboratory assays did not reveal any alterations. The treatment was instituted gently, opening the eyelids early and cleaning the purulent ocular secretion with saline solution. An ophthalmic ointment with retinol, amino acids, methionine, and chloramphenicol (Epitezan®) was prescribed four times a day for seven days. Blood plasma (2 mL/100 g) was administered subcutaneously because bacterial infections in neonates may represent a failure in the transference of passive immunity. A more thorough cleaning of the environment was also recommended. Neonatal conjunctivitis has a simple diagnosis and treatment. If not treated early, it can evolve to adherence of the eyelids to the cornea, ulceration, and perforation of the cornea. Therefore, the prognosis is favorable as long as the condition is diagnosed early, and the treatment is instituted quickly.Keywords: ophthalmia neonatorum, neonatal infection, puppy, newborn
Procedia PDF Downloads 1401077 Thermodynamics Analysis of Transcritical HTHP Cycles Using Eco-Friendly Refrigerant and low-Grade Waste Heat Recovery: A Theoretical Evaluation
Authors: Adam Y. Sulaiman, Donal F. Cotter, Ming J. Huang, Neil J. Hewitt
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Decarbonization of the industrial sector in developed countries has become indispensable for addressing climate change. Industrial processes including drying, distillation, and injection molding require a process heat exceeding 180°C, rendering the subcriticalHigh-Temperature heat pump(HTHP) technique unsuitable. A transcritical HTHP utilizing ecologically friendly working fluids is a highly recommended system that incorporates the features of high-energy efficiency, extended operational range, and decarbonizing the industrial sector. This paper delves into the possibility and feasibility of leveraging the HTTP system to provide up to 200°C of heat using R1233zd(E) as a working fluid. Using a steady-state model, various transcritical HTHP cycle configurations aretheoretically compared,analyzed, and evaluatedin this study. The heat transfer characteristics for the evaporator and gas cooler are investigated, as well as the cycle's energy, exergetic, and environmental performance. Using the LMTD method, the gas cooler's heat transfer coefficient, overall length, and heat transfer area were calculated. The findings indicate that the heat sink pressure level, as well as the waste heat temperature provided to the evaporator, have a significant impact on overall cycle performance. The investigation revealed the potential challenges and barriers, including the length of the gas cooler and the lubrication of the compression process. The basic transcritical HTTP cycle with additional IHX was demonstrated to be the most efficient cycle across a variety of heat source temperatures ranging from 70 to 90 °C based on theoretical energetic and exergetic performance.Keywords: high-temperature heat pump, transcritical cycle, refrigerants, gas cooler, energy, exergy
Procedia PDF Downloads 1631076 Low-Complex, High-Fidelity Two-Grades Cyclo-Olefin Copolymer (COC) Based Thermal Bonding Technique for Sealing a Thermoplastic Microfluidic Biosensor
Authors: Jorge Prada, Christina Cordes, Carsten Harms, Walter Lang
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The development of microfluidic-based biosensors over the last years has shown an increasing employ of thermoplastic polymers as constitutive material. Their low-cost production, high replication fidelity, biocompatibility and optical-mechanical properties are sought after for the implementation of disposable albeit functional lab-on-chip solutions. Among the range of thermoplastic materials on use, the Cyclo-Olefin Copolymer (COC) stands out due to its optical transparency, which makes it a frequent choice as manufacturing material for fluorescence-based biosensors. Moreover, several processing techniques to complete a closed COC microfluidic biosensor have been discussed in the literature. The reported techniques differ however in their implementation, and therefore potentially add more or less complexity when using it in a mass production process. This work introduces and reports results on the application of a purely thermal bonding process between COC substrates, which were produced by the hot-embossing process, and COC foils containing screen-printed circuits. The proposed procedure takes advantage of the transition temperature difference between two COC grades foils to accomplish the sealing of the microfluidic channels. Patterned heat injection to the COC foil through the COC substrate is applied, resulting in consistent channel geometry uniformity. Measurements on bond strength and bursting pressure are shown, suggesting that this purely thermal bonding process potentially renders a technique which can be easily adapted into the thermoplastic microfluidic chip production workflow, while enables a low-cost as well as high-quality COC biosensor manufacturing process.Keywords: biosensor, cyclo-olefin copolymer, hot embossing, thermal bonding, thermoplastics
Procedia PDF Downloads 2401075 Maintaining Experimental Consistency in Geomechanical Studies of Methane Hydrate Bearing Soils
Authors: Lior Rake, Shmulik Pinkert
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Methane hydrate has been found in significant quantities in soils offshore within continental margins and in permafrost within arctic regions where low temperature and high pressure are present. The mechanical parameters for geotechnical engineering are commonly evaluated in geomechanical laboratories adapted to simulate the environmental conditions of methane hydrate-bearing sediments (MHBS). Due to the complexity and high cost of natural MHBS sampling, most laboratory investigations are conducted on artificially formed samples. MHBS artificial samples can be formed using different hydrate formation methods in the laboratory, where methane gas and water are supplied into the soil pore space under the methane hydrate phase conditions. The most commonly used formation method is the excess gas method which is considered a relatively simple, time-saving, and repeatable testing method. However, there are several differences in the procedures and techniques used to produce the hydrate using the excess gas method. As a result of the difference between the test facilities and the experimental approaches that were carried out in previous studies, different measurement criteria and analyses were proposed for MHBS geomechanics. The lack of uniformity among the various experimental investigations may adversely impact the reliability of integrating different data sets for unified mechanical model development. In this work, we address some fundamental aspects relevant to reliable MHBS geomechanical investigations, such as hydrate homogeneity in the sample, the hydrate formation duration criterion, the hydrate-saturation evaluation method, and the effect of temperature measurement accuracy. Finally, a set of recommendations for repeatable and reliable MHBS formation will be suggested for future standardization of MHBS geomechanical investigation.Keywords: experimental study, laboratory investigation, excess gas, hydrate formation, standardization, methane hydrate-bearing sediment
Procedia PDF Downloads 581074 Development and Characterisation of Nonwoven Fabrics for Apparel Applications
Authors: Muhammad Cheema, Tahir Shah, Subhash Anand
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The cost of making apparel fabrics for garment manufacturing is very high because of their conventional manufacturing processes and new methods/processes are being constantly developed for making fabrics by unconventional methods. With the advancements in technology and the availability of the innovative fibres, durable nonwoven fabrics by using the hydroentanglement process that can compete with the woven fabrics in terms of their aesthetic and tensile properties are being developed. In the work reported here, the hydroentangled nonwoven fabrics were developed through a hybrid nonwoven manufacturing processes by using fibrillated Tencel® and bi-component (sheath/core) polyethylene/polyester (PE/PET) fibres, in which the initial nonwoven fabrics were prepared by the needle-punching method followed by hydroentanglement process carried out at optimal pressures of 50 to 250bars. The prepared fabrics were characterized according to the British Standards (BS 3356:1990, BS 9237:1995, BS 13934-1:1999) and the attained results were compared with those for a standard plain-weave cotton, polyester woven fabric and commercially available nonwoven fabric (Evolon®). The developed hydroentangled fabrics showed better drape properties owing to their flexural rigidity of 252 mg.cm in the machine direction, while the corresponding commercial hydroentangled fabric displayed a value of 1340 mg.cm in the machine direction. The tensile strength of the developed hydroentangled fabrics showed an approximately 200% increase than the commercial hydroentangled fabrics. Similarly, the developed hydroentangled fabrics showed higher properties in term of air permeability, such as the developed hydroentangled fabric exhibited 448 mm/sec and Evolon fabric exhibited 69 mm/sec at 100 Pa pressure. Thus for apparel fabrics, the work combining the existing methods of nonwoven production, provides additional benefits in terms of cost, time and also helps in reducing the carbon footprint for the apparel fabric manufacture.Keywords: hydroentanglement, nonwoven apparel, durable nonwoven, wearable nonwoven
Procedia PDF Downloads 2681073 Machine Learning Techniques for COVID-19 Detection: A Comparative Analysis
Authors: Abeer A. Aljohani
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COVID-19 virus spread has been one of the extreme pandemics across the globe. It is also referred to as coronavirus, which is a contagious disease that continuously mutates into numerous variants. Currently, the B.1.1.529 variant labeled as omicron is detected in South Africa. The huge spread of COVID-19 disease has affected several lives and has surged exceptional pressure on the healthcare systems worldwide. Also, everyday life and the global economy have been at stake. This research aims to predict COVID-19 disease in its initial stage to reduce the death count. Machine learning (ML) is nowadays used in almost every area. Numerous COVID-19 cases have produced a huge burden on the hospitals as well as health workers. To reduce this burden, this paper predicts COVID-19 disease is based on the symptoms and medical history of the patient. This research presents a unique architecture for COVID-19 detection using ML techniques integrated with feature dimensionality reduction. This paper uses a standard UCI dataset for predicting COVID-19 disease. This dataset comprises symptoms of 5434 patients. This paper also compares several supervised ML techniques to the presented architecture. The architecture has also utilized 10-fold cross validation process for generalization and the principal component analysis (PCA) technique for feature reduction. Standard parameters are used to evaluate the proposed architecture including F1-Score, precision, accuracy, recall, receiver operating characteristic (ROC), and area under curve (AUC). The results depict that decision tree, random forest, and neural networks outperform all other state-of-the-art ML techniques. This achieved result can help effectively in identifying COVID-19 infection cases.Keywords: supervised machine learning, COVID-19 prediction, healthcare analytics, random forest, neural network
Procedia PDF Downloads 921072 Educational Turn towards Digitalization by Changing Leadership, Networks and Qualification Concepts
Authors: Patricia Girrbach
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Currently, our society is facing a new and incremental upheaval technological revolution named digitalization. In order to face the relating challenges organizations have to be prepared. They need appropriate circumstances in order to cope with current issues concerning digital transformation processes. Nowadays digitalization emerged as top issues for companies and business leaders. In this context, it is a pressure on companies to have a positive, productive digital culture. And indeed, Organizations realize that they need to address this important issue. In this context 87 percent of organizations quote culture and engagement as one of their top challenges in terms of any change process, but especially in terms of the digital turn. Executives can give their company a competitive advantage and attract top talent by having a strong workplace culture that supports digitalization. Many current studies attest that fact. Digital-oriented companies can hire more easily, they have the lowest voluntary turnover rates, deliver better customer service, and are more profitable over the long run. Based on this background it is important to provide companies starting points and practical measurements how to reach this goal. The major findings are that firms need to make sense out of digitalization. In this context, they should focus on internal but also on external stakeholders. Furthermore, they should create certain working conditions and they should support the qualification of employees, e.g. by Virtual Reality. These measurements can create positive experiences in terms of digitalization in order to ensure the support of stuff in terms of the digital turn. Based on several current studies and literature research this paper provides concrete measurements for companies in order to enable the digital turn. Therefore, the aim of this paper is providing possible practical starting points which support both the education of employees by digitalization as well as the digital turn itself within the organization.Keywords: digitalization, industry 4.0, education 4.0, virtual reality
Procedia PDF Downloads 1591071 Graphene Metamaterials Supported Tunable Terahertz Fano Resonance
Authors: Xiaoyong He
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The manipulation of THz waves is still a challenging task due to lack of natural materials interacted with it strongly. Designed by tailoring the characters of unit cells (meta-molecules), the advance of metamaterials (MMs) may solve this problem. However, because of Ohmic and radiation losses, the performance of MMs devices is subjected to the dissipation and low quality factor (Q-factor). This dilemma may be circumvented by Fano resonance, which arises from the destructive interference between a bright continuum mode and dark discrete mode (or a narrow resonance). Different from symmetric Lorentz spectral curve, Fano resonance indicates a distinct asymmetric line-shape, ultrahigh quality factor, steep variations in spectrum curves. Fano resonance is usually realized through symmetry breaking. However, if concentric double rings (DR) are placed closely to each other, the near-field coupling between them gives rise to two hybridized modes (bright and narrowband dark modes) because of the local asymmetry, resulting into the characteristic Fano line shape. Furthermore, from the practical viewpoint, it is highly desirable requirement that to achieve the modulation of Fano spectral curves conveniently, which is an important and interesting research topics. For current Fano systems, the tunable spectral curves can be realized by adjusting the geometrical structural parameters or magnetic fields biased the ferrite-based structure. But due to limited dispersion properties of active materials, it is still a tough work to tailor Fano resonance conveniently with the fixed structural parameters. With the favorable properties of extreme confinement and high tunability, graphene is a strong candidate to achieve this goal. The DR-structure possesses the excitation of so-called “trapped modes,” with the merits of simple structure and high quality of resonances in thin structures. By depositing graphene circular DR on the SiO2/Si/ polymer substrate, the tunable Fano resonance has been theoretically investigated in the terahertz regime, including the effects of graphene Fermi level, structural parameters and operation frequency. The results manifest that the obvious Fano peak can be efficiently modulated because of the strong coupling between incident waves and graphene ribbons. As Fermi level increases, the peak amplitude of Fano curve increases, and the resonant peak position shifts to high frequency. The amplitude modulation depth of Fano curves is about 30% if Fermi level changes in the scope of 0.1-1.0 eV. The optimum gap distance between DR is about 8-12 μm, where the value of figure of merit shows a peak. As the graphene ribbon width increases, the Fano spectral curves become broad, and the resonant peak denotes blue shift. The results are very helpful to develop novel graphene plasmonic devices, e.g. sensors and modulators.Keywords: graphene, metamaterials, terahertz, tunable
Procedia PDF Downloads 3441070 Primary Care Physicians in Urgent Care Centres of the United Kingdom
Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann
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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma
Procedia PDF Downloads 4271069 The Effect of Vitamin D Supplements and Aerobic Exercise on Hunger and Serum Insulin Levels in Adolescents With Metabolic Syndrome
Authors: Vahab Behmanesh
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Metabolic syndrome is defined as having at least three of the five metabolic risk factors, including abdominal obesity, high blood pressure, high triglycerides, low HDL, and insulin resistance. Lifestyle changes towards reducing physical activity, unhealthy eating habits Especially the high-fat and high-carbohydrate diet is directly related to metabolic syndrome, and due to the epidemic of overweight and sedentary life, metabolic syndrome is a serious problem worldwide. On the other hand, vitamin D deficiency is considered as one of the most common problems in the world, which is related to the dysfunction of beta cells and insulin resistance, and therefore, vitamin D deficiency is considered as a factor in the occurrence of metabolic syndrome. 40 subjects (age: 16.12 ± 4.4 years and body mass index 25.61 ± 4.4 kg/m2) were randomly assigned to groups of aerobic exercise and placebo, aerobic exercise and vitamin D and placebo (no exercise) were divided. Vitamin D was taken at a dose of 50,000 units per week in a double-blind format for eight weeks, and the daily aerobic exercise program was performed for 50 to 60 minutes, three doses per week, with an intensity of 50-60% of the maximum heart rate. From one-way analysis of variance, Factorial variance analysis (2x2) repeated measurement and correlated t-test were used for data analysis. Aerobic exercise and vitamin D intake reduced all metabolic risk indicators and blood insulin (P < 0.05). However, the subjective feeling of hunger did not change significantly (P < 0.05). Regarding waist circumference and blood glucose, the effect of exercise combined with vitamin D consumption was greater than the corresponding effect in the vitamin D group (P < 0.05). Aerobic exercises and vitamin D intake are safe and effective for improving cardiometabolic health, Imam adds vitamin D to the exercise program has more benefits for weight and blood sugar control, which suggests prescribing it for patients with metabolic syndrome.Keywords: vitamin D, aerobic exercise, metabolic control, adolescents
Procedia PDF Downloads 1011068 Circumstantial Loneliness and Existential Isolation in the Works of Flutura Açka
Authors: Elvira Lumi, Hans Jazxhi
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In the works of the writer Flutura Açka, the play with these questions is acute, and in almost each of them, the act of loneliness and isolation builds in a completely involuntary way unique and frequent conceptual spaces. Because the object of study is too broad to grasp all the works, this study lays out a rapid paradox of our access to three of the novels in the line of numerous authorial works. The novel "Woman Loneliness" (2001), also marked as the first work in prose by the author, declares in the title the paradigm of what she has decided to confess. The gender segregation proclaimed in the title will be revealed step by step in the work as conventional human segregation without gender. In this novel, the analysis of the state of "loneliness" will require a contemplation beyond man, when the role of the environment and the distance from the center of the narrative base will be extremely visible in the work. The novel "Cross of Oblivion" (2004) has another form of perception of loneliness, which, unlike the one built by the characters themselves in the novel "Woman Loneliness," is imposed and obligatory to live by the circumstances. Its characters are trapped in loneliness, as loneliness that comes from impossibility, from the past, from dependence on fate, from fear of change, and from the obligation to accept it. At the heart of the novel, the plot of the novel game is dictated by the Kanun and its rules and the loneliness of the basis of life in unbroken waves towards the periphery of the event, a periphery that has very large geography and is played in today's Europe. The novel "Where are you?" (2009) has a completely different form of constructing the concept of loneliness and isolation that comes under conditions of repression and political pressure. The loneliness in this novel takes the form of the protective element from the circumstances that actually require a social inclusion; it is personal loneliness that ensures relative mental health of the characters, up to a new trap created by the circumstances, thus building life fragmentary “healthy” in the order of a mentally ill and socially ill society.Keywords: loneliness, existential, isolation, woman, prose
Procedia PDF Downloads 1481067 The Integration of Cleaner Production Innovation and Creativity for Supply Chain Sustainability of Bogor Batik SMEs
Authors: Sawarni Hasibuan, Juliza Hidayati
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Competitiveness and sustainability issues not only put pressure on big companies, but also small and medium enterprises (SMEs). SMEs Batik Bogor is one of the local culture-based creative industries in Bogor city which is also dealing with the issue of sustainability. The purpose of this research is to develop framework of sustainability at SMEs Batik Indonesia case of SMEs Batik Bogor by integrating innovation of cleaner production in its supply chain. The approach used is desk study, field survey, in-depth interviews, and benchmarking best practices of SMEs sustainability. In-depth interviews involve stakeholders to identify the needs and standards of sustainability of SMEs Batik. Data analysis was done by benchmarking method, Multi Dimension Scaling (MDS) method, and Strength, Weakness, Opportunity, Threat (SWOT) analysis. The results recommend the framework of sustainability for SMEs Batik in Indonesia. The sustainability status of SMEs Batik Bogor is classified as Moderate Sustainable. Factors that support the sustainability of SMEs Batik Bogor such is a strong commitment of top management in adopting cleaner production innovation and creativity approach. Successful cleaner production innovations are implemented primarily in the substitution of dye materials from toxic to non-toxic, reducing the intensity of non-renewable energy use, as well as the reuse and recycle of solid waste. “Mosaic Batik” is one of the innovations of solid waste utilization of batik waste produced by company R&D center that gives benefit to three pillars of sustainability, that is financial benefit, environmental benefit, and social benefit. The sustainability of SMEs Batik Bogor cannot be separated from the support of Bogor City Government which proactively facilitates the promotion of sustainable innovation produced by SMEs Batik Bogor.Keywords: cleaner production innovation, creativity, SMEs Batik, sustainability supply chain
Procedia PDF Downloads 2801066 Development of a Regression Based Model to Predict Subjective Perception of Squeak and Rattle Noise
Authors: Ramkumar R., Gaurav Shinde, Pratik Shroff, Sachin Kumar Jain, Nagesh Walke
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Advancements in electric vehicles have significantly reduced the powertrain noise and moving components of vehicles. As a result, in-cab noises have become more noticeable to passengers inside the car. To ensure a comfortable ride for drivers and other passengers, it has become crucial to eliminate undesirable component noises during the development phase. Standard practices are followed to identify the severity of noises based on subjective ratings, but it can be a tedious process to identify the severity of each development sample and make changes to reduce it. Additionally, the severity rating can vary from jury to jury, making it challenging to arrive at a definitive conclusion. To address this, an automotive component was identified to evaluate squeak and rattle noise issue. Physical tests were carried out for random and sine excitation profiles. Aim was to subjectively assess the noise using jury rating method and objectively evaluate the same by measuring the noise. Suitable jury evaluation method was selected for the said activity, and recorded sounds were replayed for jury rating. Objective data sound quality metrics viz., loudness, sharpness, roughness, fluctuation strength and overall Sound Pressure Level (SPL) were measured. Based on this, correlation co-efficients was established to identify the most relevant sound quality metrics that are contributing to particular identified noise issue. Regression analysis was then performed to establish the correlation between subjective and objective data. Mathematical model was prepared using artificial intelligence and machine learning algorithm. The developed model was able to predict the subjective rating with good accuracy.Keywords: BSR, noise, correlation, regression
Procedia PDF Downloads 791065 Upgrade of Value Chains and the Effect on Resilience of Russia’s Coal Industry and Receiving Regions on the Path of Energy Transition
Authors: Sergey Nikitenko, Vladimir Klishin, Yury Malakhov, Elena Goosen
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Transition to renewable energy sources (solar, wind, bioenergy, etc.) and launching of alternative energy generation has weakened the role of coal as a source of energy. The Paris Agreement and assumption of obligations by many nations to orderly reduce CO₂ emissions by means of technological modernization and climate change adaptation has abridged coal demand yet more. This paper aims to assess current resilience of the coal industry to stress and to define prospects for coal production optimization using high technologies pursuant to global challenges and requirements of energy transition. Our research is based on the resilience concept adapted to the coal industry. It is proposed to divide the coal sector into segments depending on the prevailing value chains (VC). Four representative models of VC are identified in the coal sector. The most promising lines of upgrading VC in the coal industry include: •Elongation of VC owing to introduction of clean technologies of coal conversion and utilization; •Creation of parallel VC by means of waste management; •Branching of VC (conversion of a company’s VC into a production network). The upgrade effectiveness is governed in many ways by applicability of advanced coal processing technologies, usability of waste, expandability of production, entrance to non-rival markets and localization of new segments of VC in receiving regions. It is also important that upgrade of VC by means of formation of agile high-tech inter-industry production networks within the framework of operating surface and underground mines can reduce social, economic and ecological risks associated with closure of coal mines. Such promising route of VC upgrade is application of methanotrophic bacteria to produce protein to be used as feed-stuff in fish, poultry and cattle breeding, or in production of ferments, lipoids, sterols, antioxidants, pigments and polysaccharides. Closed mines can use recovered methane as a clean energy source. There exist methods of methane utilization from uncontrollable sources, including preliminary treatment and recovery of methane from air-and-methane mixture, or decomposition of methane to hydrogen and acetylene. Separated hydrogen is used in hydrogen fuel cells to generate power to feed the process of methane utilization and to supply external consumers. Despite the recent paradigm of carbon-free energy generation, it is possible to preserve the coal mining industry using the differentiated approach to upgrade of value chains based on flexible technologies with regard to specificity of mining companies.Keywords: resilience, resilience concept, resilience indicator, resilience in the Russian coal industry, value chains
Procedia PDF Downloads 1071064 High Efficiency Double-Band Printed Rectenna Model for Energy Harvesting
Authors: Rakelane A. Mendes, Sandro T. M. Goncalves, Raphaella L. R. Silva
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The concepts of energy harvesting and wireless energy transfer have been widely discussed in recent times. There are some ways to create autonomous systems for collecting ambient energy, such as solar, vibratory, thermal, electromagnetic, radiofrequency (RF), among others. In the case of the RF it is possible to collect up to 100 μW / cm². To collect and/or transfer energy in RF systems, a device called rectenna is used, which is defined by the junction of an antenna and a rectifier circuit. The rectenna presented in this work is resonant at the frequencies of 1.8 GHz and 2.45 GHz. Frequencies at 1.8 GHz band are e part of the GSM / LTE band. The GSM (Global System for Mobile Communication) is a frequency band of mobile telephony, it is also called second generation mobile networks (2G), it came to standardize mobile telephony in the world and was originally developed for voice traffic. LTE (Long Term Evolution) or fourth generation (4G) has emerged to meet the demand for wireless access to services such as Internet access, online games, VoIP and video conferencing. The 2.45 GHz frequency is part of the ISM (Instrumentation, Scientific and Medical) frequency band, this band is internationally reserved for industrial, scientific and medical development with no need for licensing, and its only restrictions are related to maximum power transfer and bandwidth, which must be kept within certain limits (in Brazil the bandwidth is 2.4 - 2.4835 GHz). The rectenna presented in this work was designed to present efficiency above 50% for an input power of -15 dBm. It is known that for wireless energy capture systems the signal power is very low and varies greatly, for this reason this ultra-low input power was chosen. The Rectenna was built using the low cost FR4 (Flame Resistant) substrate, the antenna selected is a microfita antenna, consisting of a Meandered dipole, and this one was optimized using the software CST Studio. This antenna has high efficiency, high gain and high directivity. Gain is the quality of an antenna in capturing more or less efficiently the signals transmitted by another antenna and/or station. Directivity is the quality that an antenna has to better capture energy in a certain direction. The rectifier circuit used has series topology and was optimized using Keysight's ADS software. The rectifier circuit is the most complex part of the rectenna, since it includes the diode, which is a non-linear component. The chosen diode is the Schottky diode SMS 7630, this presents low barrier voltage (between 135-240 mV) and a wider band compared to other types of diodes, and these attributes make it perfect for this type of application. In the rectifier circuit are also used inductor and capacitor, these are part of the input and output filters of the rectifier circuit. The inductor has the function of decreasing the dispersion effect on the efficiency of the rectifier circuit. The capacitor has the function of eliminating the AC component of the rectifier circuit and making the signal undulating.Keywords: dipole antenna, double-band, high efficiency, rectenna
Procedia PDF Downloads 1241063 The Elimination of Fossil Fuel Subsidies from the Road Transportation Sector and the Promotion of Electro Mobility: The Ecuadorian Case
Authors: Henry Gonzalo Acurio Flores, Alvaro Nicolas Corral Naveda, Juan Francisco Fonseca Palacios
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In Ecuador, subventions on fossil fuels for the road transportation sector have always been part of its economy throughout time, mainly because of demagogy and populism from political leaders. It is clearly seen that the government cannot maintain the subsidies anymore due to its commercial balance and its general state budget; subsidies are a key barrier to implementing the use of cleaner technologies. However, during the last few months, the elimination of subsidies has been done gradually with the purpose of reaching international prices. It is expected that with this measure, the population will opt for other means of transportation, and in a certain way, it will promote the use of private electric vehicles and public, e.g., taxis and buses (urban transport). Considering the three main elements of sustainable development, an analysis of the social, economic, and environmental impacts of eliminating subsidies will be generated at the country level. To achieve this, four scenarios will be developed in order to determine how the subsidies will contribute to the promotion of electro-mobility. 1) A Business as Usual BAU scenario; 2) the introduction of 10 000 electric vehicles by 2025; 3) the introduction of 100 000 electric vehicles by 2030; 4) the introduction of 750 000 electric vehicles by 2040 (for all the scenarios buses, taxis, lightweight duty vehicles, and private vehicles will be introduced, as it is established in the National Electro Mobility Strategy for Ecuador). The Low Emissions Analysis Platform (LEAP) will be used, and it will be suitable to determine the cost for the government in terms of importing derivatives for fossil fuels and the cost of electricity to power the electric fleet that can be changed. The elimination of subventions generates fiscal resources for the state that can be used to develop other kinds of projects that will benefit Ecuadorian society. It will definitely change the energy matrix, and it will provide energy security for the country; it will be an opportunity for the government to incentivize a greater introduction of renewable energies, e.g., solar, wind, and geothermal. At the same time, it will also reduce greenhouse gas emissions (GHG) from the transportation sector, considering its mitigation potential, which as a result, will ameliorate the inhabitant quality of life by improving the quality of air, therefore reducing respiratory diseases associated with exhaust emissions, consequently, achieving sustainability, the Sustainable Development Goals (SDGs), and complying with the agreements established in the Paris Agreement COP 21 in 2015. Electro mobility in Latin America and the Caribbean can only be achieved by the implementation of the right policies at the central government, which need to be accompanied by a National Urban Mobility Policy (NUMP) and can encompass a greater vision to develop holistic, sustainable transport systems at local governments.Keywords: electro mobility, energy, policy, sustainable transportation
Procedia PDF Downloads 841062 The Photovoltaic Panel at End of Life: Experimental Study of Metals Release
Authors: M. Tammaro, S. Manzo, J. Rimauro, A. Salluzzo, S. Schiavo
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The solar photovoltaic (PV) modules are considered to have a negligible environmental impact compared to the fossil energy. Therefore also the waste management and the corresponding potential environmental hazard needs to be considered. The case of the photovoltaic panel is unique because the time lag from the manufacturing to the decommissioning as waste usually takes 25-30 years. Then the environmental hazard associated with end life of PV panels has been largely related to their metal contents. The principal concern regards the presence of heavy metals as Cd in thin film (TF) modules or Pb and Cr in crystalline silicon (c-Si) panels. At the end of life of PV panels, these dangerous substances could be released in the environment, if special requirements for their disposal are not adopted. Nevertheless, in literature, only a few experimental study about metal emissions from silicon crystalline/thin film panels and the corresponding environmental effect are present. As part of a study funded by the Italian national consortium for the waste collection and recycling (COBAT), the present work was aimed to analyze experimentally the potential release into the environment of hazardous elements, particularly metals, from PV waste. In this paper, for the first time, eighteen releasable metals a large number of photovoltaic panels, by c-Si and TF, manufactured in the last 30 years, together with the environmental effects by a battery of ecotoxicological tests, were investigated. Leaching tests are conducted on the crushed samples of PV module. The test is conducted according to Italian and European Standard procedure for hazard assessment of the granular waste and of the sludge. The sample material is shaken for 24 hours in HDPE bottles with an overhead mixer Rotax 6.8 VELP at indoor temperature and using pure water (18 MΩ resistivity) as leaching solution. The liquid-to-solid ratio was 10 (L/S=10, i.e. 10 liters of water per kg of solid). The ecotoxicological tests were performed in the subsequent 24 hours. A battery of toxicity test with bacteria (Vibrio fisheri), algae (Pseudochirneriella subcapitata) and crustacea (Daphnia magna) was carried out on PV panel leachates obtained as previously described and immediately stored in dark and at 4°C until testing (in the next 24 hours). For understand the actual pollution load, a comparison with the current European and Italian benchmark limits was performed. The trend of leachable metal amount from panels in relation to manufacturing years was then highlighted in order to assess the environmental sustainability of PV technology over time. The experimental results were very heterogeneous and show that the photovoltaic panels could represent an environmental hazard. The experimental results showed that the amounts of some hazardous metals (Pb, Cr, Cd, Ni), for c-Si and TF, exceed the law limits and they are a clear indication of the potential environmental risk of photovoltaic panels "as a waste" without a proper management.Keywords: photovoltaic panel, environment, ecotoxicity, metals emission
Procedia PDF Downloads 2601061 Investigations of Bergy Bits and Ship Interactions in Extreme Waves Using Smoothed Particle Hydrodynamics
Authors: Mohammed Islam, Jungyong Wang, Dong Cheol Seo
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The Smoothed Particle Hydrodynamics (SPH) method is a novel, meshless, and Lagrangian technique based numerical method that has shown promises to accurately predict the hydrodynamics of water and structure interactions in violent flow conditions. The main goal of this study is to build confidence on the versatility of the Smoothed Particle Hydrodynamics (SPH) based tool, to use it as a complementary tool to the physical model testing capabilities and support research need for the performance evaluation of ships and offshore platforms exposed to an extreme and harsh environment. In the current endeavor, an open-sourced SPH-based tool was used and validated for modeling and predictions of the hydrodynamic interactions of a 6-DOF ship and bergy bits. The study involved the modeling of a modern generic drillship and simplified bergy bits in floating and towing scenarios and in regular and irregular wave conditions. The predictions were validated using the model-scale measurements on a moored ship towed at multiple oblique angles approaching a floating bergy bit in waves. Overall, this study results in a thorough comparison between the model scale measurements and the prediction outcomes from the SPH tool for performance and accuracy. The SPH predicted ship motions and forces were primarily within ±5% of the measurements. The velocity and pressure distribution and wave characteristics over the free surface depicts realistic interactions of the wave, ship, and the bergy bit. This work identifies and presents several challenges in preparing the input file, particularly while defining the mass properties of complex geometry, the computational requirements, and the post-processing of the outcomes.Keywords: SPH, ship and bergy bit, hydrodynamic interactions, model validation, physical model testing
Procedia PDF Downloads 1331060 Development of Vacuum Planar Membrane Dehumidifier for Air-Conditioning
Authors: Chun-Han Li, Tien-Fu Yang, Chen-Yu Chen, Wei-Mon Yan
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The conventional dehumidification method in air-conditioning system mostly utilizes a cooling coil to remove the moisture in the air via cooling the supply air down below its dew point temperature. During the process, it needs to reheat the supply air to meet the set indoor condition that consumes a considerable amount of energy and affect the coefficient of performance of the system. If the processes of dehumidification and cooling are separated and operated respectively, the indoor conditions will be more efficiently controlled. Therefore, decoupling the dehumidification and cooling processes in heating, ventilation and air conditioning system is one of the key technologies as membrane dehumidification processes for the next generation. The membrane dehumidification method has the advantages of low cost, low energy consumption, etc. It utilizes the pore size and hydrophilicity of the membrane to transfer water vapor by mass transfer effect. The moisture in the supply air is removed by the potential energy and driving force across the membrane. The process can save the latent load used to condense water, which makes more efficient energy use because it does not involve heat transfer effect. In this work, the performance measurements including the permeability and selectivity of water vapor and air with the composite and commercial membranes were conducted. According to measured data, we can choose the suitable dehumidification membrane for designing the flow channel length and components of the planar dehumidifier. The vacuum membrane dehumidification system was set up to examine the effects of temperature, humidity, vacuum pressure, flow rate, the coefficient of performance and other parameters on the dehumidification efficiency. The results showed that the commercial Nafion membrane has better water vapor permeability and selectivity. They are suitable for filtration with water vapor and air. Meanwhile, Nafion membrane has promising potential in the dehumidification process.Keywords: vacuum membrane dehumidification, planar membrane dehumidifier, water vapour and air permeability, air conditioning
Procedia PDF Downloads 1471059 Impact of Different Fuel Inlet Diameters onto the NOx Emissions in a Hydrogen Combustor
Authors: Annapurna Basavaraju, Arianna Mastrodonato, Franz Heitmeir
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The Advisory Council for Aeronautics Research in Europe (ACARE) is creating awareness for the overall reduction of NOx emissions by 80% in its vision 2020. Hence this promotes the researchers to work on novel technologies, one such technology is the use of alternative fuels. Among these fuels hydrogen is of interest due to its one and only significant pollutant NOx. The influence of NOx formation due to hydrogen combustion depends on various parameters such as air pressure, inlet air temperature, air to fuel jet momentum ratio etc. Appropriately, this research is motivated to investigate the impact of the air to fuel jet momentum ratio onto the NOx formation in a hydrogen combustion chamber for aircraft engines. The air to jet fuel momentum is defined as the ratio of impulse/momentum of air with respect to the momentum of fuel. The experiments were performed in an existing combustion chamber that has been previously tested for methane. Premix of the reactants has not been considered due to the high reactivity of the hydrogen and high risk of a flashback. In order to create a less rich zone of reaction at the burner and to decrease the emissions, a forced internal recirculation flow has been achieved by integrating a plate similar to honeycomb structure, suitable to the geometry of the liner. The liner has been provided with an external cooling system to avoid the increase of local temperatures and in turn the reaction rate of the NOx formation. The injected air has been preheated to aim at so called flameless combustion. The air to fuel jet momentum ratio has been inspected by changing the area of fuel inlets and keeping the number of fuel inlets constant in order to alter the fuel jet momentum, thus maintaining the homogeneity of the flow. Within this analysis, promising results for a flameless combustion have been achieved. For a constant number of fuel inlets, it was seen that the reduction of the fuel inlet diameter resulted in decrease of air to fuel jet momentum ratio in turn lowering the NOx emissions.Keywords: combustion chamber, hydrogen, jet momentum, NOx emission
Procedia PDF Downloads 2921058 Urgent Care Centres in the United Kingdom
Authors: Mohammad Ansari, Satinder Mann, Ahmed Ismail
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Primary care patients in Emergency Departments (ED) have been the topic of discussion since 1998 in the United Kingdom. Numerous studies have analysed attendances in EDs retrospectively and suggest that at least one third to fifty percent patients attending ED with problems which could be managed appropriately in General Practice or minor injuries units. The pattern of ED Usage seems to be International. In Australia and many departments in the United States include walk in facilities staffed by physicians on family practice residency programme. It clearly appears in the United Kingdom that EDs have to accept that such patients with primary care problems will attend the ED and facilities will have to be provided to see and treat such patients. Urgent care centres were introduced in the United Kingdom nearly a decade ago to reduce the pressure on EDs. Most of these were situated near pre-existing EDs. Unfortunately these centres failed to have the desired effect of reducing the number of patients visiting EDs, it has been noticed that when more patients were seen in Urgent Care centres there were increased attendances in ED as well. A new model of Urgent Care centre was started in the ED of George Eliot Hospital, Nuneaton, UK. We looked at the working of the centre by looking at the number of patients seen daily against the number of total attendances in the ED. We studied the number and type of patients seen by the Urgent Care Doctor. All the medical records of the patients were seen and the time patients spent in the Urgent Care centre was recorded. The total number of patients seen during this study were 1532. 219 (14.3% ) were seen within our Urgent Care centre. None of the patients waited over four hours to be seen. It has been recognised that primary care patients in the ED are a major part of attendances of the department and unless these patients are seen in Urgent Care centres, overcrowding and long waits cannot been avoided. It has been shown that employing primary care Physicians in Urgent Care centres reduces overall cost because they do not carry out as many investigations as Junior Doctors. In our study over 14% patients were seen by Urgent Care Physicians and none of the patients waited for more than four hours and we feel that care provided to the patients by Urgent Care centre was highly effective and satisfying for the patient.Keywords: urgent care centres, primary care physicians, overcrowding, cost
Procedia PDF Downloads 4391057 The Asymptotic Hole Shape in Long Pulse Laser Drilling: The Influence of Multiple Reflections
Authors: Torsten Hermanns, You Wang, Stefan Janssen, Markus Niessen, Christoph Schoeler, Ulrich Thombansen, Wolfgang Schulz
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In long pulse laser drilling of metals, it can be demonstrated that the ablation shape approaches a so-called asymptotic shape such that it changes only slightly or not at all with further irradiation. These findings are already known from ultra short pulse (USP) ablation of dielectric and semiconducting materials. The explanation for the occurrence of an asymptotic shape in long pulse drilling of metals is identified, a model for the description of the asymptotic hole shape numerically implemented, tested and clearly confirmed by comparison with experimental data. The model assumes a robust process in that way that the characteristics of the melt flow inside the arising melt film does not change qualitatively by changing the laser or processing parameters. Only robust processes are technically controllable and thus of industrial interest. The condition for a robust process is identified by a threshold for the mass flow density of the assist gas at the hole entrance which has to be exceeded. Within a robust process regime the melt flow characteristics can be captured by only one model parameter, namely the intensity threshold. In analogy to USP ablation (where it is already known for a long time that the resulting hole shape results from a threshold for the absorbed laser fluency) it is demonstrated that in the case of robust long pulse ablation the asymptotic shape forms in that way that along the whole contour the absorbed heat flux density is equal to the intensity threshold. The intensity threshold depends on the special material and radiation properties and has to be calibrated be one reference experiment. The model is implemented in a numerical simulation which is called AsymptoticDrill and requires such a few amount of resources that it can run on common desktop PCs, laptops or even smart devices. Resulting hole shapes can be calculated within seconds what depicts a clear advantage over other simulations presented in literature in the context of industrial every day usage. Against this background the software additionally is equipped with a user-friendly GUI which allows an intuitive usage. Individual parameters can be adjusted using sliders while the simulation result appears immediately in an adjacent window. A platform independent development allow a flexible usage: the operator can use the tool to adjust the process in a very convenient manner on a tablet during the developer can execute the tool in his office in order to design new processes. Furthermore, at the best knowledge of the authors AsymptoticDrill is the first simulation which allows the import of measured real beam distributions and thus calculates the asymptotic hole shape on the basis of the real state of the specific manufacturing system. In this paper the emphasis is placed on the investigation of the effect of multiple reflections on the asymptotic hole shape which gain in importance when drilling holes with large aspect ratios.Keywords: asymptotic hole shape, intensity threshold, long pulse laser drilling, robust process
Procedia PDF Downloads 2131056 Haemodynamics Study in Subject Specific Carotid Bifurcation Using FSI
Authors: S. M. Abdul Khader, Anurag Ayachit, Raghuvir Pai, K. A. Ahmed, V. R. K Rao, S. Ganesh Kamath
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The numerical simulation has made tremendous advances in investigating the blood flow phenomenon through elastic arteries. Such study can be useful in demonstrating the disease progression and haemodynamics of cardiovascular diseases such as atherosclerosis. In the present study, patient specific case diagnosed with partially stenosed complete right ICA and normal left carotid bifurcation without any atherosclerotic plaque formation is considered. 3D patient specific carotid bifurcation model is generated based on CT scan data using MIMICS-4.0 and numerical analysis is performed using FSI solver in ANSYS-14.5. The blood flow is assumed to be incompressible, homogenous and Newtonian, while the artery wall is assumed to be linearly elastic. The two-way sequentially-coupled transient FSI analysis is performed using FSI solver for three pulse cycles. The haemodynamic parameters such as flow pattern, Wall Shear Stress, pressure contours and arterial wall deformation are studied at the bifurcation and critical zones such as stenosis. The variation in flow behavior is studied throughout the pulse cycle. Also, the simulation results reveals that there is a considerable increase in the flow behavior in stenosed carotid in contrast to the normal carotid bifurcation system. The investigation also demonstrates the disturbed flow pattern especially at the bifurcation and stenosed zone elevating the haemodynamics, particularly during peak systole and later part of the pulse cycle. The results obtained agree well with the clinical observation and demonstrates the potential of patient specific numerical studies in prognosis of disease progression and plaque rupture.Keywords: fluid-structure interaction, arterial stenosis, wall shear stress, carotid artery bifurcation
Procedia PDF Downloads 5711055 Proactive Change or Adaptive Response: A Study on the Impact of Digital Transformation Strategy Modes on Enterprise Profitability From a Configuration Perspective
Authors: Jing-Ma
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Digital transformation (DT) is an important way for manufacturing enterprises to shape new competitive advantages, and how to choose an effective DT strategy is crucial for enterprise growth and sustainable development. Rooted in strategic change theory, this paper incorporates the dimensions of managers' digital cognition, organizational conditions, and external environment into the same strategic analysis framework and integrates the dynamic QCA method and PSM method to study the antecedent grouping of the DT strategy mode of manufacturing enterprises and its impact on corporate profitability based on the data of listed manufacturing companies in China from 2015 to 2019. We find that the synergistic linkage of different dimensional elements can form six equivalent paths of high-level DT, which can be summarized as the proactive change mode of resource-capability dominated as well as adaptive response mode such as industry-guided resource replenishment. Capacity building under complex environments, market-industry synergy-driven, forced adaptation under peer pressure, and the managers' digital cognition play a non-essential but crucial role in this process. Except for individual differences in the market industry collaborative driving mode, other modes are more stable in terms of individual and temporal changes. However, it is worth noting that not all paths that result in high levels of DT can contribute to enterprise profitability, but only high levels of DT that result from matching the optimization of internal conditions with the external environment, such as industry technology and macro policies, can have a significant positive impact on corporate profitability.Keywords: digital transformation, strategy mode, enterprise profitability, dynamic QCA, PSM approach
Procedia PDF Downloads 241054 The Complexities of Designing a Learning Programme in Higher Education with the End-User in Mind
Authors: Andre Bechuke
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The quality of every learning programme in Higher Education (HE) is dependent on the planning, design, and development of the curriculum decisions. These curriculum development decisions are highly influenced by the knowledge of the end-user, who are not always just the students. When curriculum experts plan, design and develop learning programmes, they always have the end-users in mind throughout the process. Without proper knowledge of the end-user(s), the design and development of a learning programme might be flawed. Curriculum experts often struggle to determine who the real end-user is. As such, it is even more challenging to establish what needs to be known about the end user that should inform the plan, design, and development of a learning programme. This research sought suggest approaches to guide curriculum experts to identify the end-user(s), taking into consideration the pressure and influence other agencies and structures or stakeholders (industry, students, government, universities context, lecturers, international communities, professional regulatory bodies) have on the design of a learning programme and the graduates of the programmes. Considering the influence of these stakeholders, which is also very important, the task of deciding who the real end-user of the learning programme becomes very challenging. This study makes use of criteria 1 and 18 of the Council on Higher Education criteria for programme accreditation to guide the process of identifying the end-users when developing a learning programme. Criterion 1 suggests that designers must ensure that the programme is consonant with the institution’s mission, forms part of institutional planning and resource allocation, meets national requirements and the needs of students and other stakeholders, and is intellectually credible. According to criterion 18, in designing a learning programme, steps must be taken to enhance the employability of students and alleviate shortages of expertise in relevant fields. In conclusion, there is hardly ever one group of end-users to be considered for developing a learning programme, and the notion that students are the end-users is not true, especially when the graduates are unable to use the qualification for employment.Keywords: council on higher education, curriculum design and development, higher education, learning programme
Procedia PDF Downloads 81