Search results for: discharge
332 Profile and Care of Stroke Patients in Angola: Preliminary Results of a Longitudinal Two-Center Study
Authors: L. José, S. Vieira, E. Melo, A. R. Pinheiro
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Objectives: This study aims to characterize the stroke profile and the health care provided for people with a stroke in Luanda, Angola. Methods: A prospective longitudinal study was conducted at two Health centers, from March to November 2023, enrolling stroke patients. Data was gathered using a survey created by the researchers and validated by a health panel of experts from Angola. The analysis focused on demographic and stroke characteristics, as well as the care provided. Ethical approval and informed consent were obtained. Results: Preliminary results of a total of 186 patients are described, 122 from a Central Acute Care Hospital, with a mean age of 51.3±14.35 years old, a BMI of 26.7±4.15 kg/m2, 41% male, and 64 patients from a Rehabilitation Center, with 55.6±11.55 years old, a BMI of 27.0±3.8 kg/m2, 53% male. Ischemic stroke was reported as the most representative type in both centers (71.3% and 70.3%, respectively), though 100% of patients had no imaging diagnosis confirmation, neither data about the subtype was given. For patients admitted to the Hospital, discharge occurred before rehabilitation, and no follow-up was possible. No rehabilitation care was delivered in the first 7 days after the stroke. In the Rehabilitation Center, patient’s rehabilitation started in the late subacute phase, after a mean of 171.8±11.5 days. Conclusions: Stroke diagnosis lacks imaging confirmation, which is decisive for proper treatment, and rehabilitation starts during the late subacute phase, which is too late considering the international guidelines and the best window of opportunity for neuroplasticity and recovery. These results highlight the urgent need for the definition of Stroke-directed Health Care Policies in Angola.Keywords: stroke, personalized health care, functional recovery, quality of life, health policies
Procedia PDF Downloads 24331 Benthic Cover in Coral Reef Environments under Influence of Submarine Groundwater Discharges
Authors: Arlett A. Rosado-Torres, Ismael Marino-Tapia
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Changes in benthic cover of coral dominated systems to macroalgae dominance are widely studied worldwide. Watershed pollutants are potentially as important as overfishing causing phase shift. In certain regions of the world most of the continental inputs are through submarine groundwater discharges (SGD), which can play a significant ecological role because the concentration of its nutrients is usually greater that the one found in surface seawater. These stressors have adversely affected coral reefs, particularly in the Caribbean. Measurements of benthic cover (with video tracing, through a Go Pro camera), reef roughness (acoustic estimates with an Acoustic Doppler Current Velocity profiler and a differential GPS), thermohaline conditions (conductivity-temperature-depth (CTD) instrument) and nutrient measurements were taken in different sites in the reef lagoon of Puerto Morelos, Q. Roo, Mexico including those with influence of SGD and without it. The results suggest a link between SGD, macroalgae cover and structural complexity. Punctual water samples and data series from a CTD Diver confirm the presence of the SGD. On the site where the SGD is, the macroalgae cover is larger than in the other sites. To establish a causal link between this phase shift and SGD, the DELFT 3D hydrodynamic model (FLOW and WAVE modules) was performed under different environmental conditions and discharge magnitudes. The model was validated using measurements of oceanographic instruments anchored in the lagoon and forereef. The SGD is consistently favoring macroalgae populations and affecting structural complexity of the reef.Keywords: hydrodynamic model, macroalgae, nutrients, phase shift
Procedia PDF Downloads 152330 Reducing The Frequency of Flooding Accompanied by Low pH Wastewater In 100/200 Unit of Phosphate Fertilizer 1 Plant by Implementing The 3R Program (Reduce, Reuse and Recycle)
Authors: Pradipta Risang Ratna Sambawa, Driya Herseta, Mahendra Fajri Nugraha
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In 2020, PT Petrokimia Gresik implemented a program to increase the ROP (Run Of Pile) production rate at the Phosphate Fertilizer 1 plant, causing an increase in scrubbing water consumption in the 100/200 area unit. This increase in water consumption causes a higher discharge of wastewater, which can further cause local flooding, especially during the rainy season. The 100/200 area of the Phosphate Fertilizer 1 plant is close to the warehouse and is often a passing area for trucks transporting raw materials. This causes the pH in the wastewater to become acidic (the worst point is up to pH 1). The problem of flooding and exposure to acidic wastewater in the 100/200 area of Phosphate Fertilizer Plant 1 was then resolved by PT Petrokimia Gresik through wastewater optimization steps called the 3R program (Reduce, Reuse, and Recycle). The 3R (Reduce, reuse, and recycle) program consists of an air consumption reduction program by considering the liquid/gas ratio in scrubbing unit of 100/200 Phosphate Fertilizer 1 plant, creating a wastewater interconnection line so that wastewater from unit 100/200 can be used as scrubbing water in the Phonska 1, Phonska 2, Phonska 3 and unit 300 Phosphate Fertilizer 1 plant and increasing scrubbing effectiveness through scrubbing effectiveness simulations. Through a series of wastewater optimization programs, PT Petrokimia Gresik has succeeded in reducing NaOH consumption for neutralization up to 2,880 kg/day or equivalent in saving up to 314,359.76 dollars/year and reducing process water consumption up to 600 m3/day or equivalent in saving up to 63,739.62 dollars/year.Keywords: fertilizer, phosphate fertilizer, wastewater, wastewater treatment, water management
Procedia PDF Downloads 25329 Using Groundwater Modeling System to Create a 3-D Groundwater Flow and Solute Transport Model for a Semiarid Region: A Case Study of the Nadhour Saouaf Sisseb El Alem Aquifer, Central Tunisia
Authors: Emna Bahri Hammami, Zammouri Mounira, Tarhouni Jamila
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The Nadhour Saouaf Sisseb El Alem (NSSA) system comprises some of the most intensively exploited aquifers in central Tunisia. Since the 1970s, the growth in economic productivity linked to intensive agriculture in this semiarid region has been sustained by increasing pumping rates of the system’s groundwater. Exploitation of these aquifers has increased rapidly, ultimately causing their depletion. With the aim to better understand the behavior of the aquifer system and to predict its evolution, the paper presents a finite difference model of the groundwater flow and solute transport. The model is based on the Groundwater Modeling System (GMS) and was calibrated using data from 1970 to 2010. Groundwater levels observed in 1970 were used for the steady-state calibration. Groundwater levels observed from 1971 to 2010 served to calibrate the transient state. The impact of pumping discharge on the evolution of groundwater levels was studied through three hypothetical pumping scenarios. The first two scenarios replicated the approximate drawdown in the aquifer heads (about 17 m in scenario 1 and 23 m in scenario 2 in the center of NSSA) following an increase in pumping rates by 30% and 50% from their current values, respectively. In addition, pumping was stopped in the third scenario, which could increase groundwater reserves by about 7 Mm3/year. NSSA groundwater reserves could be improved considerably if the pumping rules were taken seriously.Keywords: pumping, depletion, groundwater modeling system GMS, Nadhour Saouaf
Procedia PDF Downloads 221328 Hydrodynamic and Morphological Simulation of Karnafuli River Using CCHE2D Model
Authors: Shah Md. Imran Kabir, Md. Mostafa Ali
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Karnafuli is one of the most important rivers of Bangladesh which is playing a vital role in our national economy. The major sea port of Bangladesh is the Chittagong port located on the right bank of Karnafuli River Bangladesh. Karnafuli river port is considered as the lifeline of the economic activities of the country. Therefore, it is always necessary to keep the river active and live in terms of its navigability. Due to man-made intervention, the river flow becomes interrupted and thereby may cause the change in the river morphology. The specific objective of this study is the application of 2D model to assess different hydrodynamic and morphological characteristics of the river due to normal flow condition and sea level rise condition. The model has been set with the recent bathymetry data collected from CPA hydrography division. For model setup, the river reach is selected between Kalurghat and Khal no-18. Time series discharge and water level data are used as boundary condition at upstream and downstream. Calibration and validation have been carried out with the recent water level data at Khal no-10 and Sadarghat. The total reach length of the river has been divided into four parts to determine different hydrodynamic and morphological assessments like variation of velocity, sediment erosion and deposition and bed level changes also have been studied. This model has been used for the assessment of river response due sediment transport and sea level rise. Model result shows slight increase in velocity. It also changes the rate of erosion and deposition at some location of the selected reach. It is hoped that the result of the model simulation will be helpful to suggest the effect of possible future development work to be implemented on this river.Keywords: CCHE 2D, hydrodynamic, morphology, sea level rise
Procedia PDF Downloads 378327 An Attempt at the Multi-Criterion Classification of Small Towns
Authors: Jerzy Banski
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The basic aim of this study is to discuss and assess different classifications and research approaches to small towns that take their social and economic functions into account, as well as relations with surrounding areas. The subject literature typically includes three types of approaches to the classification of small towns: 1) the structural, 2) the location-related, and 3) the mixed. The structural approach allows for the grouping of towns from the point of view of the social, cultural and economic functions they discharge. The location-related approach draws on the idea of there being a continuum between the center and the periphery. A mixed classification making simultaneous use of the different approaches to research brings the most information to bear in regard to categories of the urban locality. Bearing in mind the approaches to classification, it is possible to propose a synthetic method for classifying small towns that takes account of economic structure, location and the relationship between the towns and their surroundings. In the case of economic structure, the small centers may be divided into two basic groups – those featuring a multi-branch structure and those that are specialized economically. A second element of the classification reflects the locations of urban centers. Two basic types can be identified – the small town within the range of impact of a large agglomeration, or else the town outside such areas, which is to say located peripherally. The third component of the classification arises out of small towns’ relations with their surroundings. In consequence, it is possible to indicate 8 types of small-town: from local centers enjoying good accessibility and a multi-branch economic structure to peripheral supra-local centers characterised by a specialized economic structure.Keywords: small towns, classification, functional structure, localization
Procedia PDF Downloads 182326 Q-Map: Clinical Concept Mining from Clinical Documents
Authors: Sheikh Shams Azam, Manoj Raju, Venkatesh Pagidimarri, Vamsi Kasivajjala
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Over the past decade, there has been a steep rise in the data-driven analysis in major areas of medicine, such as clinical decision support system, survival analysis, patient similarity analysis, image analytics etc. Most of the data in the field are well-structured and available in numerical or categorical formats which can be used for experiments directly. But on the opposite end of the spectrum, there exists a wide expanse of data that is intractable for direct analysis owing to its unstructured nature which can be found in the form of discharge summaries, clinical notes, procedural notes which are in human written narrative format and neither have any relational model nor any standard grammatical structure. An important step in the utilization of these texts for such studies is to transform and process the data to retrieve structured information from the haystack of irrelevant data using information retrieval and data mining techniques. To address this problem, the authors present Q-Map in this paper, which is a simple yet robust system that can sift through massive datasets with unregulated formats to retrieve structured information aggressively and efficiently. It is backed by an effective mining technique which is based on a string matching algorithm that is indexed on curated knowledge sources, that is both fast and configurable. The authors also briefly examine its comparative performance with MetaMap, one of the most reputed tools for medical concepts retrieval and present the advantages the former displays over the latter.Keywords: information retrieval, unified medical language system, syntax based analysis, natural language processing, medical informatics
Procedia PDF Downloads 133325 Prospective Study to Determine the Efficacy of Day Hospital Care to Improve Treatment Adherence for Hospitalized Schizophrenic Patients
Authors: Jin Hun Choi, So Hyun Ahn, Seong Keun Wang, Ik-Seung Chee, Jung Lan Kim, Sun Woo Lee
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Objectives: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. Methods: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patient and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, World Health Organization Quality of Life Assessment and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. Results: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. Conclusions: Through the study, it was confirmed that when hospitalized schizophrenic patients received continuous day hospital care after being discharged, they received further out-patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients’ treatment adherence issues and improvement of treatment outcomes.Keywords: schizophrenia, day hospital care, adherence, outcomes
Procedia PDF Downloads 353324 Modeling Sediment Transports under Extreme Storm Situation along Persian Gulf North Coast
Authors: Majid Samiee Zenoozian
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The Persian Gulf is a bordering sea with an normal depth of 35 m and a supreme depth of 100 m near its narrow appearance. Its lengthen bathymetric axis divorces two main geological shires — the steady Arabian Foreland and the unbalanced Iranian Fold Belt — which are imitated in the conflicting shore and bathymetric morphologies of Arabia and Iran. The sediments were experimented with from 72 offshore positions through an oceanographic cruise in the winter of 2018. Throughout the observation era, several storms and river discharge actions happened, as well as the major flood on record since 1982. Suspended-sediment focus at all three sites varied in reaction to both wave resuspension and advection of river-derived sediments. We used hydrological models to evaluation and associate the wave height and inundation distance required to carriage the rocks inland. Our results establish that no known or possible storm happening on the Makran coast is accomplished of detaching and transporting the boulders. The fluid mud consequently is conveyed seaward due to gravitational forcing. The measured sediment focus and velocity profiles on the shelf provide a strong indication to provision this assumption. The sediment model is joined with a 3D hydrodynamic module in the Environmental Fluid Dynamics Code (EFDC) model that offers data on estuarine rotation and salinity transport under normal temperature conditions. 3-D sediment transport from model simulations specify dynamic sediment resuspension and transport near zones of highly industrious oyster beds.Keywords: sediment transport, storm, coast, fluid dynamics
Procedia PDF Downloads 115323 Water Quality and Coastal Management Profile Assessment of Puerto Galera Bay, Philippines
Authors: Ma. Manna Farrel B. Pinto
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As global industrialization progresses, the environment remains to be at risk of disturbances brought by developments of cities and communities. Impacts of flourishing industries such as tourism require rapid growth of establishments and may threaten ecosystems and natural resources. Puerto Galera as a biosphere reserve and declared as the Center of the World’s Center of Marine Shorefish Biodiversity is on the brink of ecological deterioration as tourism further develops in its coastal areas. Apparently, attempts were initiated to establish a baseline for designation of protection in the economic and coastal marine zones of Puerto Galera but continuity of its implementation and coordination of concerned units remains deficient. Indications of eutrophication have been observed based on water quality analysis although parameter values still comply with the national standards for coastal waters. Water quality data, biodiversity and hydrodynamic information, gathered from studies, and local government units were analysed to assess the condition of the coast as well as acting policies implemented by the local authorities. Sources of contaminants were also located in its three main communities, and their shores wherein in recommendations for installing wastewater treatment facilities and further improvement of policies of waste discharge must be addressed. With a conceptual framework proposed in the study, a comprehensive data analysis and coordinated management are necessary to form an integrated coastal management for further protection and preservation of the sustainable coastal marine ecosystem of Puerto Galera.Keywords: coastal management, environmental management, integrated resource management, Puerto Galera
Procedia PDF Downloads 267322 A Study of Basic and Reactive Dyes Removal from Synthetic and Industrial Wastewater by Electrocoagulation Process
Authors: Almaz Negash, Dessie Tibebe, Marye Mulugeta, Yezbie Kassa
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Large-scale textile industries use large amounts of toxic chemicals, which are very hazardous to human health and environmental sustainability. In this study, the removal of various dyes from effluents of textile industries using the electrocoagulation process was investigated. The studied dyes were Reactive Red 120 (RR-120), Basic Blue 3 (BB-3), and Basic Red 46 (BR-46), which were found in samples collected from effluents of three major textile factories in the Amhara region, Ethiopia. For maximum removal, the dye BB-3 required an acidic pH 3, RR120 basic pH 11, while BR-46 neutral pH 7 conditions. BB-3 required a longer treatment time of 80 min than BR46 and RR-120, which required 30 and 40 min, respectively. The best removal efficiency of 99.5%, 93.5%, and 96.3% was achieved for BR-46, BB-3, and RR-120, respectively, from synthetic wastewater containing 10 mg L1of each dye at an applied potential of 10 V. The method was applied to real textile wastewaters and 73.0 to 99.5% removal of the dyes was achieved, Indicating Electrocoagulation can be used as a simple, and reliable method for the treatment of real wastewater from textile industries. It is used as a potentially viable and inexpensive tool for the treatment of textile dyes. Analysis of the electrochemically generated sludge by X-ray Diffraction, Scanning Electron Microscope, and Fourier Transform Infrared Spectroscopy revealed the expected crystalline aluminum oxides (bayerite (Al(OH)3 diaspore (AlO(OH)) found in the sludge. The amorphous phase was also found in the floc. Textile industry owners should be aware of the impact of the discharge of effluents on the Ecosystem and should use the investigated electrocoagulation method for effluent treatment before discharging into the environment.Keywords: electrocoagulation, aluminum electrodes, Basic Blue 3, Basic Red 46, Reactive Red 120, textile industry, wastewater
Procedia PDF Downloads 53321 Achievement of Sustainable Groundwater Exploitation through the Introduction of Water-Efficient Usage Techniques in Fish Farms
Authors: Lusine Tadevosyan, Natella Mirzoyan, Anna Yeritsyan, Narek Avetisyan
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Due to high quality, the artesian groundwater is the main source of water supply for the fisheries in Ararat Valley, Armenia. From 1.6 billion m3 abstracted groundwater in 2016, half was used by fish farms. Yet, the inefficient water use, typical for low-intensity aquaculture systems in Ararat Valley, has become a key environmental issue in Armenia. In addition to excessive pure groundwater exploitation, which along with other sectors of groundwater use in this area resulted in the reduction of artesian zone by approximately 67% during last 20 years, the negative environmental impact of these productions is magnified by the discharge of large volumes of wastewater into receiving water bodies. In turn, unsustainable use of artesian groundwater in Ararat Valley along with increasingly strict policy measures on water use had a devastating impact on small and/or medium scale aquaculture: over the last two years approximately 100 fish farms have permanently seized their operations. The current project aims at the introduction of efficient and environmentally friendly fish farming practices (e.g., Recirculating Aquaculture Systems) in Ararat Valley fisheries in order to support current levels of fish production and simultaneously reduce the negative environmental pressure of aquaculture facilities in Armenia. Economic and environmental analysis of current small and medium scale operational systems and subsequently developed environmentally–friendly and economically sustainable system configurations will be presented.Keywords: aquaculture, groundwater, recirculation, sustainability
Procedia PDF Downloads 269320 The Role of Phycoremediation in the Sustainable Management of Aquatic Pollution
Authors: Raymond Ezenweani, Jeffrey Ogbebor
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The menace of aquatic pollution has become increasingly of great concern and the effects of this pollution as a result of anthropogenic activities cannot be over emphasized. Phycoremediation is the application of algal remediation technology in the removal of harmful products from the environment. Harmful products also known as pollutants are usually introduced into the environment through variety of processes such as industrial discharge, agricultural runoff, flooding, and acid rain. This work has to do with the capability of algae in the efficient removal of different pollutants, ranging from hydrocarbons, eutrophication, agricultural chemicals and wastes, heavy metals, foul smell from septic tanks or dumps through different processes such as bioconversion, biosorption, bioabsorption and biodecomposition. Algae are capable of bioconversion of environmentally persistent compounds to degradable compounds and also capable of putting harmful bacteria growth into check in waste water remediation. Numerous algal organisms such as Nannochloropsis spp, Chlorella spp, Tetraselmis spp, Shpaerocystics spp, cyanobacteria and different macroalgae have been tested by different researchers in laboratory scale and shown to have 100% efficiency in environmental remediation. Algae as a result of their photosynthetic capacity are also efficient in air cleansing and management of global warming by sequestering carbon iv oxide in air and converting it into organic carbon, thereby making food available for the other organisms in the higher trophic level of the aquatic food chain. Algae play major role in the sustenance of the aquatic ecosystem by their virtue of being photosynthetic. They are the primary producers and their role in environmental sustainability is remarkable.Keywords: Algae , Pollutant, ., Phycoremediation, Aquatic, Sustainability
Procedia PDF Downloads 126319 Offline High Voltage Diagnostic Test Findings on 15MVA Generator of Basochhu Hydropower Plant
Authors: Suprit Pradhan, Tshering Yangzom
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Even with availability of the modern day online insulation diagnostic technologies like partial discharge monitoring, the measurements like Dissipation Factor (tanδ), DC High Voltage Insulation Currents, Polarization Index (PI) and Insulation Resistance Measurements are still widely used as a diagnostic tools to assess the condition of stator insulation in hydro power plants. To evaluate the condition of stator winding insulation in one of the generators that have been operated since 1999, diagnostic tests were performed on the stator bars of 15 MVA generators of Basochhu Hydropower Plant. This paper presents diagnostic study done on the data gathered from the measurements which were performed in 2015 and 2016 as part of regular maintenance as since its commissioning no proper aging data were maintained. Measurement results of Dissipation Factor, DC High Potential tests and Polarization Index are discussed with regard to their effectiveness in assessing the ageing condition of the stator insulation. After a brief review of the theoretical background, the strengths of each diagnostic method in detecting symptoms of insulation deterioration are identified. The interesting results observed from Basochhu Hydropower Plant is taken into consideration to conclude that Polarization Index and DC High Voltage Insulation current measurements are best suited for the detection of humidity and contamination problems and Dissipation Factor measurement is a robust indicator of long-term ageing caused by oxidative degradation.Keywords: dissipation Factor (tanδ), polarization Index (PI), DC High Voltage Insulation Current, insulation resistance (IR), Tan Delta Tip-Up, dielectric absorption ratio
Procedia PDF Downloads 312318 Optimal Design of Storm Water Networks Using Simulation-Optimization Technique
Authors: Dibakar Chakrabarty, Mebada Suiting
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Rapid urbanization coupled with changes in land use pattern results in increasing peak discharge and shortening of catchment time of concentration. The consequence is floods, which often inundate roads and inhabited areas of cities and towns. Management of storm water resulting from rainfall has, therefore, become an important issue for the municipal bodies. Proper management of storm water obviously includes adequate design of storm water drainage networks. The design of storm water network is a costly exercise. Least cost design of storm water networks assumes significance, particularly when the fund available is limited. Optimal design of a storm water system is a difficult task as it involves the design of various components, like, open or closed conduits, storage units, pumps etc. In this paper, a methodology for least cost design of storm water drainage systems is proposed. The methodology proposed in this study consists of coupling a storm water simulator with an optimization method. The simulator used in this study is EPA’s storm water management model (SWMM), which is linked with Genetic Algorithm (GA) optimization method. The model proposed here is a mixed integer nonlinear optimization formulation, which takes care of minimizing the sectional areas of the open conduits of storm water networks, while satisfactorily conveying the runoff resulting from rainfall to the network outlet. Performance evaluations of the developed model show that the proposed method can be used for cost effective design of open conduit based storm water networks.Keywords: genetic algorithm (GA), optimal design, simulation-optimization, storm water network, SWMM
Procedia PDF Downloads 248317 Development of Database for Risk Assessment Appling to Ballast Water Managements
Authors: Eun-Chan Kim, Jeong-Hwan Oh, Seung-Guk Lee
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Billions of tones of ballast water including various aquatic organisms are being carried around the world by ships. When the ballast water is discharged into new environments, some aquatic organisms discharged with ballast water may become invasive and severely disrupt the native ecology. Thus, International Maritime Organization (IMO) adopted the Ballast Water Management Convention in 2004. Regulation A-4 of the convention states that a government in waters under their jurisdiction may grant exemptions to any requirements to ballast water management, but only when they are granted to a ship or ships on a voyage or voyages between specified ports or locations, or to a ship which operates exclusively between specified ports or locations. In order to grant exemptions, risk assessment should be conducted based on the guidelines for risk assessment developed by the IMO. For the risk assessment, it is essential to collect the relevant information and establish a database system. This paper studies the database system for ballast water risk assessment. This database consists of the shipping database, ballast water database, port environment database and species database. The shipping database has been established based on the data collected from the port management information system of Korea Government. For the ballast water database, ballast water discharge has only been estimated by the loading/unloading of the cargoes as the convention has not come into effect yet. The port environment database and species database are being established based on the reference documents, and existing and newly collected monitoring data. This database system has been approved to be a useful system, capable of appropriately analyzing the risk assessment in the all ports of Korea.Keywords: ballast water, IMO, risk assessment, shipping, environment, species
Procedia PDF Downloads 520316 Evaluation of Firearm Injury Syndromic Surveillance in Utah
Authors: E. Bennion, A. Acharya, S. Barnes, D. Ferrell, S. Luckett-Cole, G. Mower, J. Nelson, Y. Nguyen
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Objective: This study aimed to evaluate the validity of a firearm injury query in the Early Notification of Community-based Epidemics syndromic surveillance system. Syndromic surveillance data are used at the Utah Department of Health for early detection of and rapid response to unusually high rates of violence and injury, among other health outcomes. The query of interest was defined by the Centers for Disease Control and Prevention and used chief complaint and discharge diagnosis codes to capture initial emergency department encounters for firearm injury of all intents. Design: Two epidemiologists manually reviewed electronic health records of emergency department visits captured by the query from April-May 2020, compared results, and sent conflicting determinations to two arbiters. Results: Of the 85 unique records captured, 67 were deemed probable, 19 were ruled out, and two were undetermined, resulting in a positive predictive value of 75.3%. Common reasons for false positives included non-initial encounters and misleading keywords. Conclusion: Improving the validity of syndromic surveillance data would better inform outbreak response decisions made by state and local health departments. The firearm injury definition could be refined to exclude non-initial encounters by negating words such as “last month,” “last week,” and “aftercare”; and to exclude non-firearm injury by negating words such as “pellet gun,” “air gun,” “nail gun,” “bullet bike,” and “exit wound” when a firearm is not mentioned.Keywords: evaluation, health information system, firearm injury, syndromic surveillance
Procedia PDF Downloads 166315 Environmental Health Risk Assessment of Hospital Wastewater in Enugu Urban, Nigeria
Authors: C. T. Eze, I. N. E. Onwurah
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An important hydrogeologic problem in areas of high faults formations is high environmental health hazard occasioned by microbial and heavy metals contamination of ground waters. Consequently, we examined the microbial load and heavy metals concentration of hospital wastewater discharged into the environment at Park Lane General Hospital Enugu Urban, Nigeria. The microbial counts, characteristics and frequency of occurrences of the isolated microorganisms were determined by cultural, morphological and biochemical characteristics using established procedure while the varying concentrations of the identified heavy metals were determined using the spectrophotometric method. The microbiological analyses showed a mean total aerobic bacteria counts from 13.7 ± 0.65 × 107 to 22.8 ± 1.14 ×1010 CFU/ml, mean total anaerobic bacteria counts from 6.0 ± 1.6 × 103 to 1.7 ± 0.41 ×104 CFU/ml and mean total fungal counts from 0 ± 0 to 2.3 ± 0.16 × 105 CFU/ml. The isolated micro-organisms which included both pathogenic and non-pathogenic organisms were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Salmonella typhi, Bacillus subtilis, Proteus vulgaris, Klesbsiella pneumonia and bacteriodes sp. The only fungal isolate was Candida albican. The heavy metals identified in the leachate were Arsenic, Cadmium, Lead, Mercury and Chromium and their concentrations ranged from 0.003 ± 0.00082 to 0.14 ± 0.0082 mg/l. These values were above WHO permissible limits while others fall within the limits. Therefore, hospital waste water can pose the environmental health risk when not properly treated before discharge, especially in geologic formations with high fault formations.Keywords: bacterial isolates, fungal isolates, heavy metals, hospital wastewater, microbial counts
Procedia PDF Downloads 351314 Hourly Solar Radiations Predictions for Anticipatory Control of Electrically Heated Floor: Use of Online Weather Conditions Forecast
Authors: Helene Thieblemont, Fariborz Haghighat
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Energy storage systems play a crucial role in decreasing building energy consumption during peak periods and expand the use of renewable energies in buildings. To provide a high building thermal performance, the energy storage system has to be properly controlled to insure a good energy performance while maintaining a satisfactory thermal comfort for building’s occupant. In the case of passive discharge storages, defining in advance the required amount of energy is required to avoid overheating in the building. Consequently, anticipatory supervisory control strategies have been developed forecasting future energy demand and production to coordinate systems. Anticipatory supervisory control strategies are based on some predictions, mainly of the weather forecast. However, if the forecasted hourly outdoor temperature may be found online with a high accuracy, solar radiations predictions are most of the time not available online. To estimate them, this paper proposes an advanced approach based on the forecast of weather conditions. Several methods to correlate hourly weather conditions forecast to real hourly solar radiations are compared. Results show that using weather conditions forecast allows estimating with an acceptable accuracy solar radiations of the next day. Moreover, this technique allows obtaining hourly data that may be used for building models. As a result, this solar radiation prediction model may help to implement model-based controller as Model Predictive Control.Keywords: anticipatory control, model predictive control, solar radiation forecast, thermal storage
Procedia PDF Downloads 271313 Quality of Life Assessment across the Cancer Continuum: Understanding the Role of an Exercise Rehabilitation Programme
Authors: Bernat-Carles Serdà Ferrer, Arantza Del Valle Gómez
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The Quality of Life (QoL) paradigm is multidimensional, dynamic and modular and its definition differs across the cancer continuum. The challenge in the interpretation of QoL data in clinical research is that QoL is influenced by psychological phenomena such as adaptation to illness. This research aims to obtain a valid and sensitive assessment of QoL change over the continuum disease, and to evaluate a rehabilitation programme aimed at inverting the observed decrease in QoL when patients return to daily living activities. The sample comprised 66 men. Patients were first assessed to establish a baseline (P1-diagnosis). This was followed by a post-test (P2-discharge) and a then-test measurement (P3-retrospective evaluation) and after returning home patients were randomized in experimental and control groups. The experimental group attended a rehabilitation programme over 24 weeks (P4). Results show that from baseline to post-test, QoL decreased significantly. The recalibration then-test confirmed a low QoL in all periods evaluated. Significant differences between the experimental and control groups prove the positive effect of the Exercise Rehabilitation Programme (ERP) on QoL. Understanding the real dynamic of QoL over time would help to adapt rehabilitation programmes by improving sensitivity and efficacy and provide professionals with a more accurate perception of the impact of treatment and side effects on patients’ QoL. Our results underline the importance of changing the approach adopted by health professionals towards one of watchful waiting on patients’ QoL until their complete recovery in daily life.Keywords: exercise, prostate cancer, quality of life, rehabilitation programme, response shift
Procedia PDF Downloads 167312 Management of Urban Wastewater in the City of Maradi (Niger): The Case of Domestic Wastewater
Authors: Saidou Hassidou, Laminou Ary Mahaman Moustapha
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Uncontrolled urbanization of African cities, plus the lack of municipal waste management services in these cities, generate landscapes become places of multiple and varied interactions between health and environment. In this sense, under strong urban growth in a context of sub-equipment sanitation, the city of Maradi doesn’t escape to this situation which results in the spread of pollution (release of unpleasant odors, proliferation of mosquitoes) and many diseases posing multiple health problems. Our study focuses only on liquid waste especially domestic wastewater. To study the different domestic wastewater management options in the town of Maradi, a survey was conducted among 340 households in 17 districts. We note in most cases a crucial of waste management infrastructure (drainage and wastewater treatment) at the city. Thus, only the individual sanitation facilities are used. In the town of Maradi, in addition to the storm drains, there are, in old districts, ditches that discharge wastewater and unfortunately end up in rivers without treatment. Domestic wastewater total production is estimated at 86,761.28 m3 per day. This water is mostly from laundry activities, bathing, dishes, and is discharged in large part through the streets, by more than 60% of households. Also, pit emptying is performed at 39.11% by the vehicle Peugeot tank. The quality of service rendered by an actor is very important to encourage households to join. Existing autonomous sanitation facilities are poorly designed and poorly maintained. Fecal sludge is dumped in a hole near saturated latrines; this work is mainly done by manual scavengers or dumped in fields or on nearby vacant land concessions.Keywords: management, urban wastewater, domestic wastewater, Maradi, Niger
Procedia PDF Downloads 268311 Effect of Cladding Direction on Residual Stress Distribution in Laser Cladded Rails
Authors: Taposh Roy, Anna Paradowska, Ralph Abrahams, Quan Lai, Michael Law, Peter Mutton, Mehdi Soodi, Wenyi Yan
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In this investigation, a laser cladding process with a powder feeding was used to deposit stainless steel 410L (high strength, excellent resistance to abrasion and corrosion, and great laser compatibility) onto railhead (higher strength, heat treated hypereutectoid rail grade manufactured in accordance with the requirements of European standard EN 13674 Part 1 for R400HT grade), to investigate the development and controllability of process-induced residual stress in the cladding, heat-affected zone (HAZ) and substrate and to analyse their correlation with hardness profile during two different laser cladding directions (across and along the track). Residual stresses were analysed by neutron diffraction at OPAL reactor, ANSTO. Neutron diffraction was carried out on the samples in longitudinal (parallel to the rail), transverse (perpendicular to the rail) and normal (through thickness) directions with high spatial resolution through the thickness. Due to the thick rail and thin cladding, 4 mm thick reference samples were prepared from every specimen by Electric Discharge Machining (EDM). Metallography across the laser claded sample revealed four distinct zones: The clad zone, the dilution zone, HAZ and the substrate. Compressive residual stresses were found in the clad zone and tensile residual stress in the dilution zone and HAZ. Laser cladding in longitudinally cladding induced higher tensile stress in the HAZ, whereas transversely cladding rail showed lower tensile behavior.Keywords: laser cladding, residual stress, neutron diffraction, HAZ
Procedia PDF Downloads 273310 Modeling of Sediment Yield and Streamflow of Watershed Basin in the Philippines Using the Soil Water Assessment Tool Model for Watershed Sustainability
Authors: Warda L. Panondi, Norihiro Izumi
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Sedimentation is a significant threat to the sustainability of reservoirs and their watershed. In the Philippines, the Pulangi watershed experienced a high sediment loss mainly due to land conversions and plantations that showed critical erosion rates beyond the tolerable limit of -10 ton/ha/yr in all of its sub-basin. From this event, the prediction of runoff volume and sediment yield is essential to examine using the country's soil conservation techniques realistically. In this research, the Pulangi watershed was modeled using the soil water assessment tool (SWAT) to predict its watershed basin's annual runoff and sediment yield. For the calibration and validation of the model, the SWAT-CUP was utilized. The model was calibrated with monthly discharge data for 1990-1993 and validated for 1994-1997. Simultaneously, the sediment yield was calibrated in 2014 and validated in 2015 because of limited observed datasets. Uncertainty analysis and calculation of efficiency indexes were accomplished through the SUFI-2 algorithm. According to the coefficient of determination (R2), Nash Sutcliffe efficiency (NSE), King-Gupta efficiency (KGE), and PBIAS, the calculation of streamflow indicates a good performance for both calibration and validation periods while the sediment yield resulted in a satisfactory performance for both calibration and validation. Therefore, this study was able to identify the most critical sub-basin and severe needs of soil conservation. Furthermore, this study will provide baseline information to prevent floods and landslides and serve as a useful reference for land-use policies and watershed management and sustainability in the Pulangi watershed.Keywords: Pulangi watershed, sediment yield, streamflow, SWAT model
Procedia PDF Downloads 209309 A Study from Language and Culture Perspective of Human Needs in Chinese and Vietnamese Euphemism Languages
Authors: Quoc Hung Le Pham
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Human beings are motivated to satisfy the physiological needs and psychological needs. In the fundamental needs, bodily excretion is the most basic one, while physiological excretion refers to the final products produced in the process of discharging the body. This physiological process is a common human phenomenon. For instance, bodily secretion is totally natural, but people of various nationalities through the times avoid saying it directly. Terms like ‘shit’ are often negatively regarded as dirty, smelly and vulgar; it will lead people to negative thinking. In fact, it is in the psychology of human beings to avoid such unsightly terms. Especially in social situations where you have to take care of your image, and you have to release. The best way to solve this is to approach the use of euphemism. People prefer to say it as ‘answering nature's call’ or ‘to pass a motion’ instead. Chinese and Vietnamese nations are referring to use euphemisms to replace bodily secretions, so this research will take this phenomenon as the object aims to explore the similarities and dissimilarities between two languages euphemism. The basic of the niche of this paper is human physiological phenomenon excretion. As the preliminary results show, in expressing bodily secretions the deeply impacting factor is language and cultural factors. On language factor terms, two languages are using assonance to replace human nature discharge, whilst the dissimilarities are metonymy, loan word and personification. On culture factor terms, the convergences are metonymy and application of the semantically-contrary-word-euphemism, whilst the difference is Chinese euphemism using allusion but Vietnamese euphemism does not.Keywords: cultural factors, euphemism, human needs, language factors
Procedia PDF Downloads 300308 Growth Performance and Nutrient Digestibility of Cirrhinus mrigala Fingerlings Fed on Sunflower Meal Based Diet Supplemented with Phytase
Authors: Syed Makhdoom Hussain, Muhammad Afzal, Farhat Jabeen, Arshad Javid, Tasneem Hameed
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A feeding trial was conducted with Cirrhinus mrigala fingerlings to study the effects of microbial phytase with graded levels (0, 500, 1000, 1500, and 2000 FTUkg-1) by sunflower meal based diet on growth performance and nutrient digestibility. The chromic oxide was added as an indigestible marker in the diets. Three replicate groups of 15 fish (Average wt 5.98 g fish-1) were fed once a day and feces were collected twice daily. The results of present study showed improved growth and feed performance of Cirrhinus mrigala fingerlings in response to phytase supplementation. Maximum growth performance was obtained by the fish fed on test diet-III having 1000 FTU kg-1 phytase level. Similarly, nutrient digestibility was also significantly increased (p<0.05) by phytase supplementation. Digestibility coefficients for sunflower meal based diet increased 15.76%, 17.70%, and 12.70% for crude protein, crude fat and apparent gross energy as compared to the reference diet, respectively at 1000 FTU kg-1 level. Again, maximum response of nutrient digestibility was recorded at the phytase level of 1000 FTU kg-1 diet. It was concluded that the phytase supplementation to sunflower meal based diet at 1000 FTU kg-1 level is optimum to release adequate chelated nutrients for maximum growth performance of C. mrigala fingerlings. Our results also suggested that phytase supplementation to sunflower meal based diet can help in the development of sustainable aquaculture by reducing the feed cost and nutrient discharge through feces in the aquatic ecosystem.Keywords: sunflower meal, Cirrhinus mrigala, growth, nutrient digestibility, phytase
Procedia PDF Downloads 300307 The Scope and Effectiveness of Interactive Voice Response Technologies in Post-Operative Care
Authors: Zanib Nafees, Amir Razaghizad, Ibtisam Mahmoud, Abhinav Sharma, Renzo Cecere
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More than one million surgeries are performed each year in Canada, resulting in more than 100,000 associated serious adverse events (SAEs) per year. These are defined as unintended injuries or complications that adversely affect the well-being of patients. In recent years, there has been a proliferation of digital health interventions that have the potential to assist, monitor, and educate patients—facilitating self-care following post-operative discharge. Among digital health, interventions are interactive-voice response technologies (IVRs), which have been shown to be highly effective in certain medical settings. Although numerous IVR-based interventions have been developed, their effectiveness and utility remain unclear, notably in post-operative settings. To the best of our knowledge, no systematic or scoping reviews have evaluated this topic to date. Thus, the objective of this scoping review protocol is to systematically map and explore the literature and evidence describing and examining IVR tools, implementation, evaluation, outcome, and experience for post-operative patients. The focus will be primarily on the evaluation of baseline performance status, clinical assessment, treatment outcomes, and patient management, including self-management and self-monitoring. The objective of this scoping review is to assess the extent of the literature to direct future research efforts by identifying gaps and limitations in the literature and to highlight relevant determinants of positive outcomes in the emerging field of IVR monitoring for health outcomes in post-operative patients.Keywords: digital healthcare technologies, post-surgery, interactive voice technology, interactive voice response
Procedia PDF Downloads 264306 Intensification of Process Kinetics for Conversion of Organic Volatiles into Syngas Using Non-Thermal Plasma
Authors: Palash Kumar Mollick, Leire Olazar, Laura Santamaria, Pablo Comendador, Manomita Mollick, Gartzen Lopez, Martin Olazar
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The entire world is skeptical towards a silver line technology of converting plastic waste into valuable synthetic gas. At this junction, besides an adequately studied conventional catalytic process for steam reforming, a non-thermal plasma is being introduced. Organic volatiles are produced in the first step, pyrolysing the plastic materials. Resultant lightweight olefins and carbon monoxide are the major components that undergo a steam reforming process to achieve syngas. A non-thermal plasma consists of ionized gases and free electrons with an electronic temperature as high as 10³ K. Organic volatiles are, in general, endorganics inactive and thus demand huge bond-breaking energy. Conventional catalyst is incapable of providing the required activation energy, leading to poor thermodynamic equilibrium, whereas a non-thermal plasma can actively collide with reactants to produce a rich mix of reactive species, including vibrationally or electronically excited molecules, radicals, atoms, and ions. In addition, non-thermal plasma provides nonequilibrium conditions leading to electric discharge only in certain degrees of freedom without affecting the intrinsic chemical conditions of the participating reactants and products. In this work, we report thermodynamic and kinetic aspects of the conversion of organic volatiles into syngas using a non-thermal plasma. Detailed characteristics of plasma and its effect on the overall yield of the process will be presented.Keywords: non thermal plasma, plasma catalysis, steam reforming, syngas, plastic waste, green energy
Procedia PDF Downloads 67305 Array Type Miniaturized Ultrasonic Sensors for Detecting Sinkhole in the City
Authors: Won Young Choi, Kwan Kyu Park
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Recently, the road depression happening in the urban area is different from the cause of the sink hole and the generation mechanism occurring in the limestone area. The main cause of sinkholes occurring in the city center is the loss of soil due to the damage of old underground buried materials and groundwater discharge due to large underground excavation works. The method of detecting the sinkhole in the urban area is mostly using the Ground Penetration Radar (GPR). However, it is challenging to implement compact system and detecting watery state since it is based on electromagnetic waves. Although many ultrasonic underground detection studies have been conducted, near-ground detection (several tens of cm to several meters) has been developed for bulk systems using geophones as a receiver. The goal of this work is to fabricate a miniaturized sinkhole detecting system based on low-cost ultrasonic transducers of 40 kHz resonant frequency with high transmission pressure and receiving sensitivity. Motived by biomedical ultrasonic imaging methods, we detect air layers below the ground such as asphalt through the pulse-echo method. To improve image quality using multi-channel, linear array system is implemented, and image is acquired by classical synthetic aperture imaging method. We present the successful feasibility test of multi-channel sinkhole detector based on ultrasonic transducer. In this work, we presented and analyzed image results which are imaged by single channel pulse-echo imaging, synthetic aperture imaging.Keywords: road depression, sinkhole, synthetic aperture imaging, ultrasonic transducer
Procedia PDF Downloads 144304 Groundwater Potential Zone Identification in Unconsolidated Aquifer Using Geophysical Techniques around Tarbela Ghazi, District Haripur, Pakistan
Authors: Syed Muzyan Shahzad, Liu Jianxin, Asim Shahzad, Muhammad Sharjeel Raza, Sun Ya, Fanidi Meryem
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Electrical resistivity investigation was conducted in vicinity of Tarbela Ghazi, in order to study the subsurface layer with a view of determining the depth to the aquifer and thickness of groundwater potential zones. Vertical Electrical Sounding (VES) using Schlumberger array was carried out at 16 VES stations. Well logging data at four tube wells have been used to mark the super saturated zones with great discharge rate. The present paper shows a geoelectrical identification of the lithology and an estimate of the relationship between the resistivity and Dar Zarrouk parameters (transverse unit resistance and longitudinal unit conductance). The VES results revealed both homogeneous and heterogeneous nature of the subsurface strata. Aquifer is unconfined to confine in nature, and at few locations though perched aquifer has been identified, groundwater potential zones are developed in unconsolidated deposits layers and more than seven geo-electric layers are observed at some VES locations. Saturated zones thickness ranges from 5 m to 150 m, whereas at few area aquifer is beyond 150 m thick. The average anisotropy, transvers resistance and longitudinal conductance values are 0.86 %, 35750.9821 Ω.m2, 0.729 Siemens, respectively. The transverse unit resistance values fluctuate all over the aquifer system, whereas below at particular depth high values are observed, that significantly associated with the high transmissivity zones. The groundwater quality in all analyzed samples is below permissible limit according to World Health Standard (WHO).Keywords: aquifer, Dar Zarrouk parameters, geoelectric layers, Tarbela Ghazi
Procedia PDF Downloads 197303 Reducing the Risk of Alcohol Relapse after Liver-Transplantation
Authors: Rebeca V. Tholen, Elaine Bundy
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Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.Keywords: alcoholism, liver transplant, quality improvement, substance abuse
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