Search results for: risk transfer
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8722

Search results for: risk transfer

2302 The Effect of Additive Acid on the Phytoremediation Efficiency

Authors: G. Hosseini, A. Sadighzadeh, M. Rahimnejad, N. Hosseini, Z. Jamalzadeh

Abstract:

Metal pollutants, especially heavy metals from anthropogenic sources such as metallurgical industries’ waste including mining, smelting, casting or production of nuclear fuel, including mining, concentrate production and uranium processing ends in the environment contamination (water and soil) and risk to human health around the facilities of this type of industrial activity. There are different methods that can be used to remove these contaminants from water and soil. These are very expensive and time-consuming. In this case, the people have been forced to leave the area and the decontamination is not done. For example, in the case of Chernobyl accident, an area of 30 km around the plant was emptied of human life. A very efficient and cost-effective method for decontamination of the soil and the water is phytoremediation. In this method, the plants preferentially native plants which are more adaptive to the regional climate are well used. In this study, three types of plants including Alfalfa, Sunflower and wheat were used to Barium decontamination. Alfalfa and Sunflower were not grown good enough in Saghand mine’s soil sample. This can be due to non-native origin of these plants. But, Wheat rise in Saghand Uranium Mine soil sample was satisfactory. In this study, we have investigated the effect of 4 types of acids inclusive nitric acid, oxalic acid, acetic acid and citric acid on the removal efficiency of Barium by Wheat. Our results indicate the increase of Barium absorption in the presence of citric acid in the soil. In this paper, we will present our research and laboratory results.

Keywords: phytoremediation, heavy metal, wheat, soil

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2301 Shallow Water Lidar System in Measuring Erosion Rate of Coarse-Grained Materials

Authors: Ghada S. Ellithy, John. W. Murphy, Maureen K. Corcoran

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Erosion rate of soils during a levee or dam overtopping event is a major component in risk assessment evaluation of breach time and downstream consequences. The mechanism and evolution of dam or levee breach caused by overtopping erosion is a complicated process and difficult to measure during overflow due to accessibility and quickly changing conditions. In this paper, the results of a flume erosion tests are presented and discussed. The tests are conducted on a coarse-grained material with a median grain size D50 of 5 mm in a 1-m (3-ft) wide flume under varying flow rates. Each test is performed by compacting the soil mix r to its near optimum moisture and dry density as determined from standard Proctor test in a box embedded in the flume floor. The box measures 0.45 m wide x 1.2 m long x 0.25 m deep. The material is tested several times at varying hydraulic loading to determine the erosion rate after equal time intervals. The water depth, velocity are measured at each hydraulic loading, and the acting bed shear is calculated. A shallow water lidar (SWL) system was utilized to record the progress of soil erodibility and water depth along the scanned profiles of the tested box. SWL is a non-contact system that transmits laser pulses from above the water and records the time-delay between top and bottom reflections. Results from the SWL scans are compared with before and after manual measurements to determine the erosion rate of the soil mix and other erosion parameters.

Keywords: coarse-grained materials, erosion rate, LIDAR system, soil erosion

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2300 The Effect of Perceived Environmental Uncertainty on Corporate Entrepreneurship Performance: A Field Study in a Large Industrial Zone in Turkey

Authors: Adem Öğüt, M. Tahir Demirsel

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Rapid changes and developments today, besides the opportunities and facilities they offer to the organization, may also be a source of danger and difficulties due to the uncertainty. In order to take advantage of opportunities and to take the necessary measures against possible uncertainties, organizations must always follow the changes and developments that occur in the business environment and develop flexible structures and strategies for the alternative cases. Perceived environmental uncertainty is an outcome of managers’ perceptions of the combined complexity, instability and unpredictability in the organizational environment. An environment that is perceived to be complex, changing rapidly, and difficult to predict creates high levels of uncertainty about the appropriate organizational responses to external circumstances. In an uncertain and complex environment, organizations experiencing cutthroat competition may be successful by developing their corporate entrepreneurial ability. Corporate entrepreneurship is a process that includes many elements such as innovation, creating new business, renewal, risk-taking and being predictive. Successful corporate entrepreneurship is a critical factor which has a significant contribution to gain a sustainable competitive advantage, to renew the organization and to adapt the environment. In this context, the objective of this study is to investigate the effect of perceived environmental uncertainty of managers on corporate entrepreneurship performance. The research was conducted on 222 business executives in one of the major industrial zones of Turkey, Konya Organized Industrial Zone (KOS). According to the results, it has been observed that there is a positive statistically significant relationship between perceived environmental uncertainty and corporate entrepreneurial activities.

Keywords: corporate entrepreneurship, entrepreneurship, industrial zone, perceived environmental uncertainty, uncertainty

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2299 Transforming Identities and Relations: A Case of Taliban Peace Talks in the Pakistani Press

Authors: Zil e Huma

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This study explores the role of Pakistani conventional print media in edging peace talks between the Taliban and the Government of Pakistan from 1st January 2015 till 1st July 2015. The study examines the role of Pakistan's print media during the efforts for peace talks in the context of a Low-Intensity Conflict (LIC). This quantitative research study utilizes content analysis to examine how Pakistan's print media framed the peace negotiations between the government and the TTP. Editorials and columns from two English newspapers, Dawn and The News, were analyzed. The findings reveal that during the peace talks, the print media in Pakistan did not actively contribute to fostering constructive dialogue to support the peace process. Instead, the media failed to provide the necessary communicative space for the political negotiations to move forward, with narratives of fear and despair being dominant. This study offers insight into the psychology of newspapers, showing how they frame news, columns, and articles on complex issues such as the Taliban peace talks. Additionally, it highlights the importance of understanding the role of newspapers in shaping identities and relationships. By examining how Pakistan's print media framed peace initiatives, this research contributes to the existing literature on conflict resolution between the Taliban and the government of Pakistan. Furthermore, it explores the connection between media framing of the peace talks and the actual trajectory of the negotiations, questioning whether the Pakistani print media acted as a facilitator or portrayed the peace process as an inevitable risk of further violence.

Keywords: changing identities, low-intensity, peace journalism, terrorism, the conflict, taliban peace talks, pakistani press

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2298 Technological Innovation and Efficiency of Production of the Greek Aquaculture Industry

Authors: C. Nathanailides, S. Anastasiou, A. Dimitroglou, P. Logothetis, G. Kanlis

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In the present work we reviewed historical data of the Greek Marine aquaculture industry including adoption of new methods and technological innovation. The results indicate that the industry exhibited a rapid rise in production efficiency, employment and adoption of new technologies which reduced outbreaks of diseases, reduced production risk and the price of the farmed fish. The improvements of total quality practices and technological input on the Greek Aquaculture industry include improved survival, growth and body shape of farmed fish, which resulted from development of new aquaculture feeds and the genetic selection of the bloodstock. Also improvements in the quality of the final product were achieved via technological input in the methods and technology applied during harvesting, packaging, and transportation-preservation of farmed fish ensuring high quality of the product from the fish farm to the plate of the consumers. These parameters (health management, nutrition, genetics, harvesting and post-harvesting methods and technology) changed significantly over the last twenty years and the results of these improvements are reflected in the production efficiency of the Aquaculture industry and the quality of the final product. It is concluded that the Greek aquaculture industry exhibited a rapid growth, adoption of technologies and supply was stabilized after the global financial crisis, nevertheless, the development of the Greek aquaculture industry is currently limited by international trade sanctions, credit crunch, and increased taxation and not by limited technology or resources.

Keywords: innovation, aquaculture, total quality, management

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2297 The Impact of Maternal Micronutrient Levels on Risk of Offspring Neural Tube Defects in Egypt

Authors: Eman M. El-Sayed, Sahar A. Abdelaziz, Maha M. Saber Abd El Latif

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Neural tube defects (NTD) are important causes of infant mortality. Poor nutrition was essential factor for central nervous system deformation. Mothers gave NTD offspring had abnormal serum levels of micronutrients. The present research was designed to study the effect of maternal micronutrient levels and oxidative stress on the incidence of NTD in offspring. The study included forty mothers; twenty of them of 30.9+7.28 years had conceived fetuses with NTD were considered as cases; and twenty mothers of 28.2 + 7.82 years with healthy neonates. We determined serum vitamin B12 and folic acid by using radioimmunoassays. Also, serum zinc was assessed using atomic absorption spectrophotometry. While serum copper and iron were measured colorimetrically and serum ceruloplasmin was analyzed by radialimmunodiffusion. Cases showed significantly lower levels of folic acid, vitamin B12 and zinc (P< 0.0005, 0.01, 0.01 respectively) than that of the control. Concentrations of copper, ceruloplasmin, and iron were markedly increased in cases as compared to controls (P < 0.01, 0.01, and 0.05 respectively). In conclusion, the current study clearly indicated the etiology of NTD cannot be explained with one strict etiologic mechanism, on the contrary, an interaction among maternal nutritional factors and oxidative stress would explain these anomalies. Vitamin B12, folic acid, and zinc supplementations should be considered for further decrease in the occurrence of NTD. Preventing excess iron during pregnancy favors better pregnancy outcomes.

Keywords: ceruloplasmin, copper, folic acid, iron, neural tube defects, oxidative stress, vitamin b12, zinc

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2296 Rhizospheric Oxygen Release of Hydroponically Grown Wetland Macrophytes as Passive Source for Cathodic Reduction in Microbial Fuel Cell

Authors: Chabungbam Niranjit Khuman, Makarand Madhao Ghangrekar, Arunabha Mitra

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The cost of aeration is one of the limiting factors in the upscaling of microbial fuel cells (MFC) for field-scale applications. Wetland macrophytes have the ability to release oxygen into the water to maintain aerobic conditions in their root zone. In this experiment, the efficacy of rhizospheric oxygen release of wetland macrophytes as a source of oxygen in the cathodic chamber of MFC was conducted. The experiment was conducted in an MFC consisting of a three-liter anodic chamber made of ceramic cylinder and a 27 L cathodic chamber. Untreated carbon felts were used as electrodes (i.e., anode and cathode) and connected to an external load of 100 Ω using stainless steel wire. Wetland macrophytes (Canna indica) were grown in the cathodic chamber of the MFC in a hydroponic fashion using a styrofoam sheet (termed as macrophytes assisted-microbial fuel cell, M-MFC). The catholyte (i.e., water) in the M-MFC had negligible contact with atmospheric air due to the styrofoam sheet used for maintaining the hydroponic condition. There was no mixing of the catholyte in the M-MFC. Sucrose based synthetic wastewater having chemical oxygen demand (COD) of 3000 mg/L was fed into the anodic chamber of the MFC in fed-batch mode with a liquid retention time of four days. The C. indica thrived well throughout the duration of the experiment without much care. The average dissolved oxygen (DO) concentration and pH value in the M-MFC were 3.25 mg/L and 7.07, respectively, in the catholyte. Since the catholyte was not in contact with air, the DO in the catholyte might be considered as solely liberated from the rhizospheric oxygen release of C. indica. The maximum COD removal efficiency of M-MFC observed during the experiment was 76.9%. The inadequacy of terminal electron acceptor in the cathodic chamber in M-MFC might have hampered the electron transfer, which in turn, led to slower specific microbial activity, thereby resulting in lower COD removal efficiency than the traditional MFC with aerated catholyte. The average operating voltage (OV) and open-circuit voltage (OCV) of 294 mV and 594 mV, respectively, were observed in M-MFC. The maximum power density observed during polarization was 381 mW/m³, and the maximum sustainable power density observed during the experiment was 397 mW/m³ in M-MFC. The maximum normalized energy recovery and coulombic efficiency of 38.09 Wh/m³ and 1.27%, respectively, were observed. Therefore, it was evidenced that rhizospheric oxygen release of wetland macrophytes (C. indica) was capable of sustaining the cathodic reaction in MFC for field-scale applications.

Keywords: hydroponic, microbial fuel cell, rhizospheric oxygen release, wetland macrophytes

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2295 Nexus of Pakistan Stock Exchange with World's Top Five Stock Markets after Launching China Pakistan Economic Corridor

Authors: Abdul Rauf, Xiaoxing Liu, Waqas Amin

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Stock markets are fascinating more and more conductive to each other due to liberalization and globalization trends in recent years. China Pakistan Economic Corridor (CPEC) has dragged Pakistan stock exchange to the new heights and global investors are making investments to reap its benefits. So, in investors and government perspective, the study focuses co-integration of Pakistan stock exchange with world’s five big economies i-e US, China, England, Japan, and France. The time period of study is seven years i-e 2010 to 2016 and daily values of major indices of corresponding stock exchanges collected. All variables of that particular study are stationary at first difference confirmed by unit root test. The study Johansen system co integration test for analysis of data along with Granger causality test is performed for result purpose. Co integration test asserted that Pakistan stock exchange integrated with Shanghai stock exchange (SSE) and NIKKEI stock exchange in short run. Granger causality test also proclaimed these results. But NASDAQ, FTSE, DAX not co integrated and Granger cause at a short run but long run these markets are bonded with Pakistan stock exchange (KSE). VECM also confirmed this liaison in short and long run. Investors, therefore, need to be updated regarding co-integration of world’s stock exchanges to ensure well diversified and risk adjusted high returns. Equally, governments also need updated status so that they could reduce co-integration through multiple steps and hence drag investors for diversified investment.

Keywords: CPEC, DAX, FTSE, liberalization, NASDAQ, NIKKEI, SSE, stock markets

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2294 A Comprehensive Characterization of Cell-free RNA in Spent Blastocyst Medium and Quality Prediction for Blastocyst

Authors: Huajuan Shi

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Background: The biopsy of the preimplantation embryo may increase the potential risk and concern of embryo viability. Clinically discarded spent embryo medium (SEM) has entered the view of researchers, sparking an interest in noninvasive embryo screening. However, one of the major restrictions is the extremelty low quantity of cf-RNA, which is difficult to efficiently and unbiased amplify cf-RNA using traditional methods. Hence, there is urgently need to an efficient and low bias amplification method which can comprehensively and accurately obtain cf-RNA information to truly reveal the state of SEM cf-RNA. Result: In this present study, we established an agarose PCR amplification system, and has significantly improved the amplification sensitivity and efficiency by ~90 fold and 9.29 %, respectively. We applied agarose to sequencing library preparation (named AG-seq) to quantify and characterize cf-RNA in SEM. The number of detected cf-RNAs (3533 vs 598) and coverage of 3' end were significantly increased, and the noise of low abundance gene detection was reduced. The increasing percentage 5' end adenine and alternative splicing (AS) events of short fragments (< 400 bp) were discovered by AG-seq. Further, the profiles and characterizations of cf-RNA in spent cleavage medium (SCM) and spent blastocyst medium (SBM) indicated that 4‐mer end motifs of cf-RNA fragments could remarkably differentiate different embryo development stages. Significance: This study established an efficient and low-cost SEM amplification and library preparation method. Not only that, we successfully described the characterizations of SEM cf-RNA of preimplantation embryo by using AG-seq, including abundance features fragment lengths. AG-seq facilitates the study of cf-RNA as a noninvasive embryo screening biomarker and opens up potential clinical utilities of trace samples.

Keywords: cell-free RNA, agarose, spent embryo medium, RNA sequencing, non-invasive detection

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2293 Investigating the Effect of the Psychoactive Substances Act 2016 on the Incidence of Adverse Medical Events in Her Majesty’s Prison (HMP) Leeds

Authors: Hayley Boal, Chloe Bromley, John Fairfield

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Novel Psychoactive Substances (NPS) are synthetic compounds designed to reproduce effects of illicit drugs. Cheap, potent, and readily available on UK highstreets from so-called ‘head shops’, in recent years their use has surged and with it have emerged side effects including seizures, aggression, palpitations, coma, and death. Rapid development of new substances has vastly outpaced pre-existing drug legislation but the Psychoactive Substances Act 2016 rendered all but tobacco, alcohol, and amyl nitrates, illegal. Drug use has long been rife within prisons, but the absence of a reliable screening tool alongside the availability of NPS makes them ideal for prison use. Here we examine the occurrence of NPS-related adverse side effects within HMP Leeds, comparing May-September of 2015 and 2017 using daily reports distributed amongst prison staff summarising medical and behavioural incidents of the previous day. There was a statistically-significant rise of over 200% in the use of NPS between 2015 and 2017: 0.562 and 1.149 incidents per day respectively. In 2017, 38.46% incidents required ambulances, fallen from 51.02% in 2015. Although the most common descriptions in both years were ‘seizure’ and ‘unresponsive’, by 2017 ‘inhalation by staff’ had emerged. Patterns of NPS consumption mirrored the prison regime, peaking when cell doors opened, and prisoners could socialise. Despite limited data, the Psychoactive Substances Act has clearly been an insufficient deterrent to the prison population; more must be done to understand and address substance misuse in prison. NPS remains a significant risk to prisoners’ health and wellbeing.

Keywords: legislation, novel psychoactive substances, prison, spice

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2292 The Impact of Regulatory Changes on the Development of Mobile Medical Apps

Authors: M. McHugh, D. Lillis

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Mobile applications are being used to perform a wide variety of tasks in day-to-day life, ranging from checking email to controlling your home heating. Application developers have recognized the potential to transform a smart device into a medical device, by using a mobile medical application i.e. a mobile phone or a tablet. When initially conceived these mobile medical applications performed basic functions e.g. BMI calculator, accessing reference material etc.; however, increasing complexity offers clinicians and patients a range of functionality. As this complexity and functionality increases, so too does the potential risk associated with using such an application. Examples include any applications that provide the ability to inflate and deflate blood pressure cuffs, as well as applications that use patient-specific parameters and calculate dosage or create a dosage plan for radiation therapy. If an unapproved mobile medical application is marketed by a medical device organization, then they face significant penalties such as receiving an FDA warning letter to cease the prohibited activity, fines and possibility of facing a criminal conviction. Regulatory bodies have finalized guidance intended for mobile application developers to establish if their applications are subject to regulatory scrutiny. However, regulatory controls appear contradictory with the approaches taken by mobile application developers who generally work with short development cycles and very little documentation and as such, there is the potential to stifle further improvements due to these regulations. The research presented as part of this paper details how by adopting development techniques, such as agile software development, mobile medical application developers can meet regulatory requirements whilst still fostering innovation.

Keywords: agile, applications, FDA, medical, mobile, regulations, software engineering, standards

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2291 An Enhanced Approach in Validating Analytical Methods Using Tolerance-Based Design of Experiments (DoE)

Authors: Gule Teri

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The effective validation of analytical methods forms a crucial component of pharmaceutical manufacturing. However, traditional validation techniques can occasionally fail to fully account for inherent variations within datasets, which may result in inconsistent outcomes. This deficiency in validation accuracy is particularly noticeable when quantifying low concentrations of active pharmaceutical ingredients (APIs), excipients, or impurities, introducing a risk to the reliability of the results and, subsequently, the safety and effectiveness of the pharmaceutical products. In response to this challenge, we introduce an enhanced, tolerance-based Design of Experiments (DoE) approach for the validation of analytical methods. This approach distinctly measures variability with reference to tolerance or design margins, enhancing the precision and trustworthiness of the results. This method provides a systematic, statistically grounded validation technique that improves the truthfulness of results. It offers an essential tool for industry professionals aiming to guarantee the accuracy of their measurements, particularly for low-concentration components. By incorporating this innovative method, pharmaceutical manufacturers can substantially advance their validation processes, subsequently improving the overall quality and safety of their products. This paper delves deeper into the development, application, and advantages of this tolerance-based DoE approach and demonstrates its effectiveness using High-Performance Liquid Chromatography (HPLC) data for verification. This paper also discusses the potential implications and future applications of this method in enhancing pharmaceutical manufacturing practices and outcomes.

Keywords: tolerance-based design, design of experiments, analytical method validation, quality control, biopharmaceutical manufacturing

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2290 Local Cultural Beliefs and Practices of the Indiginous Communities Related to Wildlife in the Buffer Zone of Chitwan National Park

Authors: Neeta Pokharel

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Cultural beliefs and practices have been shaping indigenous community’s resource use and attitude toward the conservation of natural flora and fauna around them. Understanding these cultural dimensions is vital for identifying effective strategies that align with conservation efforts. This study focused on investigating the wildlife-related cultural beliefs and practices of two indigenous communities: Bote and Musahars. The study applied ethnographic methods that included Key-informant interviews, Focal Group discussion, and Household survey methods. Out of 100 respondents, 51% were male and 49% female. A significant portion (65%) of the respondents confirmed animal worship, with a majority worshipping tigers (81.5%), rhinos (73.8%), crocodiles (66%), and dolphins (40%). Additionally, 16.9% disclosed worshipping Elephants, while 10 % affirmed animal worship without specifying the particular animals. Ritualistic practices often involve the sacrifice of pigs, goats, hens, and pigeons. Their cultural ethics place a significant emphasis on biodiversity conservation, as the result shows 41 % refraining from causing harm to wild animals and 9% doing so for ethical considerations, respectively. Moreover, the majority of the respondents believe that cultural practices could enhance conservation efforts. However, the encroachment of modernization and religious conversion within the community poses a tangible risk of cultural degradation, highlighting the urgent need to preserve the cultural practices. Integrating such indigenous practices into the National Biodiversity Strategy and conservation policies can ensure sustainable conservation of endangered animals with appropriate cultural safeguards.

Keywords: tribal communities, societal belief, wild fauna, “barana”, safeguarding

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2289 Role of Social Workers in Mitigating the Effects of Climate Change in Makonde Communal Lands, Zimbabwe

Authors: Louis Nyahunda, Frans Koketso Matlakala, Jabulani Calvin Makhubele

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Climate change is among the most vital environmental aspects that the human community is endowed with. Climate as a factor of life is particularly strong to low income rural communities whose livelihoods heavily depend on rain-fed subsistence agriculture like Makonde communal lands. The purpose of social work within the context of climate change is to enhance community expertise and empower members for participation in the decision-making process through all stages of risk assessment, rescue, planning and intervention for recovery and preparedness. This paper sought to explore the role of social workers in mitigating the effects of climate change in Makonde communal lands of Zimbabwe. The objectives of the study were to identify what roles if any are social workers playing in mitigating the effects of climate change and if not, what are the impediments in that sphere. A qualitative research approach was followed within the traditional framework of descriptive and exploratory designs. Simple random, purposive and snowballing sampling techniques were used to gather twenty-five participants in the study. The Thematic Content Analysis was followed to analyse data inductively. The study found that Social Workers are not directly involved in climate change interventions in the Makonde area owing it to lack of training on climate change issues. The study recommends that climate change falls within the purview of the social work practice therefore social workers must take the lead in supporting families and communities affected by climate change following the values, knowledge base, skills and principles of the profession.

Keywords: role, social workers, mitigation, climate change, Makonde communal lands

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2288 Border Control and Human Rights Violations: Lessons Learned from the United States and Potential Solutions for the European Union

Authors: María Elena Menéndez Ibáñez

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After the terrorist attacks of 9/11, new measures were adopted by powerful countries and regions like the United States and the European Union in order to safeguard their security. In 2002, the US created the Department of Homeland Security with one sole objective; to protect American soil and people. The US adopted new policies that made every immigrant a potential terrorist and a threat to their national security. Stronger border control became one of the key elements of the fight against organized crime and terrorism. The main objective of this paper is to compare some of the most important and radical measures adopted by the US, even those that resulted in systematic violations of human rights, with some of the European measures adopted after the 2015 Paris attacks of 2015, such as unlawful detainment of prisoners and other measures against foreigners. Through the Schengen agreement, the European Union has tried to eliminate tariffs and border controls, in order to guarantee successful economic growth. Terrorists have taken advantage of this and have made the region vulnerable to attacks. Authorities need to strengthen their surveillance methods in order to safeguard the region and its stability. Through qualitative methods applied to social sciences, this research will also try to explain why some of the mechanisms proven to be useful in the US would not be so in Europe, especially because they would result in human rights violations. Finally, solutions will be offered that would not put the whole Schengen Agreement at risk. Europe cannot reinstate border control, without making individuals vulnerable to human rights violations.

Keywords: border control, immigration, international cooperation, national security

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2287 Conjugated Linoleic Acid (CLA) Health Benefits and Sources

Authors: Hilal Ahmad Punoo

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Conjugated linoleic acid (CLA) is a mixture of positional and geometric isomers of octadecadienoic acid with two conjugated double bonds. Of more than a dozen isomers of CLA found naturally in dairy and meat products from ruminants, c-9, t-11 and t-10, c-12 are the two isomers with known physiological importance, including anticarcinogenic, antidiabetic, antilipogenic, and antiatherosclerotic effects. Conjugated linoleic acids (CLA) may influence the onset and severity of several chronic diseases, including various cancers, atherosclerosis, obesity, bone density loss, and diabetes. These findings are of special interest to the agriculture community, because dietary sources of CLA are almost exclusively beef and dairy products. Thus, a better understanding of the specific isomers and mechanisms responsible for these positive effects of CLA on human health would be both prudent and economically beneficial. To date, research related to the advantages of CLA consumption on human health has been conducted using experimental laboratory animals and cell culture systems. These data consistently show that relatively low levels of CLA can influence risk of cancer. Further, very recent investigations suggest that the predominate CLA isoform (cis-9, trans-11 CLA or rumenic acid) found in beef and milk fat possesses anticarcinogenic effects but does not alter body composition; the trans-10, cis-12 CLA has been shown to inhibit lipogenesis. Clearly, further work, especially using human subjects, will be required to characterize the potential benefits of CLA consumption on human health. Moreover, we suggest that foods naturally containing high amounts of CLA (e.g., beef and dairy products) be considered as meeting the definition of functional foods.

Keywords: conjugated linoleic acid, potential health benefits, fats, animals, humans

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2286 Effect of Atrial Flutter on Alcoholic Cardiomyopathy

Authors: Ibrahim Ahmed, Richard Amoateng, Akhil Jain, Mohamed Ahmed

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Alcoholic cardiomyopathy (ACM) is a type of acquired cardiomyopathy caused by chronic alcohol consumption. Frequently ACM is associated with arrhythmias such as atrial flutter. Our aim was to characterize the patient demographics and investigate the effect of atrial flutter (AF) on ACM. This was a retrospective cohort study using the Nationwide Inpatient Sample database to identify admissions in adults with principal and secondary diagnoses of alcoholic cardiomyopathy and atrial flutter from 2019. Multivariate linear and logistic regression models were adjusted for age, gender, race, household income, insurance status, Elixhauser comorbidity score, hospital location, bed size, and teaching status. The primary outcome was all-cause mortality, and secondary outcomes were the length of stay (LOS) and total charge in USD. There was a total of 21,855 admissions with alcoholic cardiomyopathy, of which 1,635 had atrial flutter (AF-ACM). Compared to Non-AF-ACM cohort, AF-ACM cohort had fewer females (4.89% vs 14.54%, p<0.001), were older (58.66 vs 56.13 years, p<0.001), fewer Native Americans (0.61% vs2.67%, p<0.01), had fewer smaller (19.27% vs 22.45%, p<0.01) & medium-sized hospitals (23.24% vs28.98%, p<0.01), but more large-sized hospitals (57.49% vs 48.57%, p<0.01), more Medicare (40.37% vs 34.08%, p<0.05) and fewer Medicaid insured (23.55% vs 33.70%, p=<0.001), fewer hypertension (10.7% vs 15.01%, p<0.05), and more obesity (24.77% vs 16.35%, p<0.001). Compared to Non-AF-ACM cohort, there was no difference in AF-ACM cohort mortality rate (6.13% vs 4.20%, p=0.0998), unadjusted mortality OR 1.49 (95% CI 0.92-2.40, p=0.102), adjusted mortality OR 1.36 (95% CI 0.83-2.24, p=0.221), but there was a difference in LOS 1.23 days (95% CI 0.34-2.13, p<0.01), total charge $28,860.30 (95% CI 11,883.96-45,836.60, p<0.01). In patients admitted with ACM, the presence of AF was not associated with a higher all-cause mortality rate or odds of all-cause mortality; however, it was associated with 1.23 days increase in LOS and a $28,860.30 increase in total hospitalization charge. Native Americans, older age and obesity were risk factors for the presence of AF in ACM.

Keywords: alcoholic cardiomyopathy, atrial flutter, cardiomyopathy, arrhythmia

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2285 Body Image Impact on Quality of Life and Adolescents’ Binge Eating: The Indirect Role of Body Image Coping Strategies

Authors: Dora Bianchi, Anthony Schinelli, Laura Maria Fatta, Antonia Lonigro, Fabio Lucidi, Fiorenzo Laghi

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Purpose: The role of body image in adolescent binge eating is widely confirmed, albeit the various facets of this relationship are still mostly unexplored. Within the multidimensional body image framework, this study hypothesized the indirect effects of three body image coping strategies (positive rational acceptance, appearance fixing, avoidance) in the expected relationship between the perceived impact of body image on individuals’ quality of life and binge eating symptoms. Methods: Participants were 715 adolescents aged 15-21 years (49.1% girls) recruited in Italian schools. An anonymous self-report online survey was administered. A multiple mediation model was tested. Results: A more positive perceived impact of body image on quality of life was a negative predictor of adolescents’ binge eating, controlling for individual levels of body satisfaction. Three indirect effects were found in this relationship: on one hand, the positive body image impact reduced binge eating via increasing positive rational acceptance (M1), and via reducing avoidance (M2); on the contrary, the positive body image impact also enhanced binge eating via increasing appearance fixing (M3). Conclusions: The body image impact on quality of life can be alternatively protective—when adaptive coping is solicited, and maladaptive strategies are reduced—or a risk factor, which may increase binge eating by soliciting appearance fixing.

Keywords: binge eating, body image satisfaction, quality of life, coping strategies, adolescents

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2284 Sensitivity to Misusing Verb Inflections in Both Finite and Non-Finite Clauses in Native and Non-Native Russian: A Self-Paced Reading Investigation

Authors: Yang Cao

Abstract:

Analyzing the oral production of Chinese-speaking learners of English as a second language (L2), we can find a large variety of verb inflections – Why does it seem so hard for them to use consistent correct past morphologies in obligatory past contexts? Failed Functional Features Hypothesis (FFFH) attributes the rather non-target-like performance to the absence of [±past] feature in their L1 Chinese, arguing that for post puberty learners, new features in L2 are no more accessible. By contrast, Missing Surface Inflection Hypothesis (MSIH) tends to believe that all features are actually acquirable for late L2 learners, while due to the mapping difficulties from features to forms, it is hard for them to realize the consistent past morphologies on the surface. However, most of the studies are limited to the verb morphologies in finite clauses and few studies have ever attempted to figure out these learners’ performance in non-finite clauses. Additionally, it has been discussed that Chinese learners may be able to tell the finite/infinite distinction (i.e. the [±finite] feature might be selected in Chinese, even though the existence of [±past] is denied). Therefore, adopting a self-paced reading task (SPR), the current study aims to analyze the processing patterns of Chinese-speaking learners of L2 Russian, in order to find out if they are sensitive to misuse of tense morphologies in both finite and non-finite clauses and whether they are sensitive to the finite/infinite distinction presented in Russian. The study targets L2 Russian due to its systematic morphologies in both present and past tenses. A native Russian group, as well as a group of English-speaking learners of Russian, whose L1 has definitely selected both [±finite] and [±past] features, will also be involved. By comparing and contrasting performance of the three language groups, the study is going to further examine and discuss the two theories, FFFH and MSIH. Preliminary hypotheses are: a) Russian native speakers are expected to spend longer time reading the verb forms which violate the grammar; b) it is expected that Chinese participants are, at least, sensitive to the misuse of inflected verbs in non-finite clauses, although no sensitivity to the misuse of infinitives in finite clauses might be found. Therefore, an interaction of finite and grammaticality is expected to be found, which indicate that these learners are able to tell the finite/infinite distinction; and c) having selected [±finite] and [±past], English-speaking learners of Russian are expected to behave target-likely, supporting L1 transfer.

Keywords: features, finite clauses, morphosyntax, non-finite clauses, past morphologies, present morphologies, Second Language Acquisition, self-paced reading task, verb inflections

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2283 Arc Interruption Design for DC High Current/Low SC Fuses via Simulation

Authors: Ali Kadivar, Kaveh Niayesh

Abstract:

This report summarizes a simulation-based approach to estimate the current interruption behavior of a fuse element utilized in a DC network protecting battery banks under different stresses. Due to internal resistance of the battries, the short circuit current in very close to the nominal current, and it makes the fuse designation tricky. The base configuration considered in this report consists of five fuse units in parallel. The simulations are performed using a multi-physics software package, COMSOL® 5.6, and the necessary material parameters have been calculated using two other software packages.The first phase of the simulation starts with the heating of the fuse elements resulted from the current flow through the fusing element. In this phase, the heat transfer between the metallic strip and the adjacent materials results in melting and evaporation of the filler and housing before the aluminum strip is evaporated and the current flow in the evaporated strip is cut-off, or an arc is eventually initiated. The initiated arc starts to expand, so the entire metallic strip is ablated, and a long arc of around 20 mm is created within the first 3 milliseconds after arc initiation (v_elongation = 6.6 m/s. The final stage of the simulation is related to the arc simulation and its interaction with the external circuitry. Because of the strong ablation of the filler material and venting of the arc caused by the melting and evaporation of the filler and housing before an arc initiates, the arc is assumed to burn in almost pure ablated material. To be able to precisely model this arc, one more step related to the derivation of the transport coefficients of the plasma in ablated urethane was necessary. The results indicate that an arc current interruption, in this case, will not be achieved within the first tens of milliseconds. In a further study, considering two series elements, the arc was interrupted within few milliseconds. A very important aspect in this context is the potential impact of many broken strips parallel to the one where the arc occurs. The generated arcing voltage is also applied to the other broken strips connected in parallel with arcing path. As the gap between the other strips is very small, a large voltage of a few hundred volts generated during the current interruption may eventually lead to a breakdown of another gap. As two arcs in parallel are not stable, one of the arcs will extinguish, and the total current will be carried by one single arc again. This process may be repeated several times if the generated voltage is very large. The ultimate result would be that the current interruption may be delayed.

Keywords: DC network, high current / low SC fuses, FEM simulation, paralle fuses

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2282 Comparison of Er:YAG Laser with Bur Prepared Cavities: A Systematic Review

Authors: Sarina Sahmeddini, Fahimeh Safarpour, Forough Pazhuheian

Abstract:

With the concepts of minimally invasive treatment and preventive dentistry gaining more and more recognition by dentists, there are many published clinical trials comparing the use of the erbium laser with traditional drilling for caries removal. However, the efficacy of the erbium laser is still controversial. The aim of this review study is to compare the effects of tooth preparation by laser irradiation and conventional preparation by bur to identify the best means for cavity preparation and reduction of recurrent caries. Randomized controlled trials, controlled clinical trials, and prospective, and retrospective cohort studies were included in this review. The eligibility criteria included studies in humans’ permanent teeth in which cavities were conducted in their cervical third and proximal surfaces. PubMed, Google scholar, and Scopus about Er:YAG laser and bur prepared cavities were carried out. The studies’ details were organized in four tables according to the groups: (1) Microleakage; (2) Morphological changes; (3) Microhardness; and (4) Bond strength. The initial search resulted in 134 articles, 12 studies published from 2012 up to March 2020 were included in this review. According to the risk of bias evaluation, all studies were classified as high quality. Clinical implications: Er:YAG lasers with the energy levels between 250 to 300 mJ can be proper alternatives to conventional burs, as minimal invasive instruments with no significant differences or better results in microleakage, microhardness, and bond strength compared with conventional burs. In conclusion, Er:YAG laser irradiations accompanied by phosphoric acid etching can reduce the chance of recurrent carries.

Keywords: lasers, drilling, caries, micro leakage

Procedia PDF Downloads 132
2281 Antioxidant Activity of Probiotic Lactic Acid Bacteria and Their Application in Fermented Milk Products

Authors: Vitheejongjaroen P., Jaisin Y., Pachekrepapol U., Taweechotipatr M.

Abstract:

Lactic acid bacteria (LAB) are the most common type of microorganisms that had been used as probiotics also known for many beneficial health effects. The antioxidant activity of LAB is associated with numerous health-protective effects. This research aimed to investigate the antioxidant activity of lactic acid bacteria isolated from Thai sour pork sausage for their application in fermented milk products. Antioxidant activity determined by DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging assay showed that the isolate FN33-7, as 1 of 8 isolated exhibited scavenging activity in intact cell 5-7%, and supernatant 13-16%, intracellular cell free extract 42-48% respectively. This isolate was identified using 16S ribosomal DNA sequence analysis as Lactobacillus plantarum. The effect of milk fermented with L. plantarum FN33-7 on microbial count, pH and syneresis was assessed during refrigerated storage period of 28 days. The strain showed increased viability, pH level decreased, while syneresis increased. These results are similar to dairy products fermented with commercial starter cultures. Additionally, microstructure analysis of fermented milk by fluorescent microscopy showed that curd structure appeared to be dense and less porous in this fermented milk than commercial yogurt. The results of this study indicated that L. plantarum FN33-7 was a good probiotic candidate to be used in cultured milk products to reduce the risk of diseases caused by oxidative stress.

Keywords: Lactobacillus plantarum, probiotics, free radical, antioxidant, oxidative stress, fermented milk products

Procedia PDF Downloads 130
2280 Bandgap Engineering of CsMAPbI3-xBrx Quantum Dots for Intermediate Band Solar Cell

Authors: Deborah Eric, Abbas Ahmad Khan

Abstract:

Lead halide perovskites quantum dots have attracted immense scientific and technological interest for successful photovoltaic applications because of their remarkable optoelectronic properties. In this paper, we have simulated CsMAPbI3-xBrx based quantum dots to implement their use in intermediate band solar cells (IBSC). These types of materials exhibit optical and electrical properties distinct from their bulk counterparts due to quantum confinement. The conceptual framework provides a route to analyze the electronic properties of quantum dots. This layer of quantum dots optimizes the position and bandwidth of IB that lies in the forbidden region of the conventional bandgap. A three-dimensional MAPbI3 quantum dot (QD) with geometries including spherical, cubic, and conical has been embedded in the CsPbBr3 matrix. Bound energy wavefunction gives rise to miniband, which results in the formation of IB. If there is more than one miniband, then there is a possibility of having more than one IB. The optimization of QD size results in more IBs in the forbidden region. One band time-independent Schrödinger equation using the effective mass approximation with step potential barrier is solved to compute the electronic states. Envelope function approximation with BenDaniel-Duke boundary condition is used in combination with the Schrödinger equation for the calculation of eigen energies and Eigen energies are solved for the quasi-bound states using an eigenvalue study. The transfer matrix method is used to study the quantum tunneling of MAPbI3 QD through neighbor barriers of CsPbI3. Electronic states are computed using Schrödinger equation with effective mass approximation by considering quantum dot and wetting layer assembly. Results have shown the varying the quantum dot size affects the energy pinning of QD. Changes in the ground, first, second state energies have been observed. The QD is non-zero at the center and decays exponentially to zero at boundaries. Quasi-bound states are characterized by envelope functions. It has been observed that conical quantum dots have maximum ground state energy at a small radius. Increasing the wetting layer thickness exhibits energy signatures similar to bulk material for each QD size.

Keywords: perovskite, intermediate bandgap, quantum dots, miniband formation

Procedia PDF Downloads 165
2279 Study of Causes and Effects of Road Projects Abandonment in Nigeria

Authors: Monsuru Oyenola Popoola, Oladapo Samson Abiola, Wusamotu Alao Adeniji

Abstract:

The prevalent and incessant abandonment of road construction projects are alarming that it creates several negative effects to social, economic and environmental values of the project. The purpose of this paper is to investigate and determined the various causes and effects of abandoning road construction projects in Nigeria. Likert Scale questionnaire design was used to administered and analysed the data obtained for the stydy. 135 (Nr) questionnaires were completed and retrieved from the respondents, out of 200 (Nr) questionnaires sent out, representing a response rate of 67.5%. The analysis utilized the Relative Importance Index (R.I.I.) method and the results are presented in tabular form. The findings confirms that at least 20 factors were the causes of road projects abandonment in Nigeria with most including Leadership Instability, Improper Project Planning, Inconsistence in government policies and Design, Contractor Incompetence, Economy Instability and Inflation, Delay in remittance of money, Improper financial analysis, Poor risk management, Climatic Conditions, Improper Project Estimates etc. The findings also show that at least eight (8) effect were identified on the system, and these include; Waste of Financial Resources, Loss of economic value, Environmental degradation, Loss of economic value, Reduction in standard of living, Litigation and Arbitration, etc. The reflection is that allocating reasonable finance, developing appropriate and effective implementation plans and monitoring, evaluation and reporting on development project activities by key actors should enhance in resolving the problem of road projects abandonment.

Keywords: road construction, abandonment of road projects, climatic condition, project planning, contractor

Procedia PDF Downloads 299
2278 Assessment of Drinking Water Quality in Relation to Arsenic Contamination in Drinking Water in Liberia: Achieving the Sustainable Development Goal of Ensuring Clean Water and Sanitation

Authors: Victor Emery David Jr., Jiang Wenchao, Daniel Mmereki, Yasinta John

Abstract:

The fundamentals of public health are access to safe and clean drinking water. The presence of arsenic and other contaminants in drinking water leads to the potential risk to public health and the environment particularly in most developing countries where there’s inadequate access to safe and clean water and adequate sanitation. Liberia has taken steps to improve its drinking water status so as to achieve the Sustainable Development Goals (SDGs) target of ensuring clean water and effective sanitation but there is still a lot to be done. The Sustainable Development Goals are a United Nation initiative also known as transforming our world: The 2030 agenda for sustainable development. It contains seventeen goals with 169 targets to be met by respective countries. Liberia is situated within in the gold belt region where there exist the presence of arsenic and other contaminants in the underground water due to mining and other related activities. While there are limited or no epidemiological studies conducted in Liberia to confirm illness or death as a result of arsenic contamination in Liberia, it remains a public health concern. This paper assesses the drinking water quality, the presence of arsenic in groundwater/drinking water in Liberia, and proposes strategies for mitigating contaminants in drinking water and suggests options for improvement with regards to achieving the Sustainable Development Goals of ensuring clean water and effective sanitation in Liberia by 2030.

Keywords: arsenic, action plan, contaminants, environment, groundwater, sustainable development goals (SDGs), Monrovia, Liberia, public health, drinking water

Procedia PDF Downloads 261
2277 Detecting Financial Bubbles Using Gap between Common Stocks and Preferred Stocks

Authors: Changju Lee, Seungmo Ku, Sondo Kim, Woojin Chang

Abstract:

How to detecting financial bubble? Addressing this simple question has been the focus of a vast amount of empirical research spanning almost half a century. However, financial bubble is hard to observe and varying over the time; there needs to be more research on this area. In this paper, we used abnormal difference between common stocks price and those preferred stocks price to explain financial bubble. First, we proposed the ‘W-index’ which indicates spread between common stocks and those preferred stocks in stock market. Second, to prove that this ‘W-index’ is valid for measuring financial bubble, we showed that there is an inverse relationship between this ‘W-index’ and S&P500 rate of return. Specifically, our hypothesis is that when ‘W-index’ is comparably higher than other periods, financial bubbles are added up in stock market and vice versa; according to our hypothesis, if investors made long term investments when ‘W-index’ is high, they would have negative rate of return; however, if investors made long term investments when ‘W-index’ is low, they would have positive rate of return. By comparing correlation values and adjusted R-squared values of between W-index and S&P500 return, VIX index and S&P500 return, and TED index and S&P500 return, we showed only W-index has significant relationship between S&P500 rate of return. In addition, we figured out how long investors should hold their investment position regard the effect of financial bubble. Using this W-index, investors could measure financial bubble in the market and invest with low risk.

Keywords: financial bubble detection, future return, forecasting, pairs trading, preferred stocks

Procedia PDF Downloads 368
2276 DenseNet and Autoencoder Architecture for COVID-19 Chest X-Ray Image Classification and Improved U-Net Lung X-Ray Segmentation

Authors: Jonathan Gong

Abstract:

Purpose AI-driven solutions are at the forefront of many pathology and medical imaging methods. Using algorithms designed to better the experience of medical professionals within their respective fields, the efficiency and accuracy of diagnosis can improve. In particular, X-rays are a fast and relatively inexpensive test that can diagnose diseases. In recent years, X-rays have not been widely used to detect and diagnose COVID-19. The under use of Xrays is mainly due to the low diagnostic accuracy and confounding with pneumonia, another respiratory disease. However, research in this field has expressed a possibility that artificial neural networks can successfully diagnose COVID-19 with high accuracy. Models and Data The dataset used is the COVID-19 Radiography Database. This dataset includes images and masks of chest X-rays under the labels of COVID-19, normal, and pneumonia. The classification model developed uses an autoencoder and a pre-trained convolutional neural network (DenseNet201) to provide transfer learning to the model. The model then uses a deep neural network to finalize the feature extraction and predict the diagnosis for the input image. This model was trained on 4035 images and validated on 807 separate images from the ones used for training. The images used to train the classification model include an important feature: the pictures are cropped beforehand to eliminate distractions when training the model. The image segmentation model uses an improved U-Net architecture. This model is used to extract the lung mask from the chest X-ray image. The model is trained on 8577 images and validated on a validation split of 20%. These models are calculated using the external dataset for validation. The models’ accuracy, precision, recall, f1-score, IOU, and loss are calculated. Results The classification model achieved an accuracy of 97.65% and a loss of 0.1234 when differentiating COVID19-infected, pneumonia-infected, and normal lung X-rays. The segmentation model achieved an accuracy of 97.31% and an IOU of 0.928. Conclusion The models proposed can detect COVID-19, pneumonia, and normal lungs with high accuracy and derive the lung mask from a chest X-ray with similarly high accuracy. The hope is for these models to elevate the experience of medical professionals and provide insight into the future of the methods used.

Keywords: artificial intelligence, convolutional neural networks, deep learning, image processing, machine learning

Procedia PDF Downloads 130
2275 Structural Performance of Mechanically Connected Stone Panels under Cyclic Loading: Application to Aesthetic and Environmental Building Skin Design

Authors: Michel Soto Chalhoub

Abstract:

Building designers in the Mediterranean region and other parts of the world utilize natural stone panels on the exterior façades as skin cover. This type of finishing is not only intended for aesthetic reasons but also environmental. The stone, since the earliest ages of civilization, has been used in construction and to-date some of the most appealing buildings owe their beauty to stone finishing. The stone also provides warmth in winter and freshness in summer as it moderates heat transfer and absorbs radiation. However, as structural codes became increasingly stringent about the dynamic performance of buildings, it became essential to study the performance of stone panels under cyclic loading – a condition that arises under the building is subjected to wind or earthquakes. The present paper studies the performance of stone panels using mechanical connectors when subjected to load reversal. In this paper, we present a theoretical model that addresses modes of failure in the steel connectors, by yield, and modes of failure in the stone, by fracture. Then we provide an experimental set-up and test results for rectangular stone panels of varying thickness. When the building is subjected to an earthquake, its rectangular panels within the structural system are subjected to shear deformations, which in turn impart stress into the stone cover. Rectangular stone panels, which typically range from 40cmx80cm to 60cmx120cm, need to be designed to withstand transverse loading from the direct application of lateral loads, and to withstand simultaneously in-plane loading (membrane stress) caused by inter-story drift and overall building lateral deflection. Results show correlation between the theoretical model which we derive from solid mechanics fundamentals and the experimental results, and lead to practical design recommendations. We find that for panel thickness below a certain threshold, it is more advantageous to utilize structural adhesive materials to connect stone panels to the main structural system of the building. For larger panel thicknesses, it is recommended to utilize mechanical connectors with special detailing to ensure a minimum level of ductility and energy dissipation.

Keywords: solid mechanics, cyclic loading, mechanical connectors, natural stone, seismic, wind, building skin

Procedia PDF Downloads 255
2274 Comparing the Uptake of Seasonal Influenza and Pneumococcal Vaccines among Older Adults in Australia and Hong Kong between 2016 and 2018

Authors: Lynne Briggs, Patricia Fronek, Judy Siu.

Abstract:

This qualitative study aimed to gain a better understanding of the perceptions and barriers to receiving seasonal influenza and pneumococcal vaccines among Australian and Hong Kong adults aged ≥ 65 years. The findings showed that vaccine uptake for the two diseases was lower in Hong Kong than in Australia. Common and divergent issues identified included the impact of different health systems, the promotion of vaccination by health professionals, beliefs about hospitals and clinics, traditional and alternative medicines, perceptions of risk, and personal responsibility. Objective of the research: The objective of this comparison study was to gain a better understanding of the perceptions and barriers to receiving seasonal influenza and pneumococcal vaccines among Australian and Hong Kong adults aged ≥ 65 years. Methodology: This qualitative study used semi structured face to face interviews for data collection in both countries. Thematic analysis of the data allowed for a comparison of the main themes identified across the two countries. Main Contribution of the Research: Differences in vaccine uptake between Australian and Hong Kong was attributable to differing health systems, including access, prevention, socioeconomic status, and cultural attitudes. Understanding the needs of older people would enhance vaccine uptake for these two preventable diseases.

Keywords: influenza vaccine uptake, pneumonia vaccine uptake, vaccination of the elderly, hesitancy vaccine

Procedia PDF Downloads 123
2273 Prescription of Maintenance Fluids in the Emergency Department

Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

Abstract:

The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

Procedia PDF Downloads 322