Search results for: micro and macrovascular complications
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2832

Search results for: micro and macrovascular complications

2202 Web-Based Cognitive Writing Instruction (WeCWI): A Hybrid e-Framework for Instructional Design

Authors: Boon Yih Mah

Abstract:

Web-based Cognitive Writing Instruction (WeCWI) is a hybrid e-framework that consolidates instructional design and language development towards the development of a web-based instruction (WBI). WeCWI divides instructional design into macro and micro perspectives. In macro perspective, a 21st century educator is encouraged to disseminate knowledge and share ideas with in-class and global learners. By leveraging the virtue of technology, WeCWI aims to transform the educator into an aggregator, curator, publisher, social networker and finally, a web-based instructor. Since the most notable contribution of integrating technology is being a tool of teaching as well as a stimulus for learning, WeCWI focuses on the use of contemporary web tools based on the multiple roles played by the 21st century educator. The micro perspective draws attention to the pedagogical approaches focussing on three main aspects: reading, discussion, and writing. With the effective use of pedagogical approaches, technology adds new dimensions and expands the bounds of learning capacity. Lastly, WeCWI also imparts the fundamental theoretical concepts for web-based instructors’ awareness such as interactionism, e-learning interactional-based model, computer-mediated communication (CMC), cognitive theories, and learning style model.

Keywords: web-based cognitive writing instruction, WeCWI, instructional design, e-framework, web-based instructor

Procedia PDF Downloads 439
2201 Pregnancy Outcomes among Syrian Refugee and Jordanian Women: A Comparative Study

Authors: Karimeh Alnuaimi, Manal Kassab, Reem Ali, Khitam Mohammad, Kholoud Shattnawi

Abstract:

Aim: To compare pregnancy outcomes of Syrian refugee women and Jordanian women. Background and introduction: The current conflict in Syria continues to displace thousands to neighboring countries, including Jordan. Pregnant refugee women are therefore facing many difficulties are known to increase the prevalence of poor reproductive health outcomes and antenatal complications. However, there is very little awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Methods: Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental Hospitals in the north of Jordan, between January 1, 2014, and December 31, 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birth weight (< 2500 g), Apgar score and preterm delivery (< 37 weeks' gestational age). Results: Statistical analysis revealed that refugee mothers had a significant increase in the rate of cesarean section and the higher rate of anemia, a lower neonates’ weight, and Apgar scores when compared to their Jordanian counterparts. Discussion and Conclusion: Results were congruent with findings from other studies in the region and worldwide. Minimizing inequalities in pregnancy outcomes between Syrian refugees and Jordan women is a healthcare priority. Implications for nursing and health policy: The findings could guide the planning and development of health policies in Jordan that would help to alleviate the situation regarding refugee populations. The action is required by the policy makers, specifically targeting public and primary health care services, to address the problem of adequately meeting the need for antenatal care of this vulnerable population.

Keywords: pregnancy, Syrian refugee, Jordanian women, comparative study

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2200 A Comparison of Outcomes of Endoscopic Retrograde Cholangiopancreatography vs. Percutaneous Transhepatic Biliary Drainage in the Management of Obstructive Jaundice from Hepatobiliary Tuberculosis: The Philippine General Hospital Experience

Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

Abstract:

Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

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2199 Correlation between Entrepreneur's Perception of Human Resource Function and Company's Growth

Authors: Ivan Todorović, Stefan Komazec, Jelena Anđelković-Labrović, Ondrej Jaško, Miha Marič

Abstract:

Micro, small and medium enterprises (MSME) are important factors of the economy in each country. Recent years have brought increased number and higher sophistication of scientific research related to numerous aspects of entrepreneurship. Various authors try to find the positive correlation between entrepreneur's personal characteristics, skills and knowledge on one hand, and company growth and success of small business on the other hand. Different models recognize staff as one of the key elements in every organizational system. Human resource (HR) function is present in almost all large companies, despite the geographical location or industry. Small and medium enterprises also often have separate positions or even departments for HR administration. However, in early stages of organizational life cycle human resources are usually managed by the founder, entrepreneur. In this paper we want to question whether the companies where founder, entrepreneur, recognizes the significance of human capital in the organization and understands the importance of HR management have higher growth rate and better business results. The findings of this research can be implemented in practice, but also in the academia, for improving the curricula related to the MSME and entrepreneurship.

Keywords: entrepreneurship, MSME, micro small and medium enterprises, company growth, human resources, HR management

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2198 Spatial Analysis and Determinants of Number of Antenatal Health Care Visit Among Pregnant Women in Ethiopia: Application of Spatial Multilevel Count Regression Models

Authors: Muluwerk Ayele Derebe

Abstract:

Background: Antenatal care (ANC) is an essential element in the continuum of reproductive health care for preventing preventable pregnancy-related morbidity and mortality. Objective: The aim of this study is to assess the spatial pattern and predictors of ANC visits in Ethiopia. Method: This study was done using Ethiopian Demographic and Health Survey data of 2016 among 7,174 pregnant women aged 15-49 years which was a nationwide community-based cross-sectional survey. Spatial analysis was done using Getis-Ord Gi* statistics to identify hot and cold spot areas of ANC visits. Multilevel glmmTMB packages adjusted for spatial effects were used in R software. Spatial multilevel count regression was conducted to identify predictors of antenatal care visits for pregnant women, and proportional change in variance was done to uncover the effect of individual and community-level factors of ANC visits. Results: The distribution of ANC visits was spatially clustered Moran’s I = 0.271, p<.0.001, ICC = 0.497, p<0.001). The highest spatial outlier areas of ANC visit was found in Amhara (South Wollo, Weast Gojjam, North Shewa), Oromo (west Arsi and East Harariga), Tigray (Central Tigray) and Benishangul-Gumuz (Asosa and Metekel) regions. The data was found with excess zeros (34.6%) and over-dispersed. The expected ANC visit of pregnant women with pregnancy complications was higher at 0.7868 [ARR= 2.1964, 95% CI: 1.8605, 2.5928, p-value <0.0001] compared to pregnant women who had no pregnancy complications. The expected ANC visit of a pregnant woman who lived in a rural area was 1.2254 times higher [ARR=3.4057, 95% CI: 2.1462, 5.4041, p-value <0.0001] as compared to a pregnant woman who lived in an urban. The study found dissimilar clusters with a low number of zero counts for a mean number of ANC visits surrounded by clusters with a higher number of counts of an average number of ANC visits when other variables held constant. Conclusion: This study found that the number of ANC visits in Ethiopia had a spatial pattern associated with socioeconomic, demographic, and geographic risk factors. Spatial clustering of ANC visits exists in all regions of Ethiopia. The predictor age of the mother, religion, mother’s education, husband’s education, mother's occupation, husband's occupation, signs of pregnancy complication, wealth index and marital status had a strong association with the number of ANC visits by each individual. At the community level, place of residence, region, age of the mother, sex of the household head, signs of pregnancy complications and distance to health facility factors had a strong association with the number of ANC visits.

Keywords: Ethiopia, ANC, spatial, multilevel, zero inflated Poisson

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2197 Effects of Test Environment on the Sliding Wear Behaviour of Cast Iron, Zinc-Aluminium Alloy and Its Composite

Authors: Mohammad M. Khan, Gajendra Dixit

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Partially lubricated sliding wear behaviour of a zinc-based alloy reinforced with 10wt% SiC particles has been studied as a function of applied load and solid lubricant particle size and has been compared with that of matrix alloy and conventionally used grey cast iron. The wear tests were conducted at the sliding velocities of 2.1m/sec in various partial lubricated conditions using pin on disc machine as per ASTM G-99-05. Base oil (SAE 20W-40) or mixture of the base oil with 5wt% graphite of particle sizes (7-10 µm) and (100 µm) were used for creating lubricated conditions. The matrix alloy revealed primary dendrites of a and eutectoid a + h and Î phases in the Inter dendritic regions. Similar microstructure has been depicted by the composite with an additional presence of the dispersoid SiC particles. In the case of cast iron, flakes of graphite were observed in the matrix; the latter comprised of (majority of) pearlite and (limited quantity of) ferrite. Results show a large improvement in wear resistance of the zinc-based alloy after reinforcement with SiC particles. The cast iron shows intermediate response between the matrix alloy and composite. The solid lubrication improved the wear resistance and friction behaviour of both the reinforced and base alloy. Moreover, minimum wear rate is obtained in oil+ 5wt % graphite (7-10 µm) lubricated environment for the matrix alloy and composite while for cast iron addition of solid lubricant increases the wear rate and minimum wear rate is obtained in case of oil lubricated environment. The cast iron experienced higher frictional heating than the matrix alloy and composite in all the cases especially at higher load condition. As far as friction coefficient is concerned, a mixed trend of behaviour was noted. The wear rate and frictional heating increased with load while friction coefficient was affected in an opposite manner. Test duration influenced the frictional heating and friction coefficient of the samples in a mixed manner.

Keywords: solid lubricant, sliding wear, grey cast iron, zinc based metal matrix composites

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2196 Produce High-Quality Activated Carbon with a Large Surface Area from Date Seeds Biomass for Water Treatment

Authors: Rashad Al-Gaashani, Viktor Kochkodan, Jenny Lawler

Abstract:

Physico-chemical activation method wasused to produce high-quality activated carbon (AC) with a large surface area of about 2000 m2/g from low-cost and abundant biomasswastes in Qatar, namely date seeds. X-Ray diffraction (XRD), scanning electron spectroscopy (SEM), energy dispersive X-Ray spectroscopy (EDS), and Brunauer-Emmett-Teller (BET) surface area analysis were used to evaluate the AC samples. AC produced from date seeds have a wide range of the pores available, including micro- andnano-pores. This type of AC with a well-developed pore structure may be very attractive for different applications, including air and water purification from micro and nano pollutants. Heavy metalsiron (III) and copper (II) ions were removed from wastewater using the AC producedusinga batch adsorption technique. The AC produced from date seeds biomass wastes show high removal of heavy metals such as iron (III) ions (100%) and copper (II) ions (97.25%). The highest removal of copper (II) ions (100%) with AC produced from date seeds was found at pH 8, whereas the lowest removal (22.63%) occurred at pH 2. The effect of adsorption time, adsorbent dose, pH on the removal of heavy metalswere studied.

Keywords: activated carbon, date seeds, biomass, heavy metals removal, water treatment

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2195 Effect of Ramp Rate on the Preparation of Activated Carbon from Saudi Date Tree Fronds (Agro Waste) by Physical Activation Method

Authors: Muhammad Shoaib, Hassan M Al-Swaidan

Abstract:

Saudi Arabia is the major date producer in the world. In order to maximize the production from date tree, pruning of the date trees is required annually. Large amount of this agriculture waste material (palm tree fronds) is available in Saudi Arabia and considered as an ideal source as a precursor for production of activated carbon (AC). The single step procedure for the preparation of micro porous activated carbon (AC) from Saudi date tree fronds using mixture of gases (N2 and CO2) is carried out at carbonization/activation temperature at 850°C and at different ramp rates of 10, 20 and 30 degree per minute. Alloy 330 horizontal reactor is used for tube furnace. Flow rate of nitrogen and carbon dioxide gases are kept at 150 ml/min and 50 ml/min respectively during the preparation. Characterization results reveal that the BET surface area, pore volume, and average pore diameter of the resulting activated carbon generally decreases with the increase in ramp rate. The activated carbon prepared at a ramp rate of 10 degrees/minute attains larger surface area and can offer higher potential to produce activated carbon of greater adsorption capacity from agriculture wastes such as date fronds. The BET surface areas of the activated carbons prepared at a ramp rate of 10, 20 and 30 degree/minute after 30 minutes activation time are 1094, 1020 and 515 m2/g, respectively. Scanning electron microscopy (SEM) for surface morphology, and FTIR for functional groups was carried out that also verified the same trend. Moreover, by increasing the ramp rate from 10 and 20 degrees/min the yield remains same, i.e. 18%, whereas at a ramp rate of 30 degrees/min the yield increases from 18 to 20%. Thus, it is feasible to produce high-quality micro porous activated carbon from date frond agro waste using N2 carbonization followed by physical activation with CO2 and N2 mixture. This micro porous activated carbon can be used as adsorbent of heavy metals from wastewater, NOx SOx emission adsorption from ambient air and electricity generation plants, purification of gases, sewage treatment and many other applications.

Keywords: activated carbon, date tree fronds, agricultural waste, applied chemistry

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2194 Return to Bowel Function after Right versus Extended Right Hemicolectomy: A Retrospective Review

Authors: Zak Maas, Daniel Carson, Rachel McIntyre, Mark Omundsen, Teresa Holm

Abstract:

Aim: After hemicolectomy a period of obligatory bowel dysfunction is expected, termed postoperative ileus (POI). Prolonged postoperative ileus (PPOI), typically four or more days, is associated with higher morbidity and extended inpatient stay. This leads to significant financial and resource-related burdens on healthcare systems. Several studies including a meta-analysis have compared rates of PPOI in left vs right hemicolectomy, which suggest that right-sided resections may be more likely to result in PPOI. Our study aims to further investigate whether significant differences in PPOI and obligatory POI exist between right versus extended right hemicolectomy. Methods: This is a retrospective review assessing rates of PPOI in patients who underwent right vs extended right hemicolectomy at Tauranga Hospital. Patients were divided and compared depending on approach (open versus laparoscopic) and acuity (acute versus elective). Exclusion criteria included synchronous major operations and patients preoperatively on parenteral nutrition. Primary outcome was PPOI as pre-defined in contemporary literature. Secondary outcomes were time to passage of flatus, passage of stool, toleration of oral diet and rate of complications. Results: There were 669 patients identified for analysis (507 laparoscopic vs 162 open; 194 acute vs 475 elective). Early analysis indicates rates of PPOI was significantly increased in patients undergoing extended right hemicolectomy. Factors including age, gender, ethnicity, preoperative haemaglobin, preoperative albumin and diagnosis of inflammatory bowel disease were examined by multivariate analysis to determine correlation with PPOI. Conclusion: PPOI is a common complication of hemicolectomy surgery. Higher rates of PPOI in extended right vs right hemicolectomy warrants further research into determining the cause. This study examines some other factors which may contribute to PPOI.

Keywords: hemicolectomy, colorectal, complications, postoperative ileus

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2193 Effect of Postweld Soaking Temperature on Mechanical Properties of AISI 1018 Steel Plate Welded in Aqueous Environment

Authors: Yahaya Taiwo, Adedayo M. Segun

Abstract:

This study investigated the effect of postweld soaking temperature on mechanical properties of AISI 1018 steel plate welded in aqueous environment. Pairs of 90 x 70 x 12 mm, AISI 1018 steel plates were welded with weld zone beyond distance 10 mm from weld centerline immersed in a water jacket at 25°C. The welded specimens were tempered at temperature of 200, 300, 400, 500 and 600°C for 1.5 hours. Tensile, hardness and toughness tests at distances 15, 30, 45 and 60 mm from the weld centreline with micro structural evaluation were carried out. The results show that the aqueous environment as-weld sample exhibited higher hardness and tensile strength values of 45.3 HV and 448.12 N/mm2 respectively while the hardness and tensile strength of aqueous environment postweld heat treated samples were 44.9 HV and 378.98 N/mm2. This revealed 0.82% and 15.4% reduction in hardness and strength respectively. The metallographic tests showed that the postweld heat treated AISI 1018 steel micro structure contained tempered martensite with ferritic structure and precipitation of carbides. Postweld heat treatment produced materials of lower hardness and improved toughness.

Keywords: air weld samples, aqueous environment weld samples, soaking temperature, water jacket

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2192 Experimental Device for Fluorescence Measurement by Optical Fiber Combined with Dielectrophoretic Sorting in Microfluidic Chips

Authors: Jan Jezek, Zdenek Pilat, Filip Smatlo, Pavel Zemanek

Abstract:

We present a device that combines fluorescence spectroscopy with fiber optics and dielectrophoretic micromanipulation in PDMS (poly-(dimethylsiloxane)) microfluidic chips. The device allows high speed detection (in the order of kHz) of the fluorescence signal, which is coming from the sample by an inserted optical fiber, e.g. from a micro-droplet flow in a microfluidic chip, or even from the liquid flowing in the transparent capillary, etc. The device uses a laser diode at a wavelength suitable for excitation of fluorescence, excitation and emission filters, optics for focusing the laser radiation into the optical fiber, and a highly sensitive fast photodiode for detection of fluorescence. The device is combined with dielectrophoretic sorting on a chip for sorting of micro-droplets according to their fluorescence intensity. The electrodes are created by lift-off technology on a glass substrate, or by using channels filled with a soft metal alloy or an electrolyte. This device found its use in screening of enzymatic reactions and sorting of individual fluorescently labelled microorganisms. The authors acknowledge the support from the Grant Agency of the Czech Republic (GA16-07965S) and Ministry of Education, Youth and Sports of the Czech Republic (LO1212) together with the European Commission (ALISI No. CZ.1.05/2.1.00/01.0017).

Keywords: dielectrophoretic sorting, fiber optics, laser, microfluidic chips, microdroplets, spectroscopy

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2191 The Impact of Gestational Weight Gain on Subclinical Atherosclerosis, Placental Circulation and Neonatal Complications

Authors: Marina Shargorodsky

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Aim: Gestational weight gain (GWG) has been related to altering future weight-gain curves and increased risks of obesity later in life. Obesity may contribute to vascular atherosclerotic changes as well as excess cardiovascular morbidity and mortality observed in these patients. Noninvasive arterial testing, such as ultrasonographic measurement of carotid IMT, is considered a surrogate for systemic atherosclerotic disease burden and is predictive of cardiovascular events in asymptomatic individuals as well as recurrent events in patients with known cardiovascular disease. Currently, there is no consistent evidence regarding the vascular impact of excessive GWG. The present study was designed to investigate the impact of GWG on early atherosclerotic changes during late pregnancy, using intima-media thickness, as well as placental vascular circulation and inflammatory lesions and pregnancy outcomes. Methods: The study group consisted of 59 pregnant women who gave birth and underwent a placental histopathological examination at the Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Israel, in 2019. According to the IOM guidelines the study group has been divided into two groups: Group 1 included 32 women with pregnancy weight gain within recommended range; Group 2 included 27 women with excessive weight gain during pregnancy. The IMT was measured from non-diseased intimal and medial wall layers of the carotid artery on both sides, visualized by high-resolution 7.5 MHz ultrasound (Apogee CX Color, ATL). Placental histology subdivided placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion according to the criteria of the Society for Pediatric Pathology, subdividing placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion, as well as the inflammatory response of maternal and fetal origin. Results: IMT levels differed between groups and were significantly higher in Group 1 compared to Group 2 (0.7+/-0.1 vs 0.6+/-0/1, p=0.028). Multiple linear regression analysis of IMT included variables based on their associations in univariate analyses with a backward approach. Included in the model were pre-gestational BMI, HDL cholesterol and fasting glucose. The model was significant (p=0.001) and correctly classified 64.7% of study patients. In this model, pre-pregnancy BMI remained a significant independent predictor of subclinical atherosclerosis assessed by IMT (OR 4.314, 95% CI 0.0599-0.674, p=0.044). Among placental lesions related to fetal vascular malperfusion, villous changes consistent with fetal thrombo-occlusive disease (FTOD) were significantly higher in Group 1 than in Group 2, p=0.034). In Conclusion, the present study demonstrated that excessive weight gain during pregnancy is associated with an adverse effect on early stages of subclinical atherosclerosis, placental vascular circulation and neonatal complications. The precise mechanism for these vascular changes, as well as the overall clinical impact of weight control during pregnancy on IMT, placental vascular circulation as well as pregnancy outcomes, deserves further investigation.

Keywords: obesity, pregnancy, complications, weight gain

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2190 Optimization of Wire EDM Parameters for Fabrication of Micro Channels

Authors: Gurinder Singh Brar, Sarbjeet Singh, Harry Garg

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Wire Electric Discharge Machining (WEDM) is thermal machining process capable of machining very hard electrically conductive material irrespective of their hardness. WEDM is being widely used to machine micro-scale parts with the high dimensional accuracy and surface finish. The objective of this paper is to optimize the process parameters of wire EDM to fabricate the microchannels and to calculate the surface finish and material removal rate of microchannels fabricated using wire EDM. The material used is aluminum 6061 alloy. The experiments were performed using CNC wire cut electric discharge machine. The effect of various parameters of WEDM like pulse on time (TON) with the levels (100, 150, 200), pulse off time (TOFF) with the levels (25, 35, 45) and current (IP) with the levels (105, 110, 115) were investigated to study the effect on output parameter i.e. Surface Roughness and Material Removal Rate (MRR). Each experiment was conducted under different conditions of a pulse on time, pulse off time and peak current. For material removal rate, TON and Ip were the most significant process parameter. MRR increases with the increase in TON and Ip and decreases with the increase in TOFF. For surface roughness, TON and Ip have the maximum effect and TOFF was found out to be less effective.

Keywords: microchannels, Wire Electric Discharge Machining (WEDM), Metal Removal Rate (MRR), surface finish

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2189 Numerical Simulation of Fracturing Behaviour of Pre-Cracked Crystalline Rock Using a Cohesive Grain-Based Distinct Element Model

Authors: Mahdi Saadat, Abbas Taheri

Abstract:

Understanding the cracking response of crystalline rocks at mineralogical scale is of great importance during the design procedure of mining structures. A grain-based distinct element model (GBM) is employed to numerically study the cracking response of Barre granite at micro- and macro-scales. The GBM framework is augmented with a proposed distinct element-based cohesive model to reproduce the micro-cracking response of the inter- and intra-grain contacts. The cohesive GBM framework is implemented in PFC2D distinct element codes. The microstructural properties of Barre granite are imported in PFC2D to generate synthetic specimens. The microproperties of the model is calibrated against the laboratory uniaxial compressive and Brazilian split tensile tests. The calibrated model is then used to simulate the fracturing behaviour of pre-cracked Barre granite with different flaw configurations. The numerical results of the proposed model demonstrate a good agreement with the experimental counterparts. The GBM framework proposed thus appears promising for further investigation of the influence of grain microstructure and mineralogical properties on the cracking behaviour of crystalline rocks.

Keywords: discrete element modelling, cohesive grain-based model, crystalline rock, fracturing behavior

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2188 Oscillatory Electroosmotic Flow of Power-Law Fluids in a Microchannel

Authors: Rubén Bãnos, José Arcos, Oscar Bautista, Federico Méndez

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The Oscillatory electroosmotic flow (OEOF) in power law fluids through a microchannel is studied numerically. A time-dependent external electric field (AC) is suddenly imposed at the ends of the microchannel which induces the fluid motion. The continuity and momentum equations in the x and y direction for the flow field were simplified in the limit of the lubrication approximation theory (LAT), and then solved using a numerical scheme. The solution of the electric potential is based on the Debye-H¨uckel approximation which suggest that the surface potential is small,say, smaller than 0.025V and for a symmetric (z : z) electrolyte. Our results suggest that the velocity profiles across the channel-width are controlled by the following dimensionless parameters: the angular Reynolds number, Reω, the electrokinetic parameter, ¯κ, defined as the ratio of the characteristic length scale to the Debye length, the parameter λ which represents the ratio of the Helmholtz-Smoluchowski velocity to the characteristic length scale and the flow behavior index, n. Also, the results reveal that the velocity profiles become more and more non-uniform across the channel-width as the Reω and ¯κ are increased, so oscillatory OEOF can be really useful in micro-fluidic devices such as micro-mixers.

Keywords: low zeta potentials, non-newtonian, oscillatory electroosmotic flow, power-law model

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2187 Mixing Enhancement with 3D Acoustic Streaming Flow Patterns Induced by Trapezoidal Triangular Structure Micromixer Using Different Mixing Fluids

Authors: Ayalew Yimam Ali

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The T-shaped microchannel is used to mix both miscible or immiscible fluids with different viscosities. However, mixing at the entrance of the T-junction microchannel can be difficult mixing phenomena due to micro-scale laminar flow aspects with the two miscible high-viscosity water-glycerol fluids. One of the most promising methods to improve mixing performance and diffusion mass transfer in laminar flow phenomena is acoustic streaming (AS), which is a time-averaged, second-order steady streaming that can produce rolling motion in the microchannel by oscillating a low-frequency range acoustic transducer and inducing an acoustic wave in the flow field. The newly developed 3D trapezoidal, triangular structure spine used in this study was created using sophisticated CNC machine cutting tools used to create microchannel mold with a 3D trapezoidal triangular structure spine alone the T-junction longitudinal mixing region. In order to create the molds for the 3D trapezoidal structure with the 3D sharp edge tip angles of 30° and 0.3mm trapezoidal, triangular sharp edge tip depth from PMMA glass (Polymethylmethacrylate) with advanced CNC machine and the channel manufactured using PDMS (Polydimethylsiloxane) which is grown up longitudinally on the top surface of the Y-junction microchannel using soft lithography nanofabrication strategies. Flow visualization of 3D rolling steady acoustic streaming and mixing enhancement with high-viscosity miscible fluids with different trapezoidal, triangular structure longitudinal length, channel width, high volume flow rate, oscillation frequency, and amplitude using micro-particle image velocimetry (μPIV) techniques were used to study the 3D acoustic streaming flow patterns and mixing enhancement. The streaming velocity fields and vorticity flow fields show 16 times more high vorticity maps than in the absence of acoustic streaming, and mixing performance has been evaluated at various amplitudes, flow rates, and frequencies using the grayscale value of pixel intensity with MATLAB software. Mixing experiments were performed using fluorescent green dye solution with de-ionized water in one inlet side of the channel, and the de-ionized water-glycerol mixture on the other inlet side of the T-channel and degree of mixing was found to have greatly improved from 67.42% without acoustic streaming to 0.96.83% with acoustic streaming. The results show that the creation of a new 3D steady streaming rolling motion with a high volume flowrate around the entrance was enhanced by the formation of a new, three-dimensional, intense streaming rolling motion with a high-volume flowrate around the entrance junction mixing zone with the two miscible high-viscous fluids which are influenced by laminar flow fluid transport phenomena.

Keywords: micro fabrication, 3d acoustic streaming flow visualization, micro-particle image velocimetry, mixing enhancement.

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2186 Effects of Bulblet Induction Medium on Bulb Size and Weight of Endemic Fritillaria aurea Schoot after Treatment with Putrescine for Different Durations of Time

Authors: Suleyman Kizil, Khalid Mahmood Khavar

Abstract:

Fritillaria aurea Schott is an important horticultural crop with high economic potential for the ornamental plant industry and is endemic to the Central and South-Eastern Anatolian regions of Türkiye. This study reports an experiment conducted under in vitro conditions to improve the weight and diameter of the in vitro regenerated bulblets. The micro bulblets used in this study were obtained from callus induced on half-sliced bulblets cultured on MS medium containing 0.1 mg L⁻¹ NAA + 0.05 TDZ (R₁ medium) and 0.1 mg L⁻¹ NAA + 0.10 mg L⁻¹ TDZ (R₂ medium). Thereafter, the micro bulblets obtained from here were treated with 50 mg L⁻¹ putrescine, (tetramethylenediamine) for 3, 5, and 7 weeks. The putrescine treatment has a significant effect on the increase in diameter and weight of bulblets when compared to initial diameters, irrespective of the treatment periods and seed germination medium. When the duration of putrescine in weeks was compared, 7 weeks of treatments with putrescine were more conducive for induction in bulblet weight compared to 3 and 5 weeks treatment periods. Maximum seed weight of 0.52 grams was noted on 7 weeks of putrescine treated bulblets regenerated on 0.1 mg L⁻¹ TDZ. This strategy to increase bulb weight and diameter could be positively used to conserve and multiply this beautiful ornamental and endemic plant species.

Keywords: Fritillaria aurea, bulblet, diameter, weight, micropropagation, polyamine

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2185 A New Optimization Algorithm for Operation of a Microgrid

Authors: Sirus Mohammadi, Rohala Moghimi

Abstract:

The main advantages of microgrids are high energy efficiency through the application of Combined Heat and Power (CHP), high quality and reliability of the delivered electric energy and environmental and economic advantages. This study presents an energy management system (EMS) to optimize the operation of the microgrid (MG). In this paper an Adaptive Modified Firefly Algorithm (AMFA) is presented for optimal operation of a typical MG with renewable energy sources (RESs) accompanied by a back-up Micro-Turbine/Fuel Cell/Battery hybrid power source to level the power mismatch or to store the energy surplus when it’s needed. The problem is formulated as a nonlinear constraint problem to minimize the total operating cost. The management of Energy storage system (ESS), economic load dispatch and operation optimization of distributed generation (DG) are simplified into a single-object optimization problem in the EMS. The proposed algorithm is tested on a typical grid-connected MG including WT/PV/Micro Turbine/Fuel Cell and Energy Storage Devices (ESDs) then its superior performance is compared with those from other evolutionary algorithms such as Genetic Algorithm (GA), Particle Swarm Optimization (PSO), Fuzzy Self Adaptive PSO (FSAPSO), Chaotic Particle PSO (CPSO), Adaptive Modified PSO (AMPSO), and Firefly Algorithm (FA).

Keywords: microgrid, operation management, optimization, firefly algorithm (AMFA)

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2184 Diagnosis of Gingivitis Based on Correlations of Laser Doppler Data and Gingival Fluid Cytology

Authors: A. V. Belousov, Yakushenko

Abstract:

One of the main problems of modern dentistry is development a reliable method to detect inflammation in the gums on the stages of diagnosis and assessment of treatment efficacy. We have proposed a method of gingival fluid intake, which successfully combines accessibility, excluding the impact of the annoying and damaging the gingival sulcus factors and provides reliable results (patent of RF№ 2342956 Method of gingival fluid intake). The objects of the study were students - volunteers of Dentistry Faculty numbering 75 people aged 20-21 years. Cellular composition of gingival fluid was studied using microscope "Olympus CX 31" (Japan) with the calculation of epithelial leukocyte index (ELI). Assessment of gingival micro circulation was performed using the apparatus «LAKK–01» (Lazma, Moscow). Cytological investigation noted the highly informative of epithelial leukocyte index (ELI), which demonstrated changes in the mechanisms of protection gums. The increase of ELI occurs during inhibition mechanisms of phagocytosis and activation of epithelial desquamation. The cytological data correlate with micro circulation indicators obtained by laser Doppler flowmetry. We have identified and confirmed the correlations between parameters laser Doppler flowmetry and data cytology gingival fluid in patients with gingivitis.

Keywords: gingivitis, laser doppler flowmetry, gingival fluid cytology, epithelial leukocyte index (ELI)

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2183 Quality of Care for the Maternal Complications at Selected Primary and Secondary Health Facilities of Bangladesh: Lessons Learned from a Formative Research

Authors: Mohiuddin Ahsanul Kabir Chowdhury, Nafisa Lira Huq, Afroza Khanom, Rafiqul Islam, Abdullah Nurus Salam Khan, Farhana Karim, Nabila Zaka, Shams El Arifeen, Sk. Masum Billah

Abstract:

After having astounding achievements in reducing maternal mortality and achieving the target for Millennium Development Goal (MDG) 5, the Government of Bangladesh has set new target to reduce Maternal Mortality Ratio (MMR) to 70 per 100,000 live births aligning with targets of Sustainable Development Goals (SDGs). Aversion of deaths from maternal complication by ensuring quality health care could be an important path to accelerate the rate of reduction of MMR. This formative research was aimed at exploring the provision of quality maternal health services at different level of health facilities. The study was conducted in 1 district hospital (DH) and 4 Upazila health complexes (UHC) of Kurigram district of Bangladesh, utilizing both quantitative and qualitative research methods. We conducted 14 key informant interviews with facility managers and 20 in-depth interviews with health care providers and support staff. Besides, we observed 387 normal deliveries from which we found 17 cases of post partum haemorrhage (PPH) and 2 cases of eclampsia during the data collection period extended from July-September 2016. The quantitative data were analyzed by using descriptive statistics, and the qualitative component underwent thematic analysis with the broad themes of facility readiness for maternal complication management, and management of complications. Inadequacy in human resources has been identified as the most important bottleneck to provide quality care to manage maternal complications. The DH had a particular paucity of human resources in medical officer cadre where about 61% posts were unfilled. On the other hand, in the UHCs the positions mostly empty were obstetricians (75%, paediatricians (75%), staff nurses (65%), and anaesthetists (100%). The workload on the existing staff is increased because of the persistence of vacant posts. Unavailability of anesthetists and consultants does not permit the health care providers (HCP) of lower cadres to perform emergency operative procedures and forces them to refer the patients although referral system is not well organized in rural Bangladesh. Insufficient bed capacity, inadequate training, shortage of emergency medicines etc. are other hindrance factors for facility readiness. Among the 387 observed delivery case, 17 (4.4%) were identified as PPH cases, and only 2 cases were found as eclampsia/pre-eclampsia. The majority of the patients were treated with uterine message (16 out of 17, 94.1%) and injectable Oxytocin (14 out of 17, 82.4%). The providers of DH mentioned that they can manage the PPH because of having provision for diagnostic and blood transfusion services, although not as 24/7 services. Regarding management of eclampsia/pre-eclampsia, HCPs provided Diazepam, MgSO4, and other anti-hypertensives. The UHCs did not have MgSO4 at stock even, and one facility manager admitted that they treat eclampsia with Diazepam only. The nurses of the UHCs were found to be afraid to handle eclampsia cases. The upcoming interventions must ensure refresher training of service providers, continuous availability of essential medicine and equipment needed for complication management, availability of skilled health workforce, availability of functioning blood transfusion unit and pairing of consultants and anaesthetists to reach the newly set targets altogether.

Keywords: Bangladesh, health facilities, maternal complications, quality of care

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2182 Experimental investigation on the lithium-Ion Battery Thermal Management System Based on Micro Heat Pipe Array in High Temperature Environment

Authors: Ruyang Ren, Yaohua Zhao, Yanhua Diao

Abstract:

The intermittent and unstable characteristics of renewable energy such as solar energy can be effectively solved through battery energy storage system. Lithium-ion battery is widely used in battery energy storage system because of its advantages of high energy density, small internal resistance, low self-discharge rate, no memory effect and long service life. However, the performance and service life of lithium-ion battery is seriously affected by its operating temperature. Thus, the safety operation of the lithium-ion battery module is inseparable from an effective thermal management system (TMS). In this study, a new type of TMS based on micro heat pipe array (MHPA) for lithium-ion battery is established, and the TMS is applied to a battery energy storage box that needs to operate at a high temperature environment of 40 °C all year round. MHPA is a flat shape metal body with high thermal conductivity and excellent temperature uniformity. The battery energy storage box is composed of four battery modules, with a nominal voltage of 51.2 V, a nominal capacity of 400 Ah. Through the excellent heat transfer characteristics of the MHPA, the heat generated by the charge and discharge process can be quickly transferred out of the battery module. In addition, if only the MHPA cannot meet the heat dissipation requirements of the battery module, the TMS can automatically control the opening of the external fan outside the battery module according to the temperature of the battery, so as to further enhance the heat dissipation of the battery module. The thermal management performance of lithium-ion battery TMS based on MHPA is studied experimentally under different ambient temperatures and the condition to turn on the fan or not. Results show that when the ambient temperature is 40 °C and the fan is not turned on in the whole charge and discharge process, the maximum temperature of the battery in the energy storage box is 53.1 °C and the maximum temperature difference in the battery module is 2.4 °C. After the fan is turned on in the whole charge and discharge process, the maximum temperature is reduced to 50.1 °C, and the maximum temperature difference is reduced to 1.7 °C. Obviously, the lithium-ion battery TMS based on MHPA not only could control the maximum temperature of the battery below 55 °C, but also ensure the excellent temperature uniformity of the battery module. In conclusion, the lithium-ion battery TMS based on MHPA can ensure the safe and stable operation of the battery energy storage box in high temperature environment.

Keywords: heat dissipation, lithium-ion battery thermal management, micro heat pipe array, temperature uniformity

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2181 Flow Visualization and Mixing Enhancement in Y-Junction Microchannel with 3D Acoustic Streaming Flow Patterns Induced by Trapezoidal Triangular Structure using High-Viscous Liquids

Authors: Ayalew Yimam Ali

Abstract:

The Y-shaped microchannel is used to mix both miscible or immiscible fluids with different viscosities. However, mixing at the entrance of the Y-junction microchannel can be a difficult mixing phenomena due to micro-scale laminar flow aspects with the two miscible high-viscosity water-glycerol fluids. One of the most promising methods to improve mixing performance and diffusion mass transfer in laminar flow phenomena is acoustic streaming (AS), which is a time-averaged, second-order steady streaming that can produce rolling motion in the microchannel by oscillating a low-frequency range acoustic transducer and inducing an acoustic wave in the flow field. The developed 3D trapezoidal, triangular structure spine used in this study was created using sophisticated CNC machine cutting tools used to create microchannel mold with a 3D trapezoidal triangular structure spine alone the Y-junction longitudinal mixing region. In order to create the molds for the 3D trapezoidal structure with the 3D sharp edge tip angles of 30° and 0.3mm trapezoidal triangular sharp edge tip depth from PMMA glass (Polymethylmethacrylate) with advanced CNC machine and the channel manufactured using PDMS (Polydimethylsiloxane) which is grown up longitudinally on top surface of the Y-junction microchannel using soft lithography nanofabrication strategies. Flow visualization of 3D rolling steady acoustic streaming and mixing enhancement with high-viscosity miscible fluids with different trapezoidal, triangular structure longitudinal length, channel width, high volume flow rate, oscillation frequency, and amplitude using micro-particle image velocimetry (μPIV) techniques were used to study the 3D acoustic streaming flow patterns and mixing enhancement. The streaming velocity fields and vorticity flow fields show 16 times more high vorticity maps than in the absence of acoustic streaming, and mixing performance has been evaluated at various amplitudes, flow rates, and frequencies using the grayscale value of pixel intensity with MATLAB software. Mixing experiments were performed using fluorescent green dye solution with de-ionized water in one inlet side of the channel, and the de-ionized water-glycerol mixture on the other inlet side of the Y-channel and degree of mixing was found to have greatly improved from 67.42% without acoustic streaming to 0.96.83% with acoustic streaming. The results show that the creation of a new 3D steady streaming rolling motion with a high volume flowrate around the entrance was enhanced by the formation of a new, three-dimensional, intense streaming rolling motion with a high-volume flowrate around the entrance junction mixing zone with the two miscible high-viscous fluids which are influenced by laminar flow fluid transport phenomena.

Keywords: micro fabrication, 3d acoustic streaming flow visualization, micro-particle image velocimetry, mixing enhancement

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2180 Multiscale Modeling of Damage in Textile Composites

Authors: Jaan-Willem Simon, Bertram Stier, Brett Bednarcyk, Evan Pineda, Stefanie Reese

Abstract:

Textile composites, in which the reinforcing fibers are woven or braided, have become very popular in numerous applications in aerospace, automotive, and maritime industry. These textile composites are advantageous due to their ease of manufacture, damage tolerance, and relatively low cost. However, physics-based modeling of the mechanical behavior of textile composites is challenging. Compared to their unidirectional counterparts, textile composites introduce additional geometric complexities, which cause significant local stress and strain concentrations. Since these internal concentrations are primary drivers of nonlinearity, damage, and failure within textile composites, they must be taken into account in order for the models to be predictive. The macro-scale approach to modeling textile-reinforced composites treats the whole composite as an effective, homogenized material. This approach is very computationally efficient, but it cannot be considered predictive beyond the elastic regime because the complex microstructural geometry is not considered. Further, this approach can, at best, offer a phenomenological treatment of nonlinear deformation and failure. In contrast, the mesoscale approach to modeling textile composites explicitly considers the internal geometry of the reinforcing tows, and thus, their interaction, and the effects of their curved paths can be modeled. The tows are treated as effective (homogenized) materials, requiring the use of anisotropic material models to capture their behavior. Finally, the micro-scale approach goes one level lower, modeling the individual filaments that constitute the tows. This paper will compare meso- and micro-scale approaches to modeling the deformation, damage, and failure of textile-reinforced polymer matrix composites. For the mesoscale approach, the woven composite architecture will be modeled using the finite element method, and an anisotropic damage model for the tows will be employed to capture the local nonlinear behavior. For the micro-scale, two different models will be used, the one being based on the finite element method, whereas the other one makes use of an embedded semi-analytical approach. The goal will be the comparison and evaluation of these approaches to modeling textile-reinforced composites in terms of accuracy, efficiency, and utility.

Keywords: multiscale modeling, continuum damage model, damage interaction, textile composites

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2179 Research and Innovation Centre

Authors: Krasimir Ivanov, Tonyo Tonev, Nguyen Nguyen, Alexander Peltekov, Anyo Mitkov

Abstract:

Maize is among the most economically important crops and at the same time one of the most sensitive to soil deficiency in zinc. In this paper, the impact of the foliar zinc application in the form of zinc hydroxy nitrate suspension on the micro and macro elements partitioning in maize leaves and grain was studied during spring maize season, 2017. The impact of the foliar zinc fertilization on the grain yield and quality was estimated too. The experiment was performed by the randomized block design with 8 variants in 3 replications. Seven suspension solutions whit different Zn concentration were used, including ZnO suspension and zinc hydroxyl nitrate alone or nixed with other nutrients. Fertilization and irrigation were the same for all variants. The Zn content and the content of selected micro (Cu, Fe) and macro (Ca, Mg, P and K) elements in maize leaves were determined two weeks after the first spraying (5-6 sheets), two weeks after the second spraying (9-10 sheets) and after harvesting. It was concluded that the synthesized zinc hydroxy nitrate demonstrates potential as the long-term foliar fertilizer. A significant (p < 0.05) effect of zinc accumulation in maize leaves by foliar zinc application during the first growth stage was found, followed by its reutilization to other plants organs during the second growth stage. Significant export of Cu, P, and K from lower and middle leaves was observed. The content of Ca and Mg remains constant in the whole longevity period, while the content of Fe decreases sharply.

Keywords: foliar fertilization, zinc hydroxy nitrate, maize, zinc

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2178 Shaped Crystal Growth of Fe-Ga and Fe-Al Alloy Plates by the Micro Pulling down Method

Authors: Kei Kamada, Rikito Murakami, Masahiko Ito, Mototaka Arakawa, Yasuhiro Shoji, Toshiyuki Ueno, Masao Yoshino, Akihiro Yamaji, Shunsuke Kurosawa, Yuui Yokota, Yuji Ohashi, Akira Yoshikawa

Abstract:

Techniques of energy harvesting y have been widely developed in recent years, due to high demand on the power supply for ‘Internet of things’ devices such as wireless sensor nodes. In these applications, conversion technique of mechanical vibration energy into electrical energy using magnetostrictive materials n have been brought to attention. Among the magnetostrictive materials, Fe-Ga and Fe-Al alloys are attractive materials due to the figure of merits such price, mechanical strength, high magnetostrictive constant. Up to now, bulk crystals of these alloys are produced by the Bridgman–Stockbarger method or the Czochralski method. Using these method big bulk crystal up to 2~3 inch diameter can be grown. However, non-uniformity of chemical composition along to the crystal growth direction cannot be avoid, which results in non-uniformity of magnetostriction constant and reduction of the production yield. The micro-pulling down (μ-PD) method has been developed as a shaped crystal growth technique. Our group have reported shaped crystal growth of oxide, fluoride single crystals with different shape such rod, plate tube, thin fiber, etc. Advantages of this method is low segregation due to high growth rate and small diffusion of melt at the solid-liquid interface, and small kerf loss due to near net shape crystal. In this presentation, we report the shaped long plate crystal growth of Fe-Ga and Fe-Al alloys using the μ-PD method. Alloy crystals were grown by the μ-PD method using calcium oxide crucible and induction heating system under the nitrogen atmosphere. The bottom hole of crucibles was 5 x 1mm² size. A <100> oriented iron-based alloy was used as a seed crystal. 5 x 1 x 320 mm³ alloy crystal plates were successfully grown. The results of crystal growth, chemical composition analysis, magnetostrictive properties and a prototype vibration energy harvester are reported. Furthermore, continuous crystal growth using powder supply system will be reported to minimize the chemical composition non-uniformity along the growth direction.

Keywords: crystal growth, micro-pulling-down method, Fe-Ga, Fe-Al

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2177 Applying Dictogloss Technique to Improve Auditory Learners’ Writing Skills in Second Language Learning

Authors: Aji Budi Rinekso

Abstract:

There are some common problems that are often faced by students in writing. The problems are related to macro and micro skills of writing, such as incorrect spellings, inappropriate diction, grammatical errors, random ideas, and irrelevant supporting sentences. Therefore, it is needed a teaching technique that can solve those problems. Dictogloss technique is a teaching technique that involves listening practices. So, it is a suitable teaching technique for students with auditory learning style. Dictogloss technique comprises of four basic steps; (1) warm up, (2) dictation, (3) reconstruction and (4) analysis and correction. Warm up is when students find out about topics and do some preparatory vocabulary works. Then, dictation is when the students listen to texts read at normal speed by a teacher. The text is read by the teacher twice where at the first reading the students only listen to the teacher and at the second reading the students listen to the teacher again and take notes. Next, reconstruction is when the students discuss the information from the text read by the teacher and start to write a text. Lastly, analysis and correction are when the students check their writings and revise them. Dictogloss offers some advantages in relation to the efforts of improving writing skills. Through the use of dictogloss technique, students can solve their problems both on macro skills and micro skills. Easier to generate ideas and better writing mechanics are the benefits of dictogloss.

Keywords: auditory learners, writing skills, dictogloss technique, second language learning

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2176 Needle Track Technique In Strabismus Surgery

Authors: Seema Dutt Bandhu, Yashi Bansal, Tania Moudgil, Barinder Kaur

Abstract:

Introduction: Scleral perforation during the passage of suture needle is a known complication of strabismus surgery. The present study was conducted to evolve a safe and easy technique of passing the suture needle through the sclera. A scleral tunnel was created with a 26-guage needle through which the suture needle was passed. The rest of the steps of strabismus surgery were carried out as usual. Material and Methods: After taking clearance from the Institutional Ethics Committee, an interventional study was carried out on twenty patients. The scleral tunnel technique was performed on the patients of strabismus after taking written informed consent. Before passing the suture needle through the sclera during strabismus surgery, a tunnel through approximately half the thickness of the sclera was created with the help of a bent 26-gauge needle. The suture needle was then passed through this tunnel. Rest of the steps of the surgery were carried out in the conventional manner. In a control group of same number of patients, the surgery was performed in the conventional method. Both the groups were followed up for any complications. Ease of passing suture and surgeons’ satisfaction with the technique was noted on a 10-point Likert scale. Results: None of the patients in either group suffered from any complications. Four surgeons participated in the study. The average Likert scale score of the surgeons for satisfaction with the technique was 4.5 on a scale of 5. The score for ease of passage of suture needle was 5 on a score of 5. Discussion: Scleral perforation during passing the sutures through the sclera is a known complication of strabismus surgery. Incidence reported is 7.8% It occurs due to inappropriate engagement of the scleral tissue or passage of the suture needle along a wrong axis during the process of passing the suture needle. The needle track technique eases the passage of passing the suture needle through the sclera as the engagement of the scleral tissue can be done with greater control with a 26-guage needle. The surgeons have reported that they are highly satisfied with the technique and they have reported that the technique eased the passage of the suture needle through the sclera.

Keywords: suture, scleral tunnel, strabismus, scleral perforation

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2175 Mild Hypothermia Versus Normothermia in Patients Undergoing Cardiac Surgery: A Propensity Matched Analysis

Authors: Ramanish Ravishankar, Azar Hussain, Mahmoud Loubani, Mubarak Chaudhry

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Background and Aims: Currently, there are no strict guidelines in cardiopulmonary bypass temperature management in cardiac surgery not involving the aortic arch. This study aims to compare patient outcomes undergoing mild hypothermia and normothermia. The aim of this study was to compare patient outcomes between mild hypothermia and normothermia undergoing on-pump cardiac surgery not involving the aortic arch. Methods: This was a retrospective cohort study from January 2015 until May 2023. Patients who underwent cardiac surgery with cardiopulmonary bypass temperatures ≥32oC were included and stratified into mild hypothermia (32oC – 35oC) and normothermia (>35oC) cohorts. Propensity matching was applied through the nearest neighbour method (1:1) using the risk factors detailed in the EuroScore using RStudio. The primary outcome was mortality. Secondary outcomes included post-op stay, intensive care unit readmission, re-admission, stroke, and renal complications. Patients who had major aortic surgery and off-pump operations were excluded. Results: Each cohort had 1675 patients. There was a significant increase in overall mortality with the mild hypothermia cohort (3.59% vs. 2.32%; p=0.04912). There was also a greater stroke incidence (2.09% vs. 1.13%; p=0.0396) and transient ischaemic attack (TIA) risk (3.1% vs. 1.49%; p=0.0027). There was no significant difference in renal complications (9.13% vs. 7.88%; p=0.2155). Conclusions: Patient’s who underwent mild hypothermia during cardiopulmonary bypass have a significantly greater mortality, stroke, and transient ischaemic attack incidence. Mild hypothermia does not appear to provide any benefit over normothermia and does not appear to provide any neuroprotective benefits. This shows different results to that of other major studies; further trials and studies need to be conducted to reach a consensus.

Keywords: cardiac surgery, therapeutic hypothermia, neuroprotection, cardiopulmonary bypass

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2174 Case Report and Discussion of Natural History of Bouveret Syndrome

Authors: Parul Garg

Abstract:

Bouveret Syndrome is a rare presentation described as Gastric Outlet Obstruction secondary to Gallstone Ileus. Here we describe the 3-year progression of disease from cholelithiasis to gallstone ileus with relevant imaging findings. The patient was treated under an Upper Gastrointestinal Surgery service with surgical intervention in the form of a laparoscopic assisted procedure with midline laparotomy. She recovered well and was discharged 1 week post operatively. No complications occurred.

Keywords: Cholelithiasis, Bouveret syndrome, Gallstone Ileus, gastric outlet obstruction

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2173 Applying And Connecting The Microgrid Of Artificial Intelligence In The Form Of A Spiral Model To Optimize Renewable Energy Sources

Authors: PR

Abstract:

Renewable energy is a sustainable substitute to fossil fuels, which are depleting and attributing to global warming as well as greenhouse gas emissions. Renewable energy innovations including solar, wind, and geothermal have grown significantly and play a critical role in meeting energy demands recently. Consequently, Artificial Intelligence (AI) could further enhance the benefits of renewable energy systems. The combination of renewable technologies and AI could facilitate the development of smart grids that can better manage energy distribution and storage. AI thus has the potential to optimize the efficiency and reliability of renewable energy systems, reduce costs, and improve their overall performance. The conventional methods of using smart micro-grids are to connect these micro-grids in series or parallel or a combination of series and parallel. Each of these methods has its advantages and disadvantages. In this study, the proposal of using the method of connecting microgrids in a spiral manner is investigated. One of the important reasons for choosing this type of structure is the two-way reinforcement and exchange of each inner layer with the outer and upstream layer. With this model, we have the ability to increase energy from a small amount to a significant amount based on exponential functions. The geometry used to close the smart microgrids is based on nature.This study provides an overview of the applications of algorithms and models of AI as well as its advantages and challenges in renewable energy systems.

Keywords: artificial intelligence, renewable energy sources, spiral model, optimize

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