Search results for: clinical simulation

Authors: Mohamed Ouzzane, Mahmoud Bady

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Due to energy and environment context, research is looking for the use of clean and energy efficient system in cooling industry. In this regard, the ejector represents one of the promising solutions. The thermal ejector is a passive component used for thermal compression in refrigeration and cooling systems, usually activated by heat either waste or solar. The present study introduces a theoretical analysis of the cooling system which uses a gas ejector thermal compression. A theoretical model is developed and applied for the design and simulation of the ejector, as well as the whole cooling system. Besides the conservation equations of mass, energy and momentum, the gas dynamic equations, state equations, isentropic relations as well as some appropriate assumptions are applied to simulate the flow and mixing in the ejector. This model coupled with the equations of the other components (condenser, evaporator, pump, and generator) is used to analyze profiles of pressure and velocity (Mach number), as well as evaluation of the cycle cooling capacity. A FORTRAN program is developed to carry out the investigation. Properties of refrigerant R134a are calculated using real gas equations. Among many parameters, it is thought that the generator pressure is the cornerstone in the cycle, and hence considered as the key parameter in this investigation. Results show that the generator pressure has a great effect on the ejector and on the whole cooling system. At high generator pressures, strong shock waves inside the ejector are created, which lead to significant condenser pressure at the ejector exit. Additionally, at higher generator pressures, the designed system can deliver cooling capacity for high condensing pressure (hot season).

Keywords: air cooling system, refrigeration, thermal ejector, thermal compression

Procedia PDF Downloads 162

Authors: Mostafa Aminzadeh, Min Deng

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Modeling loss data is an important part of actuarial science. Actuaries use models to predict future losses and manage financial risk, which can be beneficial for marketing purposes. In the insurance industry, small claims happen frequently while large claims are rare. Traditional distributions such as Normal, Exponential, and inverse-Gaussian are not suitable for describing insurance data, which often show skewness and fat tails. Several authors have studied classical and Bayesian inference for parameters of composite distributions, such as Exponential-Pareto, Weibull-Pareto, and Inverse Gamma-Pareto. These models separate small to moderate losses from large losses using a threshold parameter. This research introduces a computational approach using a nonlinear regression model for loss data that relies on multiple predictors. Simulation studies were conducted to assess the accuracy of the proposed estimation method. The simulations confirmed that the proposed method provides precise estimates for regression parameters. It's important to note that this approach can be applied to datasets if goodness-of-fit tests confirm that the composite distribution under study fits the data well. To demonstrate the computations, a real data set from the insurance industry is analyzed. A Mathematica code uses the Fisher information algorithm as an iteration method to obtain the maximum likelihood estimation (MLE) of regression parameters.

Keywords: maximum likelihood estimation, fisher scoring method, non-linear regression models, composite distributions

Procedia PDF Downloads 37

Authors: Pratibha, Jyoti Kori

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Particles in industry, harvesting, coal mines, etc. may not necessarily be spherical in shape. In general, it is difficult to find perfectly spherical particle. The prediction of movement and deposition of non spherical particle in distinct airway generation is much more difficult as compared to spherical particles. Moreover, there is extensive inflexibility in deposition between ducts of a particular generation and inside every alveolar duct since particle concentrations can be much bigger than the mean acinar concentration. Consequently, a large number of particles fail to be exhaled during expiration. This study presents a mathematical model for the movement and deposition of those non-spherical particles by using particle aspect ratio and shape factor. We analyse the pulsatile behavior underneath sinusoidal wall oscillation due to periodic breathing condition through a non-Darcian porous medium or inside pulmonary region. Since the fluid is viscous and Newtonian, the generalized Navier-Stokes equation in two-dimensional coordinate system (r, z) is used with boundary-layer theory. Results are obtained for various values of Reynolds number, Womersley number, Forchsheimer number, particle aspect ratio and shape factor. Numerical computation is done by using finite difference scheme for very fine mesh in MATLAB. It is found that the overall air velocity is significantly increased by changes in aerodynamic diameter, aspect ratio, alveoli size, Reynolds number and the pulse rate; while velocity is decreased by increasing Forchheimer number.

Keywords: deposition, interstitial lung diseases, non-Darcian medium, numerical simulation, shape factor

Procedia PDF Downloads 187

Authors: Andreas Helwig, John Bell, Wangmo

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Hybrid energy storage systems (HESS) are gaining popularity for grid energy storage (ESS) driven by the increasingly dynamic nature of energy demands, requiring both high energy and high power density. Particularly the ability of energy storage systems via inverters to respond to increasing fluctuation in energy demands, the combination of lithium Iron Phosphate (LFP) battery and supercapacitor (SC) is a particular example of complex electro-chemical devices that may provide benefit to each other for pulse width modulated DC to AC inverter application. This is due to SC’s ability to respond to instantaneous, high-current demands and batteries' long-term energy delivery. However, there is a knowledge gap on the current sharing mechanism within a HESS supplying a load powered by high-frequency pulse-width modulation (PWM) switching to understand the mechanism of aging in such HESS. This paper investigates the prediction of current utilizing various equivalent circuits for SC to investigate sharing between battery and SC in MATLAB/Simulink simulation environment. The findings predict a significant reduction of battery current when the battery is used in a hybrid combination with a supercapacitor as compared to a battery-only model. The impact of PWM inverter carrier switching frequency on current requirements was analyzed between 500Hz and 31kHz. While no clear trend emerged, models predicted optimal frequencies for minimized current needs.

Keywords: hybrid energy storage, carrier frequency, PWM switching, equivalent circuit models

Procedia PDF Downloads 30

Authors: Sang-Wook Lee, So-Yeon Jeon, Min-Gi Cho, Dae-Young Shin, Sung-Ho Hwang

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Hydraulic system of excavator gets working energy from hydraulic pump which is connected to output shaft of engine. Recently, main control valve (MCV) which is composed of several independent metering valve (IMV) has been introduced for better energy efficiency of the hydraulic system so that fuel efficiency of the excavator can be improved. Excavator with IMV has 5 operating modes depending on the quantity of regeneration flow. In this system, the hydraulic pump is controlled to supply demanded flow which is needed to operate each mode. Because the regenerated flow supply energy to actuators, the hydraulic pump consumes less energy to make same motion than one that does not regenerate flow. The horse power control is applied to the hydraulic pump of excavator for maintaining engine start under a heavy load and this control makes the flow of hydraulic pump reduced. When excavator is in complex operation such as loading or unloading soil, the hydraulic pump discharges small quantity of working fluid in high pressure. At this operation, the engine of excavator does not run at optimal operating line (OOL). The engine needs to be operated on OOL to improve fuel efficiency and by controlling hydraulic pump the engine can drive on OOL. By continuous mode changing of IMV, the hydraulic pump is controlled to make engine runs on OOL. The simulation result of this study shows that fuel efficiency of excavator with IMV can be improved by considering engine OOL and continuous mode changing algorithm.

Keywords: continuous mode changing, engine fuel consumption, excavator, fuel efficiency, IMV

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Authors: Brayan Daniel Riascos Arteaga, Carlos Costa Perez

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Landfill leachate has an important fraction of humic substances, mainly humic acids (HAs), which often represent more than half value of COD, specially in liquids proceeded from composting processes of organic fraction of solid wastes. We propose in this article a new method of pH sensitive flocculation for COD and colour reduction in landfill leachate based on the chemical properties of HAs. Landfill leachate with a high content of humic acids can be efficiently treated by pH sensitive flocculation at pH 2.0, reducing COD value in 86.1% and colour in 84.7%. Mechanism of pH sensitive flocculation is based in protonation first of phenolic groups and later of carboxylic acid groups in the HAs molecules, resulting in a reduction of Zeta potential value. For pH over neutrality, carboxylic acid and phenolic groups are ionized and Zeta potential increases in absolute value, maintaining HAs in suspension as colloids and conducting flocculation to be obstructed. Ionized anionic groups (carboxylates) can interact electrostatically with cations abundant in leachate (site binding) aiding to maintain HAs in suspension. Simulation of this situation and ideal visualization of Zeta potential behavior is described in the paper and aggregation of molecules by H-bonds is proposed as the main step in separation of HAs from leachate and reduction of COD value in this complex liquid. CHNS analysis, FT-IR spectrometry and UV–VIS spectrophotometry show chemical elements content in the range of natural and commercial HAs, clear aromaticity and carboxylic acids and phenolic groups presence in the precipitate from landfill leachate

Keywords: landfill leachate, humic acids, COD, chemical treatment, flocculation

Procedia PDF Downloads 72

Authors: Tobias Huttche, Marco Canipa-Valdez, Corinne Mühlebach

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This article discusses the role of leasing on the digital transformation process of companies and corresponding economic effects. Based on the traditional mechanisms of leasing, this article focuses in particular on the benefits of leasing as financing instrument with regard to the innovation potential of companies. Practical examples demonstrate how leasing can become an integral part of new business models. Especially, with regard to the digital transformation and corresponding investments in know-how and infrastructure, leasing can play an important role. Furthermore, findings of an empirical survey are presented dealing with the usage of leasing in Switzerland in an international context. The survey shows not only the benefits of leasing against the backdrop of digital transformation but gives guidance on how other countries can benefit from promoting leasing in their legislation and economy. Based on a simulation model for Switzerland, the economic effect of an increase in leasing volume is being calculated. Again, the respective results underline the substantial growth potential. This holds true especially for economies where asset-based lending is rarely used because of a lack of entrepreneurial or private security of the borrower (cash-based financing for developing and emerging countries). Overall, the authors found that leasing using companies are more productive and tend to grow faster than companies using less or none leasing. The positive effects of leasing on emerging digital challenges for companies and entire economies should encourage other countries to facilitate access to leasing as financing instrument by decreasing legal-, tax- and accounting-related requirements in the respective jurisdiction.

Keywords: Cash-Based financing, digital transformation, financing instruments, growth, innovation, leasing

Procedia PDF Downloads 257

Authors: Bezhan Ghvaberidze

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A multiple criteria optimization approach for the solution of the Fuzzy Vehicle Routing Problem (FVRP) is proposed. For the possibility environment the levels of movements between customers are calculated by the constructed simulation interactive algorithm. The first criterion of the bi-criteria optimization problem - minimization of the expectation of total fuzzy travel time on closed routes is constructed for the FVRP. A new, second criterion – maximization of feasibility of movement on the closed routes is constructed by the Choquet finite averaging operator. The FVRP is reduced to the bi-criteria partitioning problem for the so called “promising” routes which were selected from the all admissible closed routes. The convenient selection of the “promising” routes allows us to solve the reduced problem in the real-time computing. For the numerical solution of the bi-criteria partitioning problem the -constraint approach is used. An exact algorithm is implemented based on D. Knuth’s Dancing Links technique and the algorithm DLX. The Main objective was to present the new approach for FVRP, when there are some difficulties while moving on the roads. This approach is called FVRP for extreme conditions (FVRP-EC) on the roads. Also, the aim of this paper was to construct the solving model of the constructed FVRP. Results are illustrated on the numerical example where all Pareto-optimal solutions are found. Also, an approach for more complex model FVRP with time windows was developed. A numerical example is presented in which optimal routes are constructed for extreme conditions on the roads.

Keywords: combinatorial optimization, Fuzzy Vehicle routing problem, multiple objective programming, possibility theory

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Authors: Anton V. Dolzhenko, Tahir Mehmood Khan

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An ability to make an evidence-based decision is a critically important skill required for practicing pharmacists. The development of this skill is incorporated into the pharmacy curriculum. We aimed in our study to estimate perception of pharmacy students regarding herbal medicines and their ability to assess information on herbal medicines professionally. The current Monash University curriculum in Pharmacy does not provide comprehensive study material on herbal medicines and students should find their way to find information, assess its quality and make a professional decision. In the Pharmacy course, students are trained how to apply this process to conventional medicines. In our survey of 93 undergraduate students from year 1-4 of Pharmacy course at Monash University Malaysia, we found that students’ view on herbal medicines is sometimes associated with common beliefs, which affect students’ ability to make evidence-based conclusions regarding the therapeutic potential of herbal medicines. The use of herbal medicines is widespread and 95.7% of the participated students have prior experience of using them. In the scale 1 to 10, students rated the importance of acquiring herbal medicine knowledge for them as 8.1±1.6. More than half (54.9%) agreed that herbal medicines have the same clinical significance as conventional medicines in treating diseases. Even more, students agreed that healthcare settings should give equal importance to both conventional and herbal medicine use (80.6%) and that herbal medicines should comply with strict quality control procedures as conventional medicines (84.9%). The latter statement also indicates that students consider safety issues associated with the use of herbal medicines seriously. It was further confirmed by 94.6% of students saying that the safety and toxicity information on herbs and spices are important to pharmacists and 95.7% of students admitting that drug-herb interactions may affect therapeutic outcome. Only 36.5% of students consider herbal medicines as s safer alternative to conventional medicines. The students use information on herbal medicines from various sources and media. Most of the students (81.7%) obtain information on herbal medicines from the Internet and only 20.4% mentioned lectures/workshop/seminars as a source of such information. Therefore, we can conclude that students attained the skills on the critical assessment of therapeutic properties of conventional medicines have a potential to use their skills for evidence-based decisions regarding herbal medicines.

Keywords: evidence-based decision, pharmacy education, student perception, traditional medicines

Procedia PDF Downloads 285

Authors: Sania Bashir

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A promising approach to healthcare delivery, telemedicine makes use of communication technology to reach out to remote regions of the world, allowing for beneficial interactions between diabetic patients and healthcare professionals as well as the provision of affordable and easily accessible medical care. The emergence of contemporary care models, fueled by the pervasiveness of mobile devices, provides better information, offers low cost with the best possible outcomes, and is known as digital health. It involves the integration of collected data using software and apps, as well as low-cost, high-quality outcomes. The goal of this study is to assess how well telemedicine works for diabetic patients and how it impacts their HbA1c levels. A questionnaire-based survey of 300 diabetics included 150 patients in each of the groups receiving usual care and via telemedicine. A descriptive and observational study that lasted from September 2021 to May 2022 was conducted. HbA1c has been gathered for both categories every three months. A remote monitoring tool has been used to assess the efficacy of telemedicine and continuing therapy instead of the customary three monthly meetings like in-person consultations. The patients were (42.3) 18.3 years old on average. 128 men were outnumbered by 172 women (57.3% of the total). 200 patients (66.6%) have type 2 diabetes, compared to over 100 (33.3%) candidates for type 1. Despite the average baseline BMI being within normal ranges at 23.4 kg/m², the mean baseline HbA1c (9.45 1.20) indicates that glycemic treatment is not well-controlled at the time of registration. While patients who use telemedicine experienced a mean percentage change of 10.5, those who visit the clinic experienced a mean percentage change of 3.9. Changes in HbA1c are dependent on several factors, including improvements in BMI (61%) after 9 months of research and compliance with healthy lifestyle recommendations for diet and activity. More compliance was achieved by the telemedicine group. It is an undeniable reality that patient-physician communication is crucial for enhancing health outcomes and avoiding long-term issues. Telemedicine has shown its value in the management of diabetes and holds promise as a novel technique for improved clinical-patient communication in the twenty-first century.

Keywords: diabetes, digital health, mobile app, telemedicine

Procedia PDF Downloads 92

Authors: Kbab H, Hamitouche T

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In recent years, significant progress has been accomplished in the field of aerospace propulsion and propulsion systems. These developments are associated with efforts to enhance the accuracy of the analysis of aerothermodynamic phenomena in the engine. This applies in particular to the flow in the nozzles used. One of the most remarkable processes in this field is thrust vectoring by means of devices able to orientate the thrust vector and control the deflection of the exit jet in the engine nozzle. In the study proposed, we are interested in the fluid thrust vectoring using a second injection in the nozzle divergence. This fluid injection causes complex phenomena, such as boundary layer separation, which generates a shock wave in the primary jet upstream of the fluid interacting zone (primary jet - secondary jet). This will cause the deviation of the main flow, and therefore of the thrust vector with reference to the axis nozzle. In the modeling of the fluidic thrust vector, various parameters can be used. The Mach number of the primary jet and the injected fluid, the total pressures ratio, the injection rate, the thickness of the upstream boundary layer, the injector position in the divergent part, and the nozzle geometry are decisive factors in this type of phenomenon. The complexity of the latter challenges researchers to understand the physical phenomena of the turbulent boundary layer encountered in supersonic nozzles, as well as the calculation of its thickness and the friction forces induced on the walls. The present study aims to numerically simulate the thrust vectoring by secondary injection using the ANSYS-FLUENT, then to analyze and validate the results and the performances obtained (angle of deflection, efficiency...), which will then be compared with those obtained by other authors.

Keywords: CD Nozzle, TVC, SVC, NPR, CFD, NPR, SPR

Procedia PDF Downloads 138

Authors: R. Ziaie Moayed, E. Ghanbari Alamouty

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Deep soil mixing is one of the improvement methods in geotechnical engineering which is widely used in soft soils. This article investigates the consolidation behavior of a soft clay soil which is improved by soil-cement column (SCC) by numerical modeling using Plaxis2D program. This behavior is simulated under vertical static and cyclic load which is applied on the soil surface. The static load problem is the simulation of a physical model test in an axisymmetric condition which uses a single SCC in the model center. The results of numerical modeling consist of settlement of soft soil composite, stress on soft soil and column, and excessive pore water pressure in the soil show a good correspondence with the test results. The response of soft soil composite to the cyclic load in vertical direction also compared with the static results. Also the effects of two variables namely the cement content used in a SCC and the area ratio (the ratio of the diameter of SCC to the diameter of composite soil model, a) is investigated. The results show that the stress on the column with the higher value of a, is lesser compared with the stress on other columns. Different rate of consolidation and excessive pore pressure distribution is observed in cyclic load problem. Also comparing the results of settlement of soil shows higher compressibility in the cyclic load problem.

Keywords: area ratio, consolidation behavior, cyclic load, numerical modeling, soil-cement column

Procedia PDF Downloads 154

Authors: Gizem Derya Demir, Ilayda Yankilic, Daglar Karamuftuoglu, Dante Dorantes

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ABSTRACT HAPTIC ROBOTIC GLOVE FOR TELE-EXPLORATION OF EXPLOSIVE DEVICES Gizem Derya Demir, İlayda Yankılıç, Dağlar Karamüftüoğlu, Dante J. Dorantes-González Department of Mechanical Engineering, MEF University Ayazağa Cad. No.4, 34396 Maslak, Sarıyer, İstanbul, Turkey Nowadays, terror attacks are, unfortunately, a more common threat around the world. Therefore, safety measures have become much more essential. An alternative to providing safety and saving human lives is done by robots, such as disassembling and liquidation of bombs. In this article, remote exploration and manipulation of potential explosive devices from a safe-distance are addressed by designing a novel, simple and ergonomic haptic robotic glove. SolidWorks® Computer-Aided Design, computerized dynamic simulation, and MATLAB® kinematic and static analysis were used for the haptic robotic glove and finger design. Angle controls of servo motors were made using ARDUINO® IDE codes on a Makeblock® MegaPi control card. Simple grasping dexterity solutions for the fingers were obtained using one linear soft and one angle sensors for each finger, and six servo motors are used in total to remotely control a slave multi-tooled robotic hand. This project is still undergoing and presents current results. Future research steps are also presented.

Keywords: Dexterity, Exoskeleton, Haptics , Position Control, Robotic Hand , Teleoperation

Procedia PDF Downloads 180

Authors: Lei Zhu, Nan Li

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Cold stamping has been widely applied in the automotive industry for the mass production of a great range of automotive panels. Predicting the springback to ensure the dimensional accuracy of the cold-stamped components is a critical step. The main approaches for the prediction and compensation of springback in cold stamping include running Finite Element (FE) simulations and conducting experiments, which require forming process expertise and can be time-consuming and expensive for the design of cold stamping tools. Machine learning technologies have been proven and successfully applied in learning complex system behaviours using presentative samples. These technologies exhibit the promising potential to be used as supporting design tools for metal forming technologies. This study, for the first time, presents a novel application of a Convolutional Neural Network (CNN) based surrogate model to predict the springback fields for variable U-shape cold bending geometries. A dataset is created based on the U-shape cold bending geometries and the corresponding FE simulations results. The dataset is then applied to train the CNN surrogate model. The result shows that the surrogate model can achieve near indistinguishable full-field predictions in real-time when compared with the FE simulation results. The application of CNN in efficient springback prediction can be adopted in industrial settings to aid both conceptual and final component designs for designers without having manufacturing knowledge.

Keywords: springback, cold stamping, convolutional neural networks, machine learning

Procedia PDF Downloads 152

Authors: Daeung Jung

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Background: In case of patients with missing teeth, multiple implant restoration has been widely used and is inevitable. To increase its survival rate, it is important to understand the influence of different implant designs on inter-implant crestal bone resorption. There are several implant systems designed to minimize loss of crestal bone, and the Astra Tech and Brånemark Implant are two of them. Aim/Hypothesis: The aim of this 10-year study was to compare the height of inter-implant bone crest in two implant systems; the Astra Tech and the Brånemark implant system. Material and Methods: In this retrospective study, 40 consecutively treated patients were utilized; 23 patients with 30 sites for Astra Tech system and 17 patients with 20 sites for Brånemark system. The implant restoration was comprised of splinted crown in partially edentulous patients. Radiographs were taken immediately after 1st surgery, at impression making, at prosthetics setting, and annually after loading. Lateral distance from implant to bone crest, inter-implant distance was gauged, and crestal bone height was measured from the implant shoulder to the first bone contact. Calibrations were performed with known length of thread pitch distance for vertical measurement, and known diameter of abutment or fixture for horizontal measurement using ImageJ. Results: After 10 years, patients treated with Astra Tech implant system demonstrated less inter-implant crestal bone resorption when implants had a distance of 3mm or less between them. In cases of implants that had a greater than 3 mm distance between them, however, there appeared to be no statistically significant difference in crestal bone loss between two systems. Conclusion and clinical implications: In the situation of partially edentulous patients planning to have more than two implants, the inter-implant distance is one of the most important factors to be considered. If it is impossible to make sure of having sufficient inter-implant distance, the implants with less micro gap in the fixture-abutment junction, less traumatic 2nd surgery approach, and the adequate surface topography would be choice of appropriate options to minimize inter-implant crestal bone resorption.

Keywords: implant design, crestal bone loss, inter-implant distance, 10-year retrospective study

Procedia PDF Downloads 166

Authors: Afshan Channa, Sameeha Aleem, Harim Mohsin

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First rank symptoms (FRS) are considered to be pathognomic for Schizophrenia. However, FRS is not a distinctive feature of Schizophrenia. It has also been noticed in affective disorder, albeit not inclusive in diagnostic criteria. The presence of FRS in Mania leads to misdiagnosis of psychotic illness, further complicating the management and delay of appropriate treatment. FRS in Mania is associated with poor clinical and functional outcome. Its existence in the first episode of bipolar disorder may be a predictor of poor short-term outcome and decompensating course of illness. FRS in Mania is studied in west. However, the cultural divergence and detriments make it pertinent to study the frequency of FRS in affective disorder independently in Pakistan. Objective: The frequency of first rank symptoms in manic patients, who were under treatment at psychiatric services of tertiary care hospital. Method: The cross sectional study was done at psychiatric services of Aga Khan University Hospital, Karachi, Pakistan. One hundred and twenty manic patients were recruited from November 2014 to May 2015. The patients who were unable to comprehend Urdu or had comorbid psychiatric or organic disorder were excluded. FRS was assessed by administration of validated Urdu version of Present State Examination (PSE) tool. Result: The mean age of the patients was 37.62 + 12.51. The mean number of previous manic episode was 2.17 + 2.23. 11.2% males and 30.6% females had FRS. This association of first rank symptoms with gender in patients of mania was found to be significant with a p-value of 0.008. All-inclusive, 19.2% exhibited FRS in their course of illness. 43.5% had thought broadcasting, made feeling, impulses, action and somatic passivity. 39.1% had thought insertion, 30.4% had auditory perceptual distortion, and 17.4% had thought withdrawal. However, none displayed delusional perception. Conclusion: The study confirms the presence of FRS in mania in both male and female, irrespective of the duration of current manic illness or previous number of manic episodes. A substantial difference was established between both the genders. Being married had no protective effect on the presence of FRS.

Keywords: first rank symptoms, Mania, psychosis, present state examination

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Authors: Lisa Fox, Jill Aylott

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There is a global need to identify ways to engage doctors in non-clinical matters such as medical leadership, service improvement and health system transformation. Using the core principles of Realistic Evaluation (RE), this study examined what works, for doctors of different grades, specialities and experience in an acute NHS Hospital Trust in the UK. Realistic Evaluation is an alternative to more traditional cause and effect evaluation models and seeks to understand the interdependencies of Context, Mechanism and Outcome proposing that Context (C) + Mechanism (M) = Outcome (O). In this study, the context, mechanism and outcome were examined from within individual medical leaders to determine what enables levels of medical engagement in a specific improvement project to reduce hospital inpatient mortality. Five qualitative case studies were undertaken with consultants who had regularly completed mortality reviews over a six month period. The case studies involved semi-structured interviews to test the theory behind the drivers for medical engagement. The interviews were analysed using a theory-driven thematic analysis to identify CMO configurations to explain what works, for whom and in what circumstances. The findings showed that consultants with a longer length of service became more engaged if there were opportunities to be involved in the beginning of an improvement project, with more opportunities to affect the design. Those that are new to a consultant role were more engaged if they felt able to apply any learning directly into their own settings or if they could use it as an opportunity to understand more about the organisation they are working in. This study concludes that RE is a useful methodology for better understanding the complexities of motivation and consultant engagement in a trust wide service improvement project. The study showed that there should be differentiated and bespoke training programmes to maximise each individual doctor’s propensity for medical engagement. The RE identified that there are different ways to ensure that doctors have the right skills to feel confident in service improvement projects.

Keywords: realistic evaluation, medical leadership, medical engagement, patient safety, service improvement

Procedia PDF Downloads 221

Authors: Kirsten Wilson, Patrick M. Brauer, Sandra Babic, Diana Golubeva, Jessica Van Eyk, Tinya Wang, Avanti Karkhanis, Tim A. Le Fevre, Andy I. Kokaji, Allen C. Eaves, Sharon A. Louis, , Nooshin Tabatabaei-Zavareh

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Long-lived plasma cells are rare, non-proliferative B cells generated from antibody-secreting cells (ASCs) following an immune response to protect the host against pathogen re-exposure. Despite their therapeutic potential, the lack of in vitro protocols in the field makes it challenging to use B cells as a cellular therapeutic tool. As a result, there is a need to establish robust and reproducible methods for the generation of B cells. To address this, we have developed a culture system for generating B cells from hematopoietic stem and/or progenitor cells (HSPCs) derived from human umbilical cord blood (CB) or pluripotent stem cells (PSCs). HSPCs isolated from CB were cultured using the StemSpan™ B Cell Generation Kit and produced CD19+ B cells at a frequency of 23.2 ± 1.5% and 59.6 ± 2.3%, with a yield of 91 ± 11 and 196 ± 37 CD19+ cells per input CD34+ cell on culture days 28 and 35, respectively (n = 50 - 59). CD19+IgM+ cells were detected at a frequency of 31.2 ± 2.6% and were produced at a yield of 113 ± 26 cells per input CD34+ cell on culture day 35 (n = 50 - 59). The B cell receptor loci of CB-derived B cells were sequenced to confirm V(D)J gene rearrangement. ELISpot analysis revealed that ASCs were generated at a frequency of 570 ± 57 per 10,000 day 35 cells, with an average IgM+ ASC yield of 16 ± 2 cells per input CD34+ cell (n = 33 - 42). PSC-derived HSPCs were generated using the STEMdiff™ Hematopoietic - EB reagents and differentiated to CD10+CD19+ B cells with a frequency of 4 ± 0.8% after 28 days of culture (n = 37, 1 embryonic and 3 induced pluripotent stem cell lines tested). Subsequent culture of PSC-derived HSPCs increased CD19+ frequency and generated ASCs from 1 - 2 iPSC lines. This method is the first report of a serum- and feeder-free system for the generation of B cells from CB and PSCs, enabling further B lineage-specific research for potential future clinical applications.

Keywords: stem cells, B cells, immunology, hematopoiesis, PSC, differentiation

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Authors: Umar D. M., Aminu A. M., Izaddeen K. Y.

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Deployments of mini macrocell base stations also referred to as femtocells, improve the quality of service of indoor and outdoor users. Nevertheless, mobility management remains a key issue with regards to their deployment. This paper is leaned towards this issue, with an in-depth focus on the most important aspect of mobility management -handover. In handover management, making a handover decision in the LTE two-tier macrocell femtocell network is a crucial research area. Decision algorithms in this research are classified and comparatively analyzed according to received signal strength, user equipment speed, cost function, and interference. However, it was observed that most of the discussed decision algorithms fail to consider cell selection with hybrid access policy in a single macrocell multiple femtocell scenario, another observation was a majority of these algorithms lack the incorporation of user equipment residence parameter. Not including this parameter boosts the number of unnecessary handover occurrence. To deal with these issues, a sophisticated handover decision algorithm is proposed. The proposed algorithm considers the user’s velocity, received signal strength, residence time, as well as the femtocell base station’s access policy. Simulation results have shown that the proposed algorithm reduces the number of unnecessary handovers when compared to conventional received signal strength-based handover decision algorithm.

Keywords: user-equipment, radio signal service, long term evolution, mobility management, handoff

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Authors: Ananchai Ukaew, Choopong Chauypen

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Design concepts of real-time embedded system can be realized initially by introducing novel design approaches. In this literature, model based design approach and in-the-loop testing were employed early in the conceptual and preliminary phase to formulate design requirements and perform quick real-time verification. The design and analysis methodology includes simulation analysis, model based testing, and in-the-loop testing. The design of conceptual drive-by-wire, or DBW, algorithm for electronic control unit, or ECU, was presented to demonstrate the conceptual design process, analysis, and functionality evaluation. The concepts of DBW ECU function can be implemented in the vehicle system to improve electric vehicle, or EV, conversion drivability. However, within a new development process, conceptual ECU functions and parameters are needed to be evaluated. As a result, the testing system was employed to support conceptual DBW ECU functions evaluation. For the current setup, the system components were consisted of actual DBW ECU hardware, electric vehicle models, and control area network or CAN protocol. The vehicle models and CAN bus interface were both implemented as real-time applications where ECU and CAN protocol functionality were verified according to the design requirements. The proposed system could potentially benefit in performing rapid real-time analysis of design parameters for conceptual system or software algorithm development.

Keywords: drive-by-wire ECU, in-the-loop testing, model-based design, real-time embedded system

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Authors: Mariem Saadi, Sabri Kanzari, Adel Zghibi

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In semi-arid areas like the Kairouan region, the constant irrigation with saline water and the overuse of groundwater resources, soils and aquifers salinization has become an increasing concern. In this study, a methodology has been developed to evaluate the groundwater contamination risk based on the unsaturated zone hydraulic properties. Two soil profiles with different ranges of salinity, one located in the north of the plain and another one in the south of plain (each 30 m deep) and both characterized by direct recharge of the aquifer were chosen. Simulations were conducted with Hydrus-1D code using measured precipitation data for the period 1998-2003 and calculated evapotranspiration for both chosen profiles. Four combinations of initial conditions of water content and salt concentration were used for the simulation process in order to find the best match between simulated and measured values. The success of the calibration of Hydrus-1D allowed the investigation of some scenarios in order to assess the contamination risk under different natural conditions. The aquifer risk contamination is related to the natural conditions where it increased while facing climate change and temperature increase and decreased in the presence of a clay layer in the unsaturated zone. Hydrus-1D was a useful tool to predict the groundwater level and quality in the case of a direct recharge and in the absence of any information related to the soil layers except for the texture.

Keywords: Hydrus-1D, Kairouan, salinization, semi-arid region, solute transport, unsaturated zone

Procedia PDF Downloads 185

Authors: Erich Gomes Schaitza, Antônio Francisco Savi, Glaucia Aparecida Prates

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The penetration of renewable energy into the electricity supply in Brazil is high, one of the highest in the World. Centralized hydroelectric generation is the main source of energy, followed by biomass and wind. Surprisingly, mini and micro-generation are negligible, with less than 2,000 connections to the national grid. In 2015, a new regulatory framework was put in place to change this situation. In the agricultural sector, the framework was complemented by the offer of low interest rate loans to in-farm renewable generation. Brazil proposed to more than double its area of planted forests as part of its INDC- Intended Nationally Determined Contributions to the UNFCCC-U.N. Framework Convention on Climate Change (UNFCCC). This is an ambitious target which will be achieved only if forests are attractive to farmers. Therefore, this paper analyses whether planting forests for in-farm energy generation with a with a woodchip gasifier is economically viable for microgeneration under the new framework and at if they could be an economic driver for forest plantation. At first, a static case was analyzed with data from Eucalyptus plantations in five farms. Then, a broader analysis developed with the use of Monte Carlo technique. Planting short rotation forests to generate energy could be a viable alternative and the low interest loans contribute to that. There are some barriers to such systems such as the inexistence of a mature market for small scale equipment and of a reference network of good practices and examples.

Keywords: biomass, distribuited generation, small-scale, Monte Carlo

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Authors: Xiao Yang, Ji Zhang, Yingli Song, Hui Huang, Jing Zhang, Yan Wang, Rongrong Han, Zhixuan Xiang, Lu Chen, Lingling Gao

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Aim and Objectives: To examine physical activity self-efficacy, identify its predictors, and further explore the mechanism of action among the predictors in mainland Chinese pregnant women with high risk for gestational diabetes mellitus (GDM). Background: Physical activity could protect pregnant women from developing GDM. Physical activity self-efficacy was the key predictor of physical activity. Design: A cross-sectional study was conducted from October 2021 to May 2022 in Zhengzhou, China. Methods: 252 eligible pregnant women completed the Pregnancy Physical Activity Self-efficacy Scale, the Social Support for Physical Activity Scale, the Knowledge on Physical Activity Questionnaire, the 7-item Generalized Anxiety Disorder scale, the Edinburgh Postnatal Depression Scale, and a socio-demographic data sheet. Multiple linear regression was applied to explore the predictors of physical activity self-efficacy. Structural equation modeling was used to explore the mechanism of action among the predictors. Results: Chinese pregnant women with a high risk for GDM reported a moderate level of physical activity self-efficacy. The best-fit regression analysis revealed four variables explained 17.5% of the variance in physical activity self-efficacy. Social support for physical activity was the strongest predictor, followed by knowledge of the physical activity, intention to do physical activity, and anxiety symptoms. The model analysis indicated that knowledge of physical activity could release anxiety and depressive symptoms and then increase physical activity self-efficacy. Conclusion: The present study revealed a moderate level of physical activity self-efficacy. Interventions targeting pregnant women with high risk for GDM need to include the predictors of physical activity self-efficacy. Relevance to clinical practice: To facilitate pregnant women with high risk for GDM to engage in physical activity, healthcare professionals may find assess physical activity self-efficacy and intervene as soon as possible on their first antenatal visit. Physical activity intervention programs focused on self-efficacy may be conducted in further research.

Keywords: physical activity, gestational diabetes, self-efficacy, predictors

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Authors: Mona Nada, Fahmy Fahmy

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Background: Pleomorphic dermal sarcoma is a rare form of skin cancer affecting cutaneous layer and, in some cases associated with recurrence and metastasis, very commonly to seen in elderly patient affecting the area of head and neck. Pleomorphic dermal sarcoma rises in ultraviolet light exposed areas. The symptoms and severity of this kind of skin cancer varies according to histological factors. The differentiation of Pleomorphic dermal sarcoma needs extensive immunohistochemistry, as the diagnosis depends mainly on exclusion to rule out other malignancy like poorly differentiated squamous cell carcinoma, melanoma, angiosarcoma and leiomyosarcoma. Objective: assessing the management of Pleomorphic dermal sarcoma in our unit and compared to the updated guidelines. Design: Retrospective study Collection of patient data from medical records at countess of Chester plastic surgery unit of the last 5 years, all histologically confirmed Pleomorphic dermal sarcoma (2017-2023). Data were collected confirmed to be Pleomorphic dermal sarcoma were included in the study. The data collected: clinical description of the lesions at first presentation, operation time, multidisciplinary team discussion, plan, referral as well as second operation and investigation done. With comparison of histological examination, immunohistochemistry staining, the excision and rate of recurrence. Results: data collected N19 from (2017-2023) showed the disease predominantly affecting males and the lesion mainly in head and neck, the diagnosis needed extensive immunohistochemistry to differentiate between other malignancy. recurrence present in numbers of the cases which managed after multidisciplinary team discussion either by excision or radiotherapy. Conclusion: Pleomorphic dermal sarcoma is a rare malignancy which needs more understanding and avoid missing as it is aggressive form of skin cancer, there is a chance of metastasis and recurrence which makes it very important to understand the process of development of the cancer and frequent review of the management guidelines.

Keywords: pleomorphic dermal sarcoma, recurrence, radiotherapy, surgical

Procedia PDF Downloads 73

Authors: Qi LI, Xu Lin, Nengming Lin

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Objective: The aim of this study was to investigate the role of desmocollin 2 (DSC2) protein in the proliferation, migration and drug resistance of lung cancer cells. Method: CCK-8 assays and colony formation assays were used to evaluate the effect of dsc2 regulation on cancer cell viability and colony formation. Transwell assays and wound healing assays were also performed. Cell flow double staining was used to detect the apoptosis rate of cells with DSC2, which was added cisplatin. Western blot assay was used to detect cell cycle, PI3k/Akt and apoptosis-related proteins. Results: Our data showed that dsc2 is upregulated in clinical lung cancer tissues compared with pericarcinomatous tissues, and it is differentially expressed in lung cancer cell lines. The down-regulation of dsc2 in A549 and H358 lung cancer cells significantly suppressed the cell proliferation, metastasis, and motility. In contrast, the opposite effects were observed in overexpression of dsc2 both in H23 and PC9 cell lines. In addition to lung adenocarcinoma cell lines, we also examined its expression in lung squamous cell lines, such as H226. Western blotting showed that dsc2 could reduce the level of phosphorylated Akt (Ser 473) and p-mTOR. Thus, it is speculated that dsc2 up-regulation promotes proliferation and invasiveness through activation of the PI3K/AKT pathway. Also, knockdown of dsc2 in A549 and H226 could significantly decreased in the levels of cyclinB and wee1 protein. Additionally, flow cytometry showed that dsc2 knockdown combined with cisplatin could significantly enhance cell apoptosis rate. Conclusion: These data suggest that dsc2 promotes the proliferation and migration of lung cancer cells in vitro. Also, the results suggested that dsc2 could affect the cell cycle and apoptosis of lung cells. Furthermore, knockdown of dsc2 could sensitize cisplatin in both lung adenocarcinoma and lung squamous cell lines. Thus we suggested that dsc2 can be used as a therapeutic target for lung cancer.

Keywords: desmocollin 2, cisplatin, lung cancer, PI3K/AKT, lung squamous cell

Procedia PDF Downloads 79

Authors: Vladimir Viktorov, M. Readul Mahmud, Carmen Visconte

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Numerical simulation were carried out to study the mixing of miscible liquid at different inlets volume ratio (1 to 3) within two existing mixers namely Chain, Tear-drop and one new “C-H” mixer. The new passive C-H micromixer is developed based on split and recombine principles, combining the operation concepts of known Chain mixer and H mixer. The mixing performances of the three micromixers were predicted by a preliminary numerical analysis of the flow patterns inside the channel in terms of the segregation or distribution of path lines. Afterward, the efficiency and the pressure drop were investigated numerically, taking into account species transport. All numerical calculations were computed at a wide range of Reynolds number from 1 to 100. Among the presented three micromixers, tear-drop provides fairly good efficiency except in the middle range of Re numbers but has high-pressure drop. In addition, inlets flow ratio has a significant influence on efficiency, especially at the Re number range of 10 to 50, Moreover maximum increase of efficiency is almost 10% when inlets flow ratio is increased by 1. Chain mixer presents relatively low mixing efficiency at low and middle range of Re numbers (5≤Re≤50) but has reasonable pressure drop. Furthermore, Chain mixer shows almost no dependence on inlets flow ratio. Whereas, C-H mixer poses excellent mixing efficiency (more than 93%) for all range of Re numbers and causes the lowest pressure drop, On top of that efficiency has slight dependency on inlets flow ratio. In addition, C-H mixer shows respectively about three and two times lower pressure drop than Tear-drop and Chain mixers.

Keywords: CFD, micromixing, passive micromixer, SAR

Procedia PDF Downloads 485

Authors: Chun-Wei Yeh, Santhanamoorthi Nachimuthu, Jyh-Chiang Jiang

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Reducing greenhouse gases or converting them into fuels and chemicals with added value is vital for the environment. Given the enhanced techniques for hydrocarbon extraction in this context, the catalytic conversion of methane to methanol is particularly intriguing for future applications as vehicle fuels and/or bulk chemicals. Metal-organic frameworks (MOFs) have received much attention recently for the oxidation of methane to methanol. In addition, biomimetic material, particulate methane monooxygenase (pMMO), has been reported to convert methane using copper oxide clusters as active sites. Inspired by these, in this study, we considered the well-known MIL-53(Al) MOF as support for copper oxide clusters (Cu2Ox, Cu3Ox) to investigate their reactivity towards methane oxidation using Density Functional Theory (DFT) calculations. The copper oxide clusters (Cu2O2, Cu3O2) are modeled by oxidizing copper clusters (Cu2, Cu3) with two oxidizers, O2 and N2O. The initial C-H bond activation barriers on Cu2O2/MIL-53(Al) and Cu3O2/MIL-53(Al) catalysts are 0.70 eV and 0.64 eV, respectively, and are the rate-determining steps in the overall methane conversion to methanol reactions. The desorption energy of the methanol over the Cu2O/MIL-53(Al) and Cu3O/MIL-53(Al) is 0.71eV and 0.75 eV, respectively. Furthermore, to explore the prospect of catalyst reusability, we considered the different oxidants and proposed the different reaction pathways for completing the reaction cycle and regenerating the active copper oxide clusters. To know the reason for the difference between bi-copper and tri-cooper systems, we also did an electronic analysis. Finally, we calculate the Microkinetic Simulation. The result shows that the reaction can happen at room temperature.

Keywords: DFT study, copper oxide cluster, MOFs, methane conversion

Procedia PDF Downloads 85

Authors: Erez Yerushalmi, Sani Ziv

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The rising demand for healthcare services, without a corresponding rise in public supply, led to a debate on whether to increase private healthcare provision - especially in hospital services and second-tier healthcare. Proponents for increasing private healthcare highlight gains in efficiency, while opponents its risk to social welfare. None, however, provide a measure of the social value and its impact on the economy in terms of a monetary value. In this paper, we impute a minimum social value of public healthcare that corresponds to indifference between gains in efficiency, with losses to social welfare. Our approach resembles contingent valuation methods that introduce a hypothetical market for non-commodities, but is different from them because we use numerical simulation techniques to exploit certain market failure conditions. In this paper, we develop a general equilibrium model that distinguishes between public-private healthcare services and public-private financing. Furthermore, the social value is modelled as a by product of healthcare services. The model is then calibrated to our unique health focused Social Accounting Matrix of Israel, and simulates the introduction of a hypothetical health-labour market - given that it is heavily regulated in the baseline (i.e., the true situation in Israel today). For baseline parameters, we estimate the minimum social value at around 18% public healthcare financing. The intuition is that the gain in economic welfare from improved efficiency, is offset by the loss in social welfare due to a reduction in available social value. We furthermore simulate a deregulated healthcare scenario that internalizes the imputed value of social value and searches for the optimal weight of public and private healthcare provision.

Keywords: contingent valuation method (CVM), general equilibrium model, hypothetical market, private-public healthcare, social value of public healthcare

Procedia PDF Downloads 149

Authors: A. Ascenso, C. Silveira, B. Augusto, S. Rafael, S. Coelho, J. Ferreira, A. Monteiro, P. Roebeling, A. I. Miranda

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Innovative nature-based solutions (NBSs) can provide answers to the challenges that urban areas are currently facing due to urban densification and extreme weather conditions. The effects of NBSs are recognized and include improved quality of life, mental and physical health and improvement of air quality, among others. Part of the work developed in the scope of the UNaLab project, which aims to guide cities in developing and implementing their own co-creative NBSs, intends to assess the impacts of NBSs on air quality, using Eindhoven city as a case study. The state-of-the-art online air quality modelling system WRF-CHEM was applied to simulate meteorological and concentration fields over the study area with a spatial resolution of 1 km2 for the year 2015. The baseline simulation (without NBSs) was validated by comparing the model results with monitored data retrieved from the Eindhoven air quality database, showing an adequate model performance. In addition, land use changes were applied in a set of simulations to assess the effects of different types of NBSs. Finally, these simulations were compared with the baseline scenario and the impacts of the NBSs were assessed. Reductions on pollutant concentrations, namely for NOx and PM, were found after the application of the NBSs in the Eindhoven study area. The present work is particularly important to support public planners and decision makers in understanding the effects of their actions and planning more sustainable cities for the future.

Keywords: air quality, modelling approach, nature based solutions, urban area

Procedia PDF Downloads 241

Authors: Sarita Magu, Deepak Singh

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Study Design: This prospective study was conducted at the department of Radio Diagnosis, at Pt B.D. Sharma PGIMS, Rohtak in 57 patients of spine injury on radiographs or radiographically normal patients with neurological deficits presenting within 72 hours of injury. Aims: Evaluation of the role of Magnetic Resonance Imaging (MRI) in Spinal Trauma Patients and to compare MRI findings with clinical profile and neurological status of the patient and to correlate the MRI findings with neurological recovery of the patient and predict the outcome. Material and Methods: Neurological status of patients was assessed at the time of admission and discharge in all the patients and at long term interval of six months to one year in 27 patients as per American spine injury association classification (ASIA). On MRI cord injury was categorized into cord hemorrhage, cord contusion, cord edema only, and normal cord. Quantitative assessment of injury on MRI was done using mean canal compromise (MCC), mean spinal cord compression (MSCC) and lesion length. Neurological status at admission and neurological recovery at discharge and long term follow up was compared with various qualitative cord findings and quantitative parameters on MRI. Results: Cord edema and normal cord was associated with favorable neurological outcome. Cord contusion show lesser neurological recovery as compared to cord edema. Cord hemorrhage was associated with worst neurological status at admission and poor neurological recovery. Mean MCC, MSCC, and lesion length values were higher in patients presenting with ASIA A grade injury and showed decreasing trends towards ASIA E grade injury. Patients showing neurological recovery over the period of hospital stay and long term follow up had lower mean MCC, MSCC, and lesion length as compared to patients showing no neurological recovery. The data was statistically significant with p value <.05. Conclusion: Cord hemorrhage and higher MCC, MSCC and lesion length has poor prognostic value in spine injury patients.

Keywords: spine injury, cord hemorrhage, cord contusion, MCC, MSCC, lesion length, ASIA grading

Procedia PDF Downloads 358