Search results for: high volume
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21331

Search results for: high volume

14431 Production and Purification of Salmonella Typhimurium MisL Autotransporter Protein in Escherichia coli

Authors: Neslihan Taskale Karatug, Mustafa Akcelik

Abstract:

Some literature data show that misL protein play a role on host immune response formed against Salmonella Typhimurium. The aim of the present study is to learn the role of the protein in S. Typhimurium pathogenicity. To describe certain functions of the protein, primarily recombinant misL protein was produced and purified. PCR was performed using a primer set targeted to passenger domain of the misL gene on S. Typhimurium LT2 genome. Amplicon and pet28a vector were enzymatically cleaved with EcoRI and NheI. The digested DNA materials were purified with High Pure PCR Product Purification Kit. The ligation reaction was achieved with the pure products. After preparation of competent Escherichia coli Dh5α, ligation mix was transformed into the cell by electroporation. To confirm the existence of insert gene, recombinant plasmid DNA of Dh5α was isolated with high pure plasmid DNA kit. Proved the correctness of recombinant plasmid was electroporated to BL21. The cell was induced by IPTG. After induction, the presence of recombinant protein was checked by SDS-PAGE. The recombinant misL protein was purified using HisPur Ni-NTA spin colon. The pure protein was shown by SDS-PAGE and western blot immünoassay. The concentration of the protein was measured BCA Protein Assay kit. In the wake of ligation with digested products (2 kb misL and 5.4 kb pet28a) visualised on gel size of the band was about 7.4 kb and was named as pNT01. The pNT01 recombinant plasmid was transformed into Dh5α and colonies were chosen in selective medium. Plasmid DNA isolation from them was carried out. PCR was achieved on the pNT01 to check misL and 2 kb band was observed on the agarose gel. After electroporation of the plasmid and induction of the cell, 68 kDa misL protein was seen. Subsequent to the purification of the protein, only a band was observed on SDS-PAGE. Association of the pure protein with anti-his antibody was verified by the western blot assay. The concentration of the pure misL protein was determined as 345 μg/mL. Production of polyclonal antibody will be achieved by using the obtained pure recombinant misL protein as next step. The role of the protein will come out on the immune system together some assays.

Keywords: cloning, Escherichia coli, recombinant protein purification, Salmonella Typhimurium

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14430 156vdc to 110vac Sinusoidal Inverter Simulation and Implementation

Authors: Phinyo Mueangmeesap

Abstract:

This paper describes about pure sinusoidal inverter simulation and implementation from high voltage DC (156 Vdc). This simulation is to study and improve the efficiency of the inverter. By reducing the loss of power from boost converter in current inverter. The simulation is done by using the H-bridge circuit with pulse width modulate (PWM) signal and low-pass filter circuit. To convert the DC into AC. This paper used the PSCad for simulation. The result of simulation can be used to create prototype inverter by converting 156 Vdc to 110Vac. The inverter gives the output signal similar to the output from a simulation.

Keywords: inverter simulation, PWM signal, single-phase inverter, sinusoidal inverter

Procedia PDF Downloads 399
14429 Ag Nanoparticle/Melamine Sulfonic Acid Supported on Alumina: Efficient Catalytic System in Synthesis of Dihydropyrimidines

Authors: Parya Nasehi, Mohammad Kazem Mohammadi

Abstract:

3,4-dihydropyrimidin-2(1H)-thiones were synthesized in the presence of Ag nanoparticle/melamine sulfonic acid (MSA) supported on alumina. The reaction was carried out at 110 oC for 20 min under solvent free conditions. This method have some advantages such as good yield, mild reaction conditions, ease of operation and work up, short reaction time and high product purity.

Keywords: nanoparticle melamine sulfonic acid, Al2O3, Biginelli reaction, 3, 4-dihydropyrimidin-2(1H, solvent free

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14428 Phyto Diversity and Conservation of Pulicat Lake-Andhra Pradesh

Authors: S. K. M. Basha

Abstract:

Pulicat Lake is the second largest brackish water lagoon after Chilika Lake of Orissa along the east coast of India. Estuaries and lagoons have brackish water which shows high biological productivity than fresh or sea water. Hence it has wide range of aquatic, terrestrial flora and fauna. The World Wide Fund for Nature declared that it is a protected area. Present study aims to explore the flora and fauna of the lagoon along with the various threats for its eco-degradation which helps to plan necessary conservation methods.

Keywords: phytodiversity, Pulicat Lake, threats, conservation

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14427 Managing Work–Family Conflict in Today's Nursing Profession: The Role of Supervisors

Authors: Alshutwi Sitah

Abstract:

Many countries around the world are struggling to maintain an adequate number of nurses. Inadequate nursing staffing could compromise the quality of patient care. Among many factors that contribute to registered nurses (RN) turnover, the influence of work–family conflict (WFC) has gained little attention. WFC was found to be significantly associated with increased turnover intention (TI) among employees. Furthermore, WFC has been linked to a number of negative consequences, including lower job satisfaction and organizational commitment, sleep insufficiency, insomnia symptoms, obesity, cardiovascular diseases, sleep insufficiency, and high cholesterol. In an effort to find strategies to manage the consequences of WFC, many behavioral, psychological, and career scholars have focused on the role of supervisor support. Family Supportive Supervisor Behaviors (FSSB) has been found to be a promising approach contributing to the reduction of TI in employees’ experiencing WFC. Despite the importance of work–family issues and the influence of FSSB, limited studies have been conducted among the nursing population and none were found that included a sample from Saudi Arabia. Therefore, the main Purpose of this study was to evaluate the influence of FSSB on the relationship among WFC, Stress, and TI in Saudi Arabian registered nurses. Method: A cross-sectional study. Sample: Convenience sampling; 113 Saudi female nurse. Result: Fifty percent of nurses intended to leave their workplace, 68 % of nurses reported having a conflict between work and family, and 44% reported having a high level of stress. A significant positive correlation was found between WFC and TI (r= .43, P < 0.01). A negative correlation was found between FSSB and TI (r= -.53, P < 0.01). Both WFC and stress were associated with TI; however, these associations were buffered (weaken), when nurses had higher FSSB. Conclusion: The FSSB could be seen as a tool to help married, female nurses to demonstrate their professional role without compromising their family responsibilities. Nurses’ turnover is a complex issue that may require multiple prevention strategies; however, enhancing FSSB could be a key resource for maintaining a positive workplace environment and reducing TI.

Keywords: turnover intention, work-family conflict, supervisor support, nursing retention

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14426 Nafion Nanofiber Mat in a Single Fuel Cell Test

Authors: Chijioke Okafor, Malik Maaza, Touhami Mokrani

Abstract:

Proton exchange membrane, PEM was developed and tested for potential application in fuel cell. Nafion was electrospun to nanofiber network with the aid of poly(ethylene oxide), PEO, as a carrier polymer. The matrix polymer was crosslinked with Norland Optical Adhesive 63 under UV after compacting and annealing. The welded nanofiber mat was characterized for morphology, proton conductivity, and methanol permeability, then tested in a single cell test station. The results of the fabricated nanofiber membrane showed a proton conductivity of 0.1 S/cm at 25 oC and higher fiber volume fraction; methanol permeability of 3.6x10^-6 cm2/s and power density of 96.1 and 81.2 mW/cm2 for 5M and 1M methanol concentration respectively.

Keywords: fuel cell, nafion, nanofiber, permeability

Procedia PDF Downloads 467
14425 Fatigue Analysis and Life Estimation of the Helicopter Horizontal Tail under Cyclic Loading by Using Finite Element Method

Authors: Defne Uz

Abstract:

Horizontal Tail of helicopter is exposed to repeated oscillatory loading generated by aerodynamic and inertial loads, and bending moments depending on operating conditions and maneuvers of the helicopter. In order to ensure that maximum stress levels do not exceed certain fatigue limit of the material and to prevent damage, a numerical analysis approach can be utilized through the Finite Element Method. Therefore, in this paper, fatigue analysis of the Horizontal Tail model is studied numerically to predict high-cycle and low-cycle fatigue life related to defined loading. The analysis estimates the stress field at stress concentration regions such as around fastener holes where the maximum principal stresses are considered for each load case. Critical element identification of the main load carrying structural components of the model with rivet holes is performed as a post-process since critical regions with high-stress values are used as an input for fatigue life calculation. Once the maximum stress is obtained at the critical element and the related mean and alternating components, it is compared with the endurance limit by applying Soderberg approach. The constant life straight line provides the limit for several combinations of mean and alternating stresses. The life calculation based on S-N (Stress-Number of Cycles) curve is also applied with fully reversed loading to determine the number of cycles corresponds to the oscillatory stress with zero means. The results determine the appropriateness of the design of the model for its fatigue strength and the number of cycles that the model can withstand for the calculated stress. The effect of correctly determining the critical rivet holes is investigated by analyzing stresses at different structural parts in the model. In the case of low life prediction, alternative design solutions are developed, and flight hours can be estimated for the fatigue safe operation of the model.

Keywords: fatigue analysis, finite element method, helicopter horizontal tail, life prediction, stress concentration

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14424 To Examine Perceptions and Associations of Shock Food Labelling and to Assess the Impact on Consumer Behaviour: A Quasi-Experimental Approach

Authors: Amy Heaps, Amy Burns, Una McMahon-Beattie

Abstract:

Shock and fear tactics have been used to encourage consumer behaviour change within the UK regarding lifestyle choices such as smoking and alcohol abuse, yet such measures have not been applied to food labels to encourage healthier purchasing decisions. Obesity levels are continuing to rise within the UK, despite efforts made by government and charitable bodies to encourage consumer behavioural changes, which will have a positive influence on their fat, salt, and sugar intake. We know that taking extreme measures to shock consumers into behavioural changes has worked previously; for example, the anti-smoking television adverts and new standardised cigarette and tobacco packaging have reduced the numbers of the UK adult population who smoke or encouraged those who are currently trying to quit. The USA has also introduced new front-of-pack labelling, which is clear, easy to read, and includes concise health warnings on products high in fat, salt, or sugar. This model has been successful, with consumers reducing purchases of products with these warning labels present. Therefore, investigating if shock labels would have an impact on UK consumer behaviour and purchasing decisions would help to fill the gap within this research field. This study aims to develop an understanding of consumer’s initial responses to shock advertising with an interest in the perceived impact of long-term effect shock advertising on consumer food purchasing decisions, behaviour, and attitudes and will achieve this through a mixed methodological approach taken with a sample size of 25 participants ages ranging from 22 and 60. Within this research, shock mock labels were developed, including a graphic image, health warning, and get-help information. These labels were made for products (available within the UK) with large market shares which were high in either fat, salt, or sugar. The use of online focus groups and mouse-tracking experiments results helped to develop an understanding of consumer’s initial responses to shock advertising with interest in the perceived impact of long-term effect shock advertising on consumer food purchasing decisions, behaviour, and attitudes. Preliminary results have shown that consumers believe that the use of graphic images, combined with a health warning, would encourage consumer behaviour change and influence their purchasing decisions regarding those products which are high in fat, salt and sugar. Preliminary main findings show that graphic mock shock labels may have an impact on consumer behaviour and purchasing decisions, which will, in turn, encourage healthier lifestyles. Focus group results show that 72% of participants indicated that these shock labels would have an impact on their purchasing decisions. During the mouse tracking trials, this increased to 80% of participants, showing that more exposure to shock labels may have a bigger impact on potential consumer behaviour and purchasing decision change. In conclusion, preliminary results indicate that graphic shock labels will impact consumer purchasing decisions. Findings allow for a deeper understanding of initial emotional responses to these graphic labels. However, more research is needed to test the longevity of these labels on consumer purchasing decisions, but this research exercise is demonstrably the foundation for future detailed work.

Keywords: consumer behavior, decision making, labelling legislation, purchasing decisions, shock advertising, shock labelling

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14423 Price Gouging in Time of Covid-19 Pandemic: When National Competition Agencies are Weak Institutions that Exacerbate the Effects of Exploitative Economic Behaviour

Authors: Cesar Leines

Abstract:

The social effects of the pandemic are significant and diverse, most of those effects have widened the gap of economic inequality. Without a doubt, each country faces difficulties associated with the strengths and weaknesses of its own institutions that can address these causes and consequences. Around the world, pricing practices that have no connection to production costs have been used extensively in numerous markets beyond those relating to the supply of essential goods and services, and although it is not unlawful to adjust pricing considering the increased demand of certain products, shortages and disruption of supply chains, illegitimate pricing practices may arise and these tend to transfer wealth from consumers to producers that affect the purchasing power of the former, making people worse off. High prices with no objective justification indicate a poor state of the competitive process in any market and the impact of those underlying competition issues leading to inefficiency is increased when national competition agencies are weak and ineffective in enforcing competition in law and policy. It has been observed that in those countries where competition authorities are perceived as weak or ineffective, price increases of a wide range of products and services were more significant during the pandemic than those price increases observed in countries where the perception of the effectiveness of the competition agency is high. When a perception is created of a highly effective competition authority, one which enforces competition law and its non-enforcement activities result in the fulfillment of its substantive functions of protecting competition as the means to create efficient markets, the price rise observed in markets under its jurisdiction is low. A case study focused on the effectiveness of the national competition agency in Mexico (COFECE) points to institutional weakness as one of the causes leading to excessive pricing. There are many factors that contribute to its low effectiveness and which, in turn, have led to a very significant price hike, potentiated by the pandemic. This paper contributes to the discussion of these factors and proposes different steps that overall help COFECE or any other competition agency to increase the perception of effectiveness for the benefit of the consumers.

Keywords: agency effectiveness, competition, institutional weakness, price gouging

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14422 Effect of Roasting Temperature on the Proximate, Mineral and Antinutrient Content of Pigeon Pea (Cajanus cajan) Ready-to-Eat Snack

Authors: Olaide Ruth Aderibigbe, Oluwatoyin Oluwole

Abstract:

Pigeon pea is one of the minor leguminous plants; though underutilised, it is used traditionally by farmers to alleviate hunger and malnutrition. Pigeon pea is cultivated in Nigeria by subsistence farmers. It is rich in protein and minerals, however, its utilisation as food is only common among the poor and rural populace who cannot afford expensive sources of protein. One of the factors contributing to its limited use is the high antinutrient content which makes it indigestible, especially when eaten by children. The development of value-added products that can reduce the antinutrient content and make the nutrients more bioavailable will increase the utilisation of the crop and contribute to reduction of malnutrition. This research, therefore, determined the effects of different roasting temperatures (130 0C, 140 0C, and 150 0C) on the proximate, mineral and antinutrient component of a pigeon pea snack. The brown variety of pigeon pea seeds were purchased from a local market- Otto in Lagos, Nigeria. The seeds were cleaned, washed, and soaked in 50 ml of water containing sugar and salt (4:1) for 15 minutes, and thereafter the seeds were roasted at 130 0C, 140 0C, and 150 0C in an electric oven for 10 minutes. Proximate, minerals, phytate, tannin and alkaloid content analyses were carried out in triplicates following standard procedures. The results of the three replicates were polled and expressed as mean±standard deviation; a one-way analysis of variance (ANOVA) and the Least Significance Difference (LSD) were carried out. The roasting temperatures significantly (P<0.05) affected the protein, ash, fibre and carbohydrate content of the snack. Ready-to-eat snack prepared by roasting at 150 0C significantly had the highest protein (23.42±0.47%) compared the ones roasted at 130 0C and 140 0C (18.38±1.25% and 20.63±0.45%, respectively). The same trend was observed for the ash content (3.91±0.11 for 150 0C, 2.36±0.15 for 140 0C and 2.26±0.25 for 130 0C), while the fibre and carbohydrate contents were highest at roasting temperature of 130 0C. Iron, zinc, and calcium were not significantly (P<0.5) affected by the different roasting temperatures. Antinutrients decreased with increasing temperature. Phytate levels recorded were 0.02±0.00, 0.06±0.00, and 0.07±0.00 mg/g; tannin levels were 0.50±0.00, 0.57±0.00, and 0.68±0.00 mg/g, while alkaloids levels were 0.51±0.01, 0.78±0.01, and 0.82±0.01 mg/g for 150 0C, 140 0C, and 130 0C, respectively. These results show that roasting at high temperature (150 0C) can be utilised as a processing technique for increasing protein and decreasing antinutrient content of pigeon pea.

Keywords: antinutrients, pigeon pea, protein, roasting, underutilised species

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14421 Experimental Verification of the Relationship between Physiological Indexes and the Presence or Absence of an Operation during E-learning

Authors: Masaki Omata, Shumma Hosokawa

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An experiment to verify the relationships between physiological indexes of an e-learner and the presence or absence of an operation during e-learning is described. Electroencephalogram (EEG), hemoencephalography (HEG), skin conductance (SC), and blood volume pulse (BVP) values were measured while participants performed experimental learning tasks. The results show that there are significant differences between the SC values when reading with clicking on learning materials and the SC values when reading without clicking, and between the HEG ratio when reading (with and without clicking) and the HEG ratio when resting for four of five participants. We conclude that the SC signals can be used to estimate whether or not a learner is performing an active task and that the HEG ratios can be used to estimate whether a learner is learning.

Keywords: e-learning, physiological index, physiological signal, state of learning

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14420 Spatial Distribution of Virus-Transmitting Aphids of Plants in Al Bahah Province, Saudi Arabia

Authors: Sabir Hussain, Muhammad Naeem, Yousif Aldryhim, Susan E. Halbert, Qingjun Wu

Abstract:

Plant viruses annually cause severe economic losses in crop production and globally, different aphid species are responsible for the transmission of such viruses. Additionally, aphids are also serious pests of trees, and agricultural crops. Al Bahah Province, Kingdom of Saudi Arabia (KSA) has a high native and introduced plant species with a temperate climate that provides ample habitats for aphids. In this study, we surveyed virus-transmitting aphids from the Province to highlight their spatial distributions and hot spot areas for their target control strategies. During our fifteen month's survey in Al Bahah Province, three hundred and seventy samples of aphids were collected using both beating sheets and yellow water pan traps. Consequently, fifty-four aphid species representing 30 genera belonging to four families were recorded from Al Bahah Province. Alarmingly, 35 aphid species from our records are virus transmitting species. The most common virus transmitting aphid species based on number of collecting samples, were Macrosiphum euphorbiae (Thomas, 1878), Brachycaudus rumexicolens (Patch, 1917), Uroleucon sonchi (Linnaeus, 1767), Brachycaudus helichrysi (Kaltenbach, 1843), and Myzus persicae (Sulzer, 1776). The numbers of samples for the forementioned species were 66, 24, 23, 22, and 20, respectively. The widest range of plant hosts were found for M. euphorbiae (39 plant species), B. helichrysi (12 plant species), M. persicae (12 plant species), B. rumexicolens (10 plant species), and U. sonchi (9 plant species). The hottest spot areas were found in Al-Baha, Al Mekhwah and Biljarashi cities of the province on the basis of their abundance. This study indicated that Al Bahah Province has relatively rich aphid diversity due to the relatively high plant diversity in a favorable climatic condition. ArcGIS tools can be helpful for biologists to implement the target control strategies against these pests in the integrated pest management, and ultimately to save money and time.

Keywords: Al Bahah province, aphid-virus interaction, biodiversity, global information system

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14419 Phycoremiadation of Heavy Metals by Marine Macroalgae Collected from Olaikuda, Rameswaram, Southeast Coast of India

Authors: Suparna Roy, Anatharaman Perumal

Abstract:

The industrial effluent with high amount of heavy metals is known to have adverse effects on the environment. For the removal of heavy metals from aqueous environment, different conventional treatment technologies had been applied gradually which are not economically beneficial and also produce huge quantity of toxic chemical sludge. So, bio-sorption of heavy metals by marine plant is an eco-friendly innovative and alternative technology for removal of these pollutants from aqueous environment. The aim of this study is to evaluate the capacity of heavy metals accumulation and removal by some selected marine macroalgae (seaweeds) from marine environment. Methods: Seaweeds Acanthophora spicifera (Vahl.) Boergesen, Codium tomentosum Stackhouse, Halimeda gracilis Harvey ex. J. Agardh, Gracilaria opuntia Durairatnam.nom. inval. Valoniopsis pachynema (Martens) Boergesen, Caulerpa racemosa var. macrophysa (Sonder ex Kutzing) W. R. Taylor and Hydroclathrus clathratus (C. Agardh) Howe were collected from Olaikuda (09°17.526'N-079°19.662'E), Rameshwaram, south east coast of India during post monsoon period (April’2016). Seaweeds were washed with sterilized and filtered in-situ seawater repeatedly to remove all the epiphytes and debris and clean seaweeds were kept for shade drying for one week. The dried seaweeds were grinded to powder, and one gm powder seaweeds were taken in a 250ml conical flask, and 8 ml of 10 % HNO3 (70 % pure) was added to each sample and kept in room temperature (28 ̊C) for 24 hours and then samples were heated in hotplate at 120 ̊C, boiled to evaporate up to dryness and 20 ml of Nitric acid: Percholoric acid in 4:1 were added to it and again heated to hotplate at 90 ̊C up to evaporate to dryness, then samples were kept in room temperature for few minutes to cool and 10ml 10 % HNO3 were added to it and kept for 24 hours in cool and dark place and filtered with Whatman (589/2) filter paper and the filtrates were collected in 250ml clean conical flask and diluted accurately to 25 ml volume with double deionised water and triplicate of each sample were analysed with Inductively-Coupled plasma analysis (ICP-OES) to analyse total eleven heavy metals (Ag, Cd, B, Cu, Mn, Co, Ni, Cr, Pb, Zn, and Al content of the specified species and data were statistically evaluated for standard deviation. Results: Acanthophora spicifera contains highest amount of Ag (0.1± 0.2 mg/mg) followed by Cu (0.16±0.01 mg/mg), Mn (1.86±0.02 mg/mg), B (3.59±0.2 mg/mg), Halimeda gracilis showed highest accumulation of Al (384.75±0.12mg/mg), Valoniopsis pachynema accumulates maximum amount of Co (0.12±0.01 mg/mg), Zn (0.64±0.02 mg/mg), Caulerpa racemosa var. macrophysa contains Zn (0.63±0.01), Cr (0.26±0.01 mg/mg ), Ni (0.21±0.05), Pb (0.16±0.03 ) and Cd ( 0.02±00 ). Hydroclathrus clathratus, Codium tomentosum and Gracilaria opuntia also contain adequate amount of heavy metals. Conclusions: The mentioned species of seaweeds are contributing important role for decreasing the heavy metals pollution in marine environment by bioaccumulation. So, we can utilise this species to remove excess amount of heavy metals from polluted area.

Keywords: heavy metals pollution, seaweeds, bioaccumulation, eco-friendly, phyco-remediation

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14418 The Effect of Photochemical Smog on Respiratory Health Patients in Abuja Nigeria

Authors: Christabel Ihedike, John Mooney, Monica Price

Abstract:

Summary: This study aims to critically evaluate effect of photochemical smog on respiratory health in Nigeria. Cohort of chronic obstructive pulmonary disease (COPD) patients was recruited from two large hospitals in Abuja Nigeria. Respiratory health questionnaires, daily diaries, dyspnoea scale and lung function measurement were used to obtain health data and investigate the relationship with air quality data (principally ozone, NOx and particulate pollution). Concentrations of air pollutants were higher than WHO and Nigerian air quality standard. The result suggests a correlation between measured air quality and exacerbation of respiratory illness. Introduction: Photochemical smog is a significant health challenge in most cities and its effect on respiratory health is well acknowledged. This type of pollution is most harmful to the elderly, children and those with underlying respiratory disease. This study aims to investigate impact of increasing temperature and photo-chemically generated secondary air pollutants on respiratory health in Abuja Nigeria. Method and Result: Health data was collected using spirometry to measure lung function on routine attendance at the clinic, daily diaries kept by patients and information obtained using respiratory questionnaire. Questionnaire responses (obtained using an adapted and internally validated version of St George’s Hospital Respiratory Questionnaire), shows that ‘time of wheeze’ showed an association with participants activities: 30% had worse wheeze in the morning: 10% cannot shop, 15% take long-time to get washed, 25% walk slower, 15% if hurry have to stop and 5% cannot take-bath. There was also a decrease in Forced expiratory volume in the first second and Forced Vital Capacity, and daily change in the afternoon–morning may be associated with the concentration level of pollutants. Also, dyspnoea symptoms recorded that 60% of patients were on grade 3, 25% grade 2 and 15% grade 1. Daily frequency of the number of patients in the cohort that cough /brought sputum is 78%. Air pollution in the city is higher than Nigerian and WHO standards with NOx and PM10 concentrations of 693.59ug/m-3 and 748ugm-3 being measured respectively. The result shows that air pollution may increase occurrence and exacerbation of respiratory disease. Conclusion: High temperature and local climatic conditions in urban Nigeria encourages formation of Ozone, the major constituent of photochemical smog, resulting also in the formation of secondary air pollutants associated with health challenges. In this study we confirm the likely potency of the pattern of secondary air pollution in exacerbating COPD symptoms in vulnerable patient group in urban Nigeria. There is need for better regulation and measures to reduce ozone, particularly when local climatic conditions favour development of photochemical smog in such settings. Climate change and likely increasing temperatures add impetus and urgency for better air quality standards and measures (traffic-restrictions and emissions standards) in developing world settings such as Nigeria.

Keywords: Abuja-Nigeria, effect, photochemical smog, respiratory health

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14417 Heteroatom Doped Binary Metal Oxide Modified Carbon as a Bifunctional Electrocatalysts for all Vanadium Redox Flow Battery

Authors: Anteneh Wodaje Bayeh, Daniel Manaye Kabtamu, Chen-Hao Wang

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As one of the most promising electrochemical energy storage systems, vanadium redox flow batteries (VRFBs) have received increasing attention owing to their attractive features for largescale storage applications. However, their high production cost and relatively low energy efficiency still limit their feasibility. For practical implementation, it is of great interest to improve their efficiency and reduce their cost. One of the key components of VRFBs that can greatly influence the efficiency and final cost is the electrode, which provide the reactions sites for redox couples (VO²⁺/VO₂ + and V²⁺/V³⁺). Carbon-based materials are considered to be the most feasible electrode materials in the VRFB because of their excellent potential in terms of operation range, good permeability, large surface area, and reasonable cost. However, owing to limited electrochemical activity and reversibility and poor wettability due to its hydrophobic properties, the performance of the cell employing carbon-based electrodes remained limited. To address the challenges, we synthesized heteroatom-doped bimetallic oxide grown on the surface of carbon through the one-step approach. When applied to VRFBs, the prepared electrode exhibits significant electrocatalytic effect toward the VO²⁺/VO₂ + and V³⁺/V²⁺ redox reaction compared with that of pristine carbon. It is found that the presence of heteroatom on metal oxide promotes the absorption of vanadium ions. The controlled morphology of bimetallic metal oxide also exposes more active sites for the redox reaction of vanadium ions. Hence, the prepared electrode displays the best electrochemical performance with energy and voltage efficiencies of 74.8% and 78.9%, respectively, which is much higher than those of 59.8% and 63.2% obtained from the pristine carbon at high current density. Moreover, the electrode exhibit durability and stability in an acidic electrolyte during long-term operation for 1000 cycles at the higher current density.

Keywords: VRFB, VO²⁺/VO₂ + and V³⁺/V²⁺ redox couples, graphite felt, heteroatom-doping

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14416 Acceleration Techniques of DEM Simulation for Dynamics of Particle Damping

Authors: Masato Saeki

Abstract:

Presented herein is a novel algorithms for calculating the damping performance of particle dampers. The particle damper is a passive vibration control technique and has many practical applications due to simple design. It consists of granular materials constrained to move between two ends in the cavity of a primary vibrating system. The damping effect results from the exchange of momentum during the impact of granular materials against the wall of the cavity. This damping has the advantage of being independent of the environment. Therefore, particle damping can be applied in extreme temperature environments, where most conventional dampers would fail. It was shown experimentally in many papers that the efficiency of the particle dampers is high in the case of resonant vibration. In order to use the particle dampers effectively, it is necessary to solve the equations of motion for each particle, considering the granularity. The discrete element method (DEM) has been found to be effective for revealing the dynamics of particle damping. In this method, individual particles are assumed as rigid body and interparticle collisions are modeled by mechanical elements as springs and dashpots. However, the computational cost is significant since the equation of motion for each particle must be solved at each time step. In order to improve the computational efficiency of the DEM, the new algorithms are needed. In this study, new algorithms are proposed for implementing the high performance DEM. On the assumption that behaviors of the granular particles in the each divided area of the damper container are the same, the contact force of the primary system with all particles can be considered to be equal to the product of the divided number of the damper area and the contact force of the primary system with granular materials per divided area. This convenience makes it possible to considerably reduce the calculation time. The validity of this calculation method was investigated and the calculated results were compared with the experimental ones. This paper also presents the results of experimental studies of the performance of particle dampers. It is shown that the particle radius affect the noise level. It is also shown that the particle size and the particle material influence the damper performance.

Keywords: particle damping, discrete element method (DEM), granular materials, numerical analysis, equivalent noise level

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14415 Purification and Characterization of a Novel Extracellular Chitinase from Bacillus licheniformis LHH100

Authors: Laribi-Habchi Hasiba, Bouanane-Darenfed Amel, Drouiche Nadjib, Pausse André, Mameri Nabil

Abstract:

Chitin, a linear 1, 4-linked N-acetyl-d-glucosamine (GlcNAc) polysaccharide is the major structural component of fungal cell walls, insect exoskeletons and shells of crustaceans. It is one of the most abundant naturally occurring polysaccharides and has attracted tremendous attention in the fields of agriculture, pharmacology and biotechnology. Each year, a vast amount of chitin waste is released from the aquatic food industry, where crustaceans (prawn, crab, Shrimp and lobster) constitute one of the main agricultural products. This creates a serious environmental problem. This linear polymer can be hydrolyzed by bases, acids or enzymes such as chitinase. In this context an extracellular chitinase (ChiA-65) was produced and purified from a newly isolated LHH100. Pure protein was obtained after heat treatment and ammonium sulphate precipitation followed by Sephacryl S-200 chromatography. Based on matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF/MS) analysis, the purified enzyme is a monomer with a molecular mass of 65,195.13 Da. The sequence of the 27 N-terminal residues of the mature ChiA-65 showed high homology with family-18 chitinases. Optimal activity was achieved at pH 4 and 75◦C. Among the inhibitors and metals tested p-chloromercuribenzoic acid, N-ethylmaleimide, Hg2+ and Hg + completelyinhibited enzyme activity. Chitinase activity was high on colloidal chitin, glycol chitin, glycol chitosane, chitotriose and chitooligosaccharide. Chitinase activity towards synthetic substrates in the order of p-NP-(GlcNAc) n (n = 2–4) was p-NP-(GlcNAc)2> p-NP-(GlcNAc)4> p-NP-(GlcNAc)3. Our results suggest that ChiA-65 preferentially hydrolyzed the second glycosidic link from the non-reducing end of (GlcNAc) n. ChiA-65 obeyed Michaelis Menten kinetics the Km and kcat values being 0.385 mg, colloidal chitin/ml and5000 s−1, respectively. ChiA-65 exhibited remarkable biochemical properties suggesting that this enzyme is suitable for bioconversion of chitin waste.

Keywords: Bacillus licheniformis LHH100, characterization, extracellular chitinase, purification

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14414 Endometrial Biopsy Curettage vs Endometrial Aspiration: Better Modality in Female Genital Tuberculosis

Authors: Rupali Bhatia, Deepthi Nair, Geetika Khanna, Seema Singhal

Abstract:

Introduction: Genital tract tuberculosis is a chronic disease (caused by reactivation of organisms from systemic distribution of Mycobacterium tuberculosis) that often presents with low grade symptoms and non-specific complaints. Patients with genital tuberculosis are usually young women seeking workup and treatment for infertility. Infertility is the commonest presentation due to involvement of the fallopian tubes, endometrium and ovarian damage with poor ovarian volume and reserve. The diagnosis of genital tuberculosis is difficult because of the fact that it is a silent invader of genital tract. Since tissue cannot be obtained from fallopian tubes, the diagnosis is made by isolation of bacilli from endometrial tissue obtained by endometrial biopsy curettage and/or aspiration. Problems are associated with sampling technique as well as diagnostic modality due to lack of adequate sample volumes and the segregation of the sample for various diagnostic tests resulting in non-uniform distribution of microorganisms. Moreover, lack of an efficient sampling technique universally applicable for all specific diagnostic tests contributes to the diagnostic challenges. Endometrial sampling plays a key role in accurate diagnosis of female genital tuberculosis. It may be done by 2 methods viz. endometrial curettage and endometrial aspiration. Both endometrial curettage and aspirate have their own limitations as curettage picks up strip of the endometrium from one of the walls of the uterine cavity including tubal osteal areas whereas aspirate obtains total tissue with exfoliated cells present in the secretory fluid of the endometrial cavity. Further, sparse and uneven distribution of the bacilli remains a major factor contributing to the limitations of the techniques. The sample that is obtained by either technique is subjected to histopathological examination, AFB staining, culture and PCR. Aim: Comparison of the sampling techniques viz. endometrial biopsy curettage and endometrial aspiration using different laboratory methods of histopathology, cytology, microbiology and molecular biology. Method: In a hospital based observational study, 75 Indian females suspected of genital tuberculosis were selected on the basis of inclusion criteria. The women underwent endometrial tissue sampling using Novaks biopsy curette and Karmans cannula. One part of the specimen obtained was sent in formalin solution for histopathological testing and another part was sent in normal saline for acid fast bacilli smear, culture and polymerase chain reaction. The results so obtained were correlated using coefficient of correlation and chi square test. Result: Concordance of results showed moderate agreement between both the sampling techniques. Among HPE, AFB and PCR, maximum sensitivity was observed for PCR, though the specificity was not as high as other techniques. Conclusion: Statistically no significant difference was observed between the results obtained by the two sampling techniques. Therefore, one may use either EA or EB to obtain endometrial samples and avoid multiple sampling as both the techniques are equally efficient in diagnosing genital tuberculosis by HPE, AFB, culture or PCR.

Keywords: acid fast bacilli (AFB), histopatholgy examination (HPE), polymerase chain reaction (PCR), endometrial biopsy curettage

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14413 Comparison with Two Clinical Cases of Plasma Cell Neoplasm by Using the Method of Capillary Electrophoresis

Authors: Kai Pai Huang

Abstract:

Background: There are several types of plasma cell neoplasms including multiple myeloma, plasmacytoma, lymphoplasmacytic lymphoma, and monoclonal gammopathy of undetermined significance (MGUS) are found in our lab. Today, we want to compare with two cases using the method of capillary electrophoresis. Method: Serum is prepared and electrophoresis is performed at alkaline PH in a capillary using the Sebia® Capillary 2. Albumin and globulins are detected by the detector which is located in the cathode of the capillary and the signals are transformed to peaks. Serum was treated with beta-mercaptoethanol which reducing the polymerized immunoglobulin to monomer immunoglobulin to clarify two M-protein are secreted from the same plasma cell clone in bone marrow. Result: Case 1: A 78-year-old female presenting dysuria, oliguria and leg edema for several months. Laboratory data showed proteinuria, leukocytosis, results of high serum IgA and lambda light chain. A renal biopsy found amyloid fibrils in the glomerular mesangial area. Serum protein electrophoresis shows a major monoclonal peak in the β region and minor small peak in gamma region, and the immunotyping studies for serum showed two IgA/λ type. Case 2: A 55-year-old male presenting abdominal distension and low back pain for more than one month. Laboratory data showed T12 T8 compression fracture, results of high serum IgM and kappa light chain. Bone marrow aspiration showed the cells from the bone marrow are B cells with monotypic kappa chain expression. Bone marrow biopsy found this is lymphoplasmacytic lymphoma (Waldenstrom macroglobulin). Serum protein electrophoresis shows a monoclonal peak in the β region and the immunotyping studies for serum showed IgM/κ type. Conclusion: Plasma cell neoplasm can be diagnosed by many examinations. Among them, using capillary electrophoresis by a lab can separate several types of gammopathy and the quantification of a monoclonal peak can be used to evaluate the patients’ prognosis or treatment.

Keywords: plasma cell neoplasm, capillary electrophoresis, serum protein electrophoresis, immunotyping

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14412 Transitional Separation Bubble over a Rounded Backward Facing Step Due to a Temporally Applied Very High Adverse Pressure Gradient Followed by a Slow Adverse Pressure Gradient Applied at Inlet of the Profile

Authors: Saikat Datta

Abstract:

Incompressible laminar time-varying flow is investigated over a rounded backward-facing step for a triangular piston motion at the inlet of a straight channel with very high acceleration, followed by a slow deceleration experimentally and through numerical simulation. The backward-facing step is an important test-case as it embodies important flow characteristics such as separation point, reattachment length, and recirculation of flow. A sliding piston imparts two successive triangular velocities at the inlet, constant acceleration from rest, 0≤t≤t0, and constant deceleration to rest, t0≤tKeywords: laminar boundary layer separation, rounded backward facing step, separation bubble, unsteady separation, unsteady vortex flows

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14411 Preliminary Experience in Multiple Green Health Hospital Construction

Authors: Ming-Jyh Chen, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang

Abstract:

Introduction: Social responsibility is the key to sustainable organizational development. Under the ground Green Health Hospital Declaration signed by our superintendent, we have launched comprehensive energy conservation management in medical services, the community, and the staff’s life. To execute environment-friendly promotion with robust strategies, we build up a low-carbon medical system and community with smart green public construction promotion as well as intensifying energy conservation education and communication. Purpose/Methods: With the support of the board and the superintendent, we construct an energy management team, commencing with an environment-friendly system, management, education, and ISO 50001 energy management system; we have ameliorated energy performance and energy efficiency and continuing. Results: In the year 2021, we have achieved multiple goals. The energy management system efficiently controls diesel, natural gas, and electricity usage. About 5% of the consumption is saved when compared to the numbers from 2018 and 2021. Our company develops intelligent services and promotes various paperless electronic operations to provide people with a vibrant and environmentally friendly lifestyle. The goal is to save 68.6% on printing and photocopying by reducing 35.15 million sheets of paper yearly. We strengthen the concept of environmental protection classification among colleagues. In the past two years, the amount of resource recycling has reached more than 650 tons, and the resource recycling rate has reached 70%. The annual growth rate of waste recycling is about 28 metric tons. Conclusions: To build a green medical system with “high efficacy, high value, low carbon, low reliance,” energy stewardship, economic prosperity, and social responsibility are our principles when it comes to formulation of energy conservation management strategies, converting limited sources to efficient usage, developing clean energy, and continuing with sustainable energy.

Keywords: energy efficiency, environmental education, green hospital, sustainable development

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14410 Prioritization of Sub-Watersheds in Semi Arid Region: A Case Study of Shevgaon and Pathardi Tahsils in Maharashtra

Authors: Dadasaheb R. Jawre, Maya G. Unde

Abstract:

Prioritization of sub-watershed plays important role in watershed management. It shows the requirement of watershed to give a treatment for the green growth of the region and conservation of the sub-watersheds. There is a number of factors like topography of the region, climatic characteristics like rainfall and runoff, land-use land-cover, social factors which are related to the development of watershed for agricultural uses and domestic purposes in the region. The present research is throwing a focus on how morphometric parameters in association with GIS analysis will help in identifying the ranking of the sub-watersheds for further development which help of suggested watershed structures. Shevgaon and Pathardi tahsils are drought prone tahsils of Ahmednagar district in Maharashtra. These tahsils come under the semi-arid region. Sub-watershed prioritization is necessary for proper planning and management of natural resources for sustainable development of the study area. Less rainfall and increasing population pressure on the land as well as water resources lead to scarcity of the water in the region. Hence, researcher has selected Shevgaon and Pathardi tahsils for sub-watershed prioritization. There are seven sub-watersheds which selected for the present research paper. In the morphological analysis linear aspects, aerial aspects and relief aspects are considered for the prioritization. The largest sub-watershed is Erdha which is located at Karanji in Pathardi tahsil having an area of 145.06 km2 and smallest sub-watershed is Erandgaon which is located in Shevgaon tahsil having an area of 40.143 km2. For all seven sub-watersheds, seven morphometric parameters were considered for calculating the compound parameter values. Finally, compound parameter values are grouped into three groups such as, high priority (below 4.0), moderate priority (4.0 to 5.0) and low priority (above 5.0) according to the compound value Erandgaon, Chapadgaon and Tarak sub-watersheds comes under high priority group, Erdha and Domeshwar sub-watersheds come under moderate priority group and Chandani and Kasichi sub-watershed come under low priority group. Both the tahsils falls in drought prone area, after getting the watershed structure overall development of the region will take place.

Keywords: sub-watersheds, GIS and remote sensing, morphometric analysis, compound parameter value, prioritization

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14409 Effects of Particle Size Distribution of Binders on the Performance of Slag-Limestone Ternary Cement

Authors: Zhuomin Zou, Thijs Van Landeghem, Elke Gruyaert

Abstract:

Using supplementary cementitious materials, such as blast-furnace slag and limestone, to replace cement clinker is a promising method to reduce the carbon emissions from cement production. To efficiently use slag and limestone, it is necessary to carefully select the particle size distribution (PSD) of the binders. This study investigated the effects of the PSD of binders on the performance of slag-limestone ternary cement. The Portland cement (PC) was prepared by grinding 95% clinker + 5% gypsum. Based on the PSD parameters of the binders, three types of ternary cements with a similar overall PSD were designed, i.e., NO.1 fine slag, medium PC, and coarse limestone; NO.2 fine limestone, medium PC, and coarse slag; NO.3. fine PC, medium slag, and coarse limestone. The binder contents in the ternary cements were (a) 50 % PC, 40 % slag, and 10 % limestone (called high cement group) or (b) 35 % PC, 55 % slag, and 10 % limestone (called low cement group). The pure PC and binary cement with 50% slag and 50% PC prepared with the same binders as the ternary cement were considered as reference cements. All these cements were used to investigate the mortar performance in terms of workability, strength at 2, 7, 28, and 90 days, carbonation resistance, and non-steady state chloride migration resistance at 28 and 56 days. Results show that blending medium PC with fine slag could exhibit comparable performance to blending fine PC with medium/coarse slag in binary cement. For the three ternary cements in the high cement group, ternary cement with fine limestone (NO.2) shows the lowest strength, carbonation, and chloride migration performance. Ternary cements with fine slag (NO.1) and with fine PC (NO.3) show the highest flexural strength at early and late ages, respectively. In addition, compared with ternary cement with fine PC (NO.3), ternary cement with fine slag (NO.1) has a similar carbonation resistance and a better chloride migration resistance. For the low cement group, three ternary cements have a similar flexural and compressive strength before 7 days. After 28 days, ternary cement with fine limestone (NO.2) shows the highest flexural strength while fine PC (NO.3) has the highest compressive strength. In addition, ternary cement with fine slag (NO.1) shows a better chloride migration resistance but a lower carbonation resistance compared with the other two ternary cements. Moreover, the durability performance of ternary cement with fine PC (NO.3) is better than that of fine limestone (NO.2).

Keywords: limestone, particle size distribution, slag, ternary cement

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14408 Free Vibration of Functionally Graded Smart Beams Based on the First Order Shear Deformation Theory

Authors: A. R. Nezamabadi, M. Veiskarami

Abstract:

This paper studies free vibration of simply supported functionally graded beams with piezoelectric layers based on the first order shear deformation theory. The Young's modulus of beam is assumed to be graded continuously across the beam thickness. The governing equation is established. Resulting equation is solved using the Euler's equation. The effects of the constituent volume fractions, the influences of applied voltage on the vibration frequency are presented. To investigate the accuracy of the present analysis, a compression study is carried out with a known data.

Keywords: mechanical buckling, functionally graded beam, first order shear deformation theory, free vibration

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14407 Preparation and Characterization of Activated Carbon from Animal Bone

Authors: Getenet Aseged Zeleke

Abstract:

The aim of this project was to study the synthesis of activated carbon from low-cost animal beef and the characterization of the product obtained. The bone was carbonized in an inert atmosphere at three different temperatures (500°C, 700oC and 900°C) in an electric furnace, followed by activation with hydrochloric acid. The activated animal bone charcoals obtained were characterized by using scanning electron microscopy (SEM)to observe the effect of activation compared to the unactivated bone charcoal. The following parameters were also determined: ash content, moisture content, volatile content, fixed carbon, pH, pore volume and bulk (apparent) density. The characterization result showed that the activated bone charcoal has good properties and is compared favorably with other reference activated carbons.

Keywords: bones, carbonization, activation, characterization, activated carbon

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14406 Numerical Study of a Nanofluid in a Truncated Cone

Authors: B. Mahfoud, A. Bendjaghlouli

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Natural convection is simulated in a truncated cone filled with nanofluid. Inclined and top walls have constant temperature where the heat source is located on the bottom wall of the conical container which is thermally insulated. A finite volume approach is used to solve the governing equations using the SIMPLE algorithm for different parameters such as Rayleigh number, inclination angle of inclined walls of the enclosure and heat source length. The results showed an enhancement in cooling system by using a nanofluid, when conduction regime is assisted. The inclination angle of inclined sidewall and heat source length affect the heat transfer rate and the maximum temperature.

Keywords: heat source, truncated cone, nanofluid, natural convection

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14405 Exact Phase Diagram of High-TC Superconductors

Authors: Abid Boudiar

Abstract:

We propose a simple model to obtain an exact expression of Tc/(Tc,max) for the temperature-doping phase diagram of superconducting cuprates. We showed that our model predicted most phase diagram scenario. We found the exact special doping points p(opt), p(qcp) and an accurate E(g,max). Some other properties such as the stripes length 100.1°A and the energy gap in cuprates chain 6meV can also be calculated exactly. Another interesting consequence of this simple picture is the new magic numbers and the ability to express everything using a (Tc,p) diagram via the golden ratio.

Keywords: superconducting cuprates, phase, pseudogap, hole doping, strips, golden ratio, soliton

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14404 Reduction of Chlordecone Rates in Bioelectrochemicals Systems from Water and Sediment Swamp Mangrove in Absence of a Redox Mediator

Authors: Malory Beaujolais

Abstract:

Chlordecone is an organochlorine pesticide with a bishomocubane structure which led to high stability in organic matter. Microbial fuel cell is a type of electrochemical system that can convert organic matters into electricity thanks to electroactive bacteria. This technique has been used with mangrove swamp from Martinique to try to reduce chlordecone rates. Those experiments led to characterize the behavior of the electroactive biofilm formed at the cathode, without added redox mediator. The designed bioelectrochemical system seems to provide the necessary conditions for chlordecone degradation.

Keywords: bioelectrochemistry, bioremediation, chlordecone, mangrove swamp

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14403 Bioinformatic Design of a Non-toxic Modified Adjuvant from the Native A1 Structure of Cholera Toxin with Membrane Synthetic Peptide of Naegleria fowleri

Authors: Frida Carrillo Morales, Maria Maricela Carrasco Yépez, Saúl Rojas Hernández

Abstract:

Naegleria fowleri is the causative agent of primary amebic meningoencephalitis, this disease is acute and fulminant that affects humans. It has been reported that despite the existence of therapeutic options against this disease, its mortality rate is 97%. Therefore, the need arises to have vaccines that confer protection against this disease and, in addition to developing adjuvants to enhance the immune response. In this regard, in our work group, we obtained a peptide designed from the membrane protein MP2CL5 of Naegleria fowleri called Smp145 that was shown to be immunogenic; however, it would be of great importance to enhance its immunological response, being able to co-administer it with a non-toxic adjuvant. Therefore, the objective of this work was to carry out the bioinformatic design of a peptide of the Naegleria fowleri membrane protein MP2CL5 conjugated with a non-toxic modified adjuvant from the native A1 structure of Cholera Toxin. For which different bioinformatics tools were used to obtain a model with a modification in amino acid 61 of the A1 subunit of the CT (CTA1), to which the Smp145 peptide was added and both molecules were joined with a 13-glycine linker. As for the results obtained, the modification in CTA1 bound to the peptide produces a reduction in the toxicity of the molecule in in silico experiments, likewise, the prediction in the binding of Smp145 to the receptor of B cells suggests that the molecule is directed in specifically to the BCR receptor, decreasing its native enzymatic activity. The stereochemical evaluation showed that the generated model has a high number of adequately predicted residues. In the ERRAT test, the confidence with which it is possible to reject regions that exceed the error values was evaluated, in the generated model, a high score was obtained, which determines that the model has a good structural resolution. Therefore, the design of the conjugated peptide in this work will allow us to proceed with its chemical synthesis and subsequently be able to use it in the mouse meningitis protection model caused by N. fowleri.

Keywords: immunology, vaccines, pathogens, infectious disease

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14402 The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) Process: An Audit of Its Utilisation on a UK Tertiary Specialist Intensive Care Unit

Authors: Gokulan Vethanayakam, Daniel Aston

Abstract:

Introduction: The ReSPECT process supports healthcare professionals when making patient-centered decisions in the event of an emergency. It has been widely adopted by the NHS in England and allows patients to express thoughts and wishes about treatments and outcomes that they consider acceptable. It includes (but is not limited to) cardiopulmonary resuscitation decisions. ReSPECT conversations should ideally occur prior to ICU admission and should be documented in the eight sections of the nationally-standardised ReSPECT form. This audit evaluated the use of ReSPECT on a busy cardiothoracic ICU in an NHS Trust where established policies advocating its use exist. Methods: This audit was a retrospective review of ReSPECT forms for a sample of high-risk patients admitted to ICU at the Royal Papworth Hospital between January 2021 and March 2022. Patients all received one of the following interventions: Veno-Venous Extra-Corporeal Membrane Oxygenation (VV-ECMO) for severe respiratory failure (retrieved via the national ECMO service); cardiac or pulmonary transplantation-related surgical procedures (including organ transplants and Ventricular Assist Device (VAD) implantation); or elective non-transplant cardiac surgery. The quality of documentation on ReSPECT forms was evaluated using national standards and a graded ranking tool devised by the authors which was used to assess narrative aspects of the forms. Quality was ranked as A (excellent) to D (poor). Results: Of 230 patients (74 VV-ECMO, 104 transplant, 52 elective non-transplant surgery), 43 (18.7%) had a ReSPECT form and only one (0.43%) patient had a ReSPECT form completed prior to ICU admission. Of the 43 forms completed, 38 (88.4%) were completed due to the commencement of End of Life (EoL) care. No non-transplant surgical patients included in the audit had a ReSPECT form. There was documentation of balance of care (section 4a), CPR status (section 4c), capacity assessment (section 5), and patient involvement in completing the form (section 6a) on all 43 forms. Of the 34 patients assessed as lacking capacity to make decisions, only 22 (64.7%) had reasons documented. Other sections were variably completed; 29 (67.4%) forms had relevant background information included to a good standard (section 2a). Clinical guidance for the patient (section 4b) was given in 25 (58.1%), of which 11 stated the rationale that underpinned it. Seven forms (16.3%) contained information in an inappropriate section. In a comparison of ReSPECT forms completed ahead of an EoL trigger with those completed when EoL care began, there was a higher number of entries in section 3 (considering patient’s values/fears) that were assessed at grades A-B in the former group (p = 0.014), suggesting higher quality. Similarly, forms from the transplant group contained higher quality information in section 3 than those from the VV-ECMO group (p = 0.0005). Conclusions: Utilisation of the ReSPECT process in high-risk patients is yet to be well-adopted in this trust. Teams who meet patients before hospital admission for transplant or high-risk surgery should be encouraged to engage with the ReSPECT process at this point in the patient's journey. VV-ECMO retrieval teams should consider ReSPECT conversations with patients’ relatives at the time of retrieval.

Keywords: audit, critical care, end of life, ICU, ReSPECT, resuscitation

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