Search results for: optimal site selection

Authors: Christopher Latella, Ashlee M. Hendy, Dan Vander Westhuizen, Wei-Peng Teo

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Introduction: Neural adaptations following resistance training interventions have been widely investigated, however the evidence regarding the mechanisms of early adaptation are less clear. Understanding neural responses from an acute resistance training session is pivotal in the prescription of frequency, intensity and volume in applied strength and conditioning practice. Therefore the primary aim of this study was to investigate the time course of neurophysiological mechanisms post training against current super compensation theory, and secondly, to examine whether these responses reflect neural adaptations observed with resistance training interventions. Methods: Participants (N=14) completed a randomised, counterbalanced crossover study comparing; control, strength and hypertrophy conditions. The strength condition involved 3 x 5RM leg extensions with 3min recovery, while the hypertrophy condition involved 3 x 12 RM with 60s recovery. Transcranial magnetic stimulation (TMS) and peripheral nerve stimulation were used to measure excitability of the central and peripheral neural pathways, and maximal voluntary contraction (MVC) to quantify strength changes. Measures were taken pre, immediately post, 10, 20 and 30 mins and 1, 2, 6, 24, 48, 72 and 96 hrs following training. Results: Significant decreases were observed at post, 10, 20, 30 min, 1 and 2 hrs for both training groups compared to control group for force, (p <.05), maximal compound wave; (p < .005), silent period; (p < .05). A significant increase in corticospinal excitability; (p < .005) was observed for both groups. Corticospinal excitability between strength and hypertrophy groups was near significance, with a large effect (η2= .202). All measures returned to baseline within 6 hrs post training. Discussion: Neurophysiological mechanisms appear to be significantly altered in the period 2 hrs post training, returning to homeostasis by 6 hrs. The evidence suggests that the time course of neural recovery post resistance training occurs 18-40 hours shorter than previous super compensation models. Strength and hypertrophy protocols showed similar response profiles with current findings suggesting greater post training corticospinal drive from hypertrophy training, despite previous evidence that strength training requires greater neural input. The increase in corticospinal drive and decrease inl inhibition appear to be a compensatory mechanism for decreases in peripheral nerve excitability and maximal voluntary force output. The changes in corticospinal excitability and inhibition are akin to adaptive processes observed with training interventions of 4 wks or longer. It appears that the 2 hr recovery period post training is the most influential for priming further neural adaptations with resistance training. Secondly, the frequency of prescribed resistance sessions can be scheduled closer than previous super compensation theory for optimal strength gains.

Keywords: neural responses, resistance training, super compensation, transcranial magnetic stimulation

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Authors: Klaudia Pluta, Katarzyna Bialik-Wąs, Dagmara Malina, Mateusz Barczewski

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Hydrogel networks, due to their unique properties, are highly attractive materials for wound dressing. The three-dimensional structure of hydrogels provides tissues with optimal moisture, which supports the wound healing process. Moreover, a characteristic feature of hydrogels is their absorption properties which allow for the absorption of wound exudates. For the fabrication of biomedical hydrogels, a combination of natural polymers ensuring biocompatibility and synthetic ones that provide adequate mechanical strength are often used. Sodium alginate (SA) is one of the polymers widely used in wound dressing materials because it exhibits excellent biocompatibility and biodegradability. However, due to poor strength properties, often alginate-based hydrogel materials are enhanced by the addition of another polymer such as poly(vinyl alcohol) (PVA). This paper is concentrated on the preparation methods of sodium alginate/polyvinyl alcohol hydrogel system incorporating Aloe vera extract and glycerin for wound healing material with particular focus on the role of their composition on structure, thermal properties, and stability. Briefly, the hydrogel preparation is based on the chemical cross-linking method using poly(ethylene glycol) diacrylate (PEGDA, Mn = 700 g/mol) as a crosslinking agent and ammonium persulfate as an initiator. In vitro degradation tests of SA/PVA/AV hydrogels were carried out in Phosphate-Buffered Saline (pH – 7.4) as well as in distilled water. Hydrogel samples were firstly cut into half-gram pieces (in triplicate) and immersed in immersion fluid. Then, all specimens were incubated at 37°C and then the pH and conductivity values were measurements at time intervals. The post-incubation fluids were analyzed using SEC/GPC to check the content of oligomers. The separation was carried out at 35°C on a poly(hydroxy methacrylate) column (dimensions 300 x 8 mm). 0.1M NaCl solution, whose flow rate was 0.65 ml/min, was used as the mobile phase. Three injections with a volume of 50 µl were made for each sample. The thermogravimetric data of the prepared hydrogels were collected using a Netzsch TG 209 F1 Libra apparatus. The samples with masses of about 10 mg were weighed separately in Al2O3 crucibles and then were heated from 30°C to 900°C with a scanning rate of 10 °C∙min−1 under a nitrogen atmosphere. Based on the conducted research, a fast and simple method was developed to produce potential wound dressing material containing sodium alginate, poly(vinyl alcohol) and Aloe vera extract. As a result, transparent and flexible SA/PVA/AV hydrogels were obtained. The degradation experiments indicated that most of the samples immersed in PBS as well as in distilled water were not degraded throughout the whole incubation time.

Keywords: hydrogels, wound dressings, sodium alginate, poly(vinyl alcohol)

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Authors: Melanie Redding

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Historic widespread nitrate contamination of the Lower Yakima Valley aquifer in Washington State initiated a community-based effort to reduce nitrate concentrations to below-drinking water standards. This group commissioned studies on characterizing local nitrogen sources, deep soil assessments, drinking water, and assessing nitrate concentrations at the water table. Nitrate is the most prevalent groundwater contaminant with common sources from animal and human waste, fertilizers, plants and precipitation. It is challenging to address groundwater contamination when common sources, such as agriculture, on-site sewage systems, and animal production, are widespread. Remediation is not possible, so mitigation is essential. The Lower Yakima Valley is located over 175,000 acres, with a population of 56,000 residents. Approximately 25% of the population do not have access to safe, clean drinking water, and 20% of the population is at or below the poverty level. Agriculture is the primary economic land-use activity. Irrigated agriculture and livestock production make up the largest percentage of acreage and nitrogen load. Commodities include apples, grapes, hops, dairy, silage corn, triticale, alfalfa and cherries. These commodities are important to the economic viability of the residents of the Lower Yakima Valley, as well as Washington State. Mitigation of nitrate in groundwater is challenging. The goal is to ensure everyone has safe drinking water. There are no easy remedies due to the extensive and pervasiveness of the contamination. Monitoring at the water table indicates that 45% of the 30 spatially distributed monitoring wells exceeded the drinking water standard. This indicates that there are multiple sources that are impacting water quality. Washington State has several areas which have extensive groundwater nitrate contamination. The groundwater in these areas continues to degrade over time. However, the Lower Yakima Valley is being successful in addressing this health issue because of the following reasons: the community is engaged and committed; there is one common goal; there has been extensive public education and outreach to citizens; and generating credible data using sound scientific methods. Work in this area is continuing as an ambient groundwater monitoring network is established to assess the condition of the aquifer over time. Nitrate samples are being collected from 170 wells, spatially distributed across the aquifer. This research entails quarterly sampling for two years to characterize seasonal variability and then continue annually afterward. This assessment will provide the data to statistically determine trends in nitrate concentrations across the aquifer, over time. Thirty-three of these wells are monitoring wells that are screened across the aquifer. The water quality from these wells are indicative of activities at the land surface. Additional work is being conducted to identify land use management practices that are effective in limiting nitrate migration through the soil column. Tracking nitrate in the soil column every season is an important component of bridging land-use practices with the fate and transport of nitrate through the subsurface. Patience, tenacity, and the ability to think outside the box are essential for dealing with widespread nitrate contamination of groundwater.

Keywords: community, groundwater, monitoring, nitrate

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Authors: Katie Dolaghan, Christina Tran, Kim Hamilton, Amanda Beresford, Vicky Adams, Jamie Toole, John Marley

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During the Covid 19 pandemic routine outpatient appointments were not possible face to face. That resulted in many branches of healthcare starting virtual clinics. These clinics have continued following the return to face to face patient appointments. With these new types of clinic it is important to ensure that a high standard of patient care is maintained. In order to improve patient and clinician experience of the telephone clinics a quality improvement project was carried out to ensure the patient and clinician experience of these clinics was enhanced whilst remaining a safe, effective and an efficient use of resources. The project began by developing a process map for the consultation process and agreed on the design of a driver diagram and tests of change. In plan do study act (PDSA) cycle1 a single consultant completed an online survey after every patient encounter over a 5 week period. Baseline patient responses were collected using a follow-up telephone survey for each patient. Piloting led to several iterations of both survey designs. Salient results of PDSA1 included; patients not receiving appointment letters, patients feeling more anxious about a virtual appointment and many would prefer a face to face appointment. The initial clinician data showed a positive response with a provisional diagnosis being reached in 96.4% of encounters. PDSA cycle 2 included provision of a patient information sheet and information leaflets relevant to the patients’ conditions were developed and sent following new patient telephone clinics with follow-up survey analysis as before to monitor for signals of change. We also introduced the ability for patients to send an images of their lesion prior to the consultation. Following the changes implemented we noted an improvement in patient satisfaction and, in fact, many patients preferring virtual clinics as it lead to less disruption of their working lives. The extra reading material both before and after the appointments eased patients’ anxiety around virtual clinics and helped them to prepare for their appointment. Following the patient feedback virtual clinics are now used for review patients as well, with all four consultants within the department continuing to utilise virtual clinics. During this presentation the progression of these clinics and the reasons that these clinics are still operating following the return to face to face appointments will be explored. The lessons that have been gained using a QI approach have helped to deliver an optimal service that is valid and reliable as well as being safe, effective and efficient for the patient along with helping reduce the pressures from ever increasing waiting lists. In summary our work in improving the quality of virtual clinics has resulted in improved patient satisfaction along with reduced pressures on the facilities of the health trust.

Keywords: clinic, satisfaction, telephone, virtual

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Authors: Zihan Geng, L. Quentin Dixon

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It has been proposed that early bilingual experience confers a number of advantages in the development of executive control mechanisms. Although the literature provides empirical evidence for bilingual benefits, some studies also reported null or mixed results. To make sense of these contradictory findings, the current review synthesize recent empirical studies investigating bilingual effects on children’s executive function and attention control. The publication time of the studies included in the review ranges from 2010 to 2017. The key searching terms are bilingual, bilingualism, children, executive control, executive function, and attention. The key terms were combined within each of the following databases: ERIC (EBSCO), Education Source, PsycINFO, and Social Science Citation Index. Studies involving both children and adults were also included but the analysis was based on the data generated only by the children group. The initial search yielded 137 distinct articles. Twenty-eight studies from 27 articles with a total of 3367 participants were finally included based on the selection criteria. The selective studies were then coded in terms of (a) the setting (i.e., the country where the data was collected), (b) the participants (i.e., age and languages), (c) sample size (i.e., the number of children in each group), (d) cognitive outcomes measured, (e) data collection instruments (i.e., cognitive tasks and tests), and (f) statistic analysis models (e.g., t-test, ANOVA). The results show that the majority of the studies were undertaken in western countries, mainly in the U.S., Canada, and the UK. A variety of languages such as Arabic, French, Dutch, Welsh, German, Spanish, Korean, and Cantonese were involved. In relation to cognitive outcomes, the studies examined children’s overall planning and problem-solving abilities, inhibition, cognitive complexity, working memory (WM), and sustained and selective attention. The results indicate that though bilingualism is associated with several cognitive benefits, the advantages seem to be weak, at least, for children. Additionally, the nature of the cognitive measures was found to greatly moderate the results. No significant differences are observed between bilinguals and monolinguals in overall planning and problem-solving ability, indicating that there is no bilingual benefit in the cooperation of executive function components at an early age. In terms of inhibition, the mixed results suggest that bilingual children, especially young children, may have better conceptual inhibition measured in conflict tasks, but not better response inhibition measured by delay tasks. Further, bilingual children showed better inhibitory control to bivalent displays, which resembles the process of maintaining two language systems. The null results were obtained for both cognitive complexity and WM, suggesting no bilingual advantage in these two cognitive components. Finally, findings on children’s attention system associate bilingualism with heightened attention control. Together, these findings support the hypothesis of cognitive benefits for bilingual children. Nevertheless, whether these advantages are observable appears to highly depend on the cognitive assessments. Therefore, future research should be more specific about the cognitive outcomes (e.g., the type of inhibition) and should report the validity of the cognitive measures consistently.

Keywords: attention, bilingual advantage, children, executive function

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Authors: Anna Marie Fisker, Daniele Sepe, Mette Bøgh Jensen, Daniela Rimei

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In the space of just a few years, the European policy framework on cultural heritage has been completely overhauled, moving towards a people-centred and holistic approach, and eliminating the divisions between the tangible, intangible and digital dimensions. The European Union regards cultural heritage as a potential shared resource, highlighting that all stakeholders share responsibility for its transmission to future generations. This new framework will potentially change the way in which cultural institutions manage, protect and provide access to their heritage. It will change the way in which citizens and communities engage with their cultural heritage and naturally influence the way that professionals deal with it. Participating in the creation of cultural heritage awareness can lead to an increased perception of its value, be it economic, social, environmental or cultural. It can also strengthen our personal identity, sense of belonging and community citizenship. Open Atelier, a Creative Europe project, is based on this foundation, with the goal through co-creation to develop the use, understanding and engagement with our cultural heritage. The project aim to transform selected parts of the heritage into an “experience lab” – an interactive, co-creative, dynamic and participatory space, where cultural heritage is the point of departure for new interactions and experiences between the audience and the museum and its professionals. Through a workshop-based approach built on interdisciplinary collaboration and co-creative processes, Open Atelier has started to design, develop, test, and evaluate a set of Experiences. The first collaborative initiative was set out in the discourse and knowledge of a highly creative period in Denmark where a specific group of Scandinavian artists, the Skagen Painters, gathered in the village of Skagen, the northernmost part of Denmark from the late 1870s until the turn of the century. The Art Museums of Skagen have a large collection of photos from the period, that has never been the subject of more thorough research. The photos display a variation of many different subjects: community, family photos, reproductions of art works, costume parties, family gatherings etc., and carry with them the energies of those peoples’ work and life and evoke instances of communication with the past. This paper is about how we in Open Atelier connect these special stories, this legacy, with another place, in another time, in another context and with another audience. The first Open Atelier Experience – the performance “Around the Lighthouse” – was an initiative resulted from the collaboration between AMAT, an Italian creative organisation, and the Art Museums of Skagen. A group of Italian artists developed a co-creative investigation and reinterpretation of a selection of these historical photos. A poetic journey through videos and voices, aimed at exploring new perspectives on the museum and its heritage. An experiment on how to create new ways to actively engage audiences in the way cultural heritage is explored, interpreted, mediated, presented, and used to examine contemporary issues. This article is about this experiment and its findings, and how different views and methodologies can be adopted to discuss the cultural heritage in museums around Europe and their connection to the community.

Keywords: cultural heritage, community, innovation, museums

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Authors: Mohammed Fayez Al Rez

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Nowadays, there is an unmet clinical need for new small-diameter vascular grafts to overcome the drawbacks of traditional methods used for treatment of widespread cardiovascular diseases. Vascular tissue engineering (VTE) is a promising approach that can be utilized to develop viable vascular grafts by in vitro seeding of functional cells onto a scaffold allowing them to attach, proliferate and differentiate. To achieve this purpose, the scaffold should provide cells with the initial necessary extracellular matrix environment and structure until being able to reconstruct the required vascular tissue. Therefore, producing scaffolds with suitable features is crucial for guiding cells properly to develop the desired tissue-engineered vascular grafts for clinical applications. The main objective of this work is fabrication and characterization of tubular small-diameter ( < 6 mm) bilayered scaffolds for VTE. The scaffolds were prepared via mixing electrospinning approach of biodegradable poly(ε-caprolactone) (PCL) polymer – due to its favorable physicochemical properties – to mimic the natural environment-extracellular matrix. Firstly, tubular nanofibrous construct with inner diameter of 3, 4 or 5 mm was electrospun as inner layer, and secondly, microfibrous construct was electrospun as outer layer directly on the first produced inner layer. To improve the biological properties of PCL, a group of the electrospun scaffolds was immersed in type-1 collagen solution. The morphology and structure of the resulting fibrous scaffolds were investigated by scanning electron microscope. The electrospun nanofibrous inner layer contained fibers measuring 219±35 nm in diameter, while the electrospun microfibrous outer layer contained fibers measuring 1011 ± 150 nm. Furthermore, mechanical, thermal and physical tests were conducted with both electrospun bilayered scaffold types where revealed improved properties. Biological investigations using endothelial, smooth muscle and fibroblast cell line showed good biocompatibility of both tested electrospun scaffolds. Better attachment and proliferation were obviously found when cells were cultured on the scaffolds immersed with collagen due to increasing the hydrophilicity of the PCL. The easy, inexpensive and versatile electrospinning approach used in this work was able to successfully produce double layered tubular elastic structures containing both nanofibers and microfibers to imitate the native vascular structure. The PCL – as a suitable and approved biomaterial for many biomedical and tissue engineering applications – can ensure favorable mechanical properties of scaffolds used for VTE. The VTE approach using electrospun bilayered scaffolds offers optimal solutions and holds significant promises for treatment of many cardiovascular diseases.

Keywords: electrospinning, poly(ε-caprolactone) (PCL), tissue-engineered vascular graft, tubular bilayered scaffolds, vascular cells

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Authors: Kimberley Adamek

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According to the Council on Tall Buildings, there has been a rapid increase in the construction of tall or “megatall” buildings over the past two decades. Simultaneously, the New England Journal of Medicine has reported that there has been a steady increase in climate related natural disasters since the 1970s; the eastern expansion of the USA's infamous Tornado Alley being just one of many current issues. In the future, this could mean that tall buildings, which already guide high speed winds down to pedestrian levels would have to withstand stronger forces and protect pedestrians in more extreme ways. Although many projects are required to be verified within wind tunnels and a handful of cities such as San Francisco have included wind testing within building code standards, there are still many examples where wind is only considered for basic loading. This typically results in and an increase of structural expense and unwanted mitigation strategies that are proposed late within a project. When building cities, architects rarely consider how each building alters the invisible patterns of wind and how these alterations effect other areas in different ways later on. It is not until these forces move, overpower and even destroy cities that people take notice. For example, towers have caused winds to blow objects into people (Walkie-Talkie Tower, Leeds, England), cause building parts to vibrate and produce loud humming noises (Beetham Tower, Manchester), caused wind tunnels in streets as well as many other issues. Alternatively, there exist towers which have used their form to naturally draw in air and ventilate entire facilities in order to eliminate the needs for costly HVAC systems (The Met, Thailand) and used their form to increase wind speeds to generate electricity (Bahrain Tower, Dubai). Wind and weather exist and effect all parts of the world in ways such as: Science, health, war, infrastructure, catastrophes, tourism, shopping, media and materials. Working in partnership with a leading wind engineering company RWDI, a series of tests, images and animations documenting discovered interactions of different building forms with wind will be collected to emphasize the possibilities for wind use to architects. A site within San Francisco (due to its increasing tower development, consistently wind conditions and existing strict wind comfort criteria) will host a final design. Iterations of this design will be tested within the wind tunnel and computational fluid dynamic systems which will expose, utilize and manipulate wind flows to create new forms, technologies and experiences. Ultimately, this thesis aims to question the amount which the environment is allowed to permeate building enclosures, uncover new programmatic possibilities for wind in buildings, and push the boundaries of working with the wind to ensure the development and safety of future cities. This investigation will improve and expand upon the traditional understanding of wind in order to give architects, wind engineers as well as the general public the ability to broaden their scope in order to productively utilize this living phenomenon that everyone constantly feels but cannot see.

Keywords: wind engineering, climate, visualization, architectural aerodynamics

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Authors: Ammar Alali, Mahmoud Abughaban

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Cost reduction and drilling optimization is the goal of many drilling operators. Historically, stuck pipe incidents were a major segment of non-productive time (NPT) associated costs. Traditionally, stuck pipe problems are part of the operations and solved post-sticking. However, the real key to savings and success is in predicting the stuck pipe incidents and avoiding the conditions leading to its occurrences. Previous attempts in stuck-pipe predictions have neglected the local geology of the problem. The proposed predictive tool utilizes geophysical data processing techniques and Machine Learning (ML) algorithms to predict drilling activities events in real-time using surface drilling data with minimum computational power. The method combines two types of analysis: (1) real-time prediction, and (2) cause analysis. Real-time prediction aggregates the input data, including historical drilling surface data, geological formation tops, and petrophysical data, from wells within the same field. The input data are then flattened per the geological formation and stacked per stuck-pipe incidents. The algorithm uses two physical methods (stacking and flattening) to filter any noise in the signature and create a robust pre-determined pilot that adheres to the local geology. Once the drilling operation starts, the Wellsite Information Transfer Standard Markup Language (WITSML) live surface data are fed into a matrix and aggregated in a similar frequency as the pre-determined signature. Then, the matrix is correlated with the pre-determined stuck-pipe signature for this field, in real-time. The correlation used is a machine learning Correlation-based Feature Selection (CFS) algorithm, which selects relevant features from the class and identifying redundant features. The correlation output is interpreted as a probability curve of stuck pipe incidents prediction in real-time. Once this probability passes a fixed-threshold defined by the user, the other component, cause analysis, alerts the user of the expected incident based on set pre-determined signatures. A set of recommendations will be provided to reduce the associated risk. The validation process involved feeding of historical drilling data as live-stream, mimicking actual drilling conditions, of an onshore oil field. Pre-determined signatures were created for three problematic geological formations in this field prior. Three wells were processed as case studies, and the stuck-pipe incidents were predicted successfully, with an accuracy of 76%. This accuracy of detection could have resulted in around 50% reduction in NPT, equivalent to 9% cost saving in comparison with offset wells. The prediction of stuck pipe problem requires a method to capture geological, geophysical and drilling data, and recognize the indicators of this issue at a field and geological formation level. This paper illustrates the efficiency and the robustness of the proposed cross-disciplinary approach in its ability to produce such signatures and predicting this NPT event.

Keywords: drilling optimization, hazard prediction, machine learning, stuck pipe

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Authors: Mohamad F. Jamiluddin, Emeline Sarry, Ana Bejanariu, Cécile Bauche

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Introduction: Over 360 million people are chronically infected with hepatitis B virus (HBV), of whom 1 million die each year from HBV-associated liver cirrhosis or hepatocellular carcinoma. Current treatment options for chronic hepatitis B depend on interferon-α (IFNα) or nucleos(t)ide analogs, which control virus replication but rarely eliminate the virus. Treatment with PEG-IFNα leads to a sustained antiviral response in only one third of patients. After withdrawal of the drugs, the rebound of viremia is observed in the majority of patients. Furthermore, the long-term treatment is subsequently associated with the appearance of drug resistant HBV strains that is often the cause of the therapy failure. Among the new therapeutic avenues being developed, therapeutic vaccine aimed at inducing immune responses similar to those found in resolvers is of growing interest. The high prevalence of chronic hepatitis B necessitates the design of better vaccination strategies capable of eliciting broad-spectrum of cell-mediated immunity(CMI) and humoral immune response that can control chronic hepatitis B. Induction of HBV-specific T cells and B cells by therapeutic vaccination may be an innovative strategy to overcome virus persistence. Lentiviral vectors developed and optimized by THERAVECTYS, due to their ability to transduce non-dividing cells, including dendritic cells, and induce CMI response, have demonstrated their effectiveness as vaccination tools. Method: To develop a HBV therapeutic vaccine that can induce a broad but specific immune response, we generated recombinant lentiviral vector carrying IRES(Internal Ribosome Entry Site)-containing bicistronic constructs which allow the coexpression of two vaccine products, namely HBV T- cell epitope vaccine and HBV virus like particle (VLP) vaccine. HBV T-cell epitope vaccine consists of immunodominant cluster of CD4 and CD8 epitopes with spacer in between them and epitopes are derived from HBV surface protein, HBV core, HBV X and polymerase. While HBV VLP vaccine is a HBV core protein based chimeric VLP with surface protein B-cell epitopes displayed. In order to evaluate the immunogenicity, mice were immunized with lentiviral constructs by intramuscular injection. The T cell and antibody immune responses of the two vaccine products were analyzed using IFN-γ ELISpot assay and ELISA respectively to quantify the adaptive response to HBV antigens. Results: Following a single administration in mice, lentiviral construct elicited robust antigen-specific IFN-γ responses to the encoded antigens. The HBV T- cell epitope vaccine demonstrated significantly higher T cell immunogenicity than HBV VLP vaccine. Importantly, we demonstrated by ELISA that antibodies are induced against both HBV surface protein and HBV core protein when mice injected with vaccine construct (p < 0.05). Conclusion: Our results highlight that THERAVECTYS lentiviral vectors may represent a powerful platform for immunization strategy against chronic hepatitis B. Our data suggests the likely importance of Lentiviral vector based novel bicistronic construct for further study, in combination with drugs or as standalone antigens, as a therapeutic lentiviral based HBV vaccines. THERAVECTYS bicistronic HBV vaccine will be further evaluated in animal efficacy studies.

Keywords: chronic hepatitis B, lentiviral vectors, therapeutic vaccine, virus-like particle

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Authors: Igor A. Krichtafovitch

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The evolutionary processes are not linear. Long periods of quiet and slow development turn to rather rapid emergences of new species and even phyla. During Cambrian explosion, 22 new phyla were added to the previously existed 3 phyla. Contrary to the common credence the natural selection or a survival of the fittest cannot be accounted for the dominant evolution vector which is steady and accelerated advent of more complex and more intelligent living organisms. Neither Darwinism nor alternative concepts including panspermia and intelligent design propose a satisfactory solution for these phenomena. The proposed hypothesis offers a logical and plausible explanation of the evolutionary processes in general. It is based on two postulates: a) the Biosphere is a single living organism, all parts of which are interconnected, and b) the Biosphere acts as a giant biological supercomputer, storing and processing the information in digital and analog forms. Such supercomputer surpasses all human-made computers by many orders of magnitude. Living organisms are the product of intelligent creative action of the biosphere supercomputer. The biological evolution is driven by growing amount of information stored in the living organisms and increasing complexity of the biosphere as a single organism. Main evolutionary vector is not a survival of the fittest but an accelerated growth of the computational complexity of the living organisms. The following postulates may summarize the proposed hypothesis: biological evolution as a natural life origin and development is a reality. Evolution is a coordinated and controlled process. One of evolution’s main development vectors is a growing computational complexity of the living organisms and the biosphere’s intelligence. The intelligent matter which conducts and controls global evolution is a gigantic bio-computer combining all living organisms on Earth. The information is acting like a software stored in and controlled by the biosphere. Random mutations trigger this software, as is stipulated by Darwinian Evolution Theories, and it is further stimulated by the growing demand for the Biosphere’s global memory storage and computational complexity. Greater memory volume requires a greater number and more intellectually advanced organisms for storing and handling it. More intricate organisms require the greater computational complexity of biosphere in order to keep control over the living world. This is an endless recursive endeavor with accelerated evolutionary dynamic. New species emerge when two conditions are met: a) crucial environmental changes occur and/or global memory storage volume comes to its limit and b) biosphere computational complexity reaches critical mass capable of producing more advanced creatures. The hypothesis presented here is a naturalistic concept of life creation and evolution. The hypothesis logically resolves many puzzling problems with the current state evolution theory such as speciation, as a result of GM purposeful design, evolution development vector, as a need for growing global intelligence, punctuated equilibrium, happening when two above conditions a) and b) are met, the Cambrian explosion, mass extinctions, happening when more intelligent species should replace outdated creatures.

Keywords: supercomputer, biological evolution, Darwinism, speciation

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Authors: Zhenyu Zhang, Hsi-Hsien Wei

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Highway networks play a vital role in post-disaster recovery for disaster-damaged areas. Damaged bridges in such networks can disrupt the recovery activities by impeding the transportation of people, cargo, and reconstruction resources. Therefore, rapid restoration of damaged bridges is of paramount importance to long-term disaster recovery. In the post-disaster recovery phase, the key to restoration scheduling for a highway network is prioritization of bridge-repair tasks. Resilience is widely used as a measure of the ability to recover with which a network can return to its pre-disaster level of functionality. In practice, highways will be temporarily blocked during the downtime of bridge restoration, leading to the decrease of highway-network functionality. The failure to take downtime effects into account can lead to overestimation of network resilience. Additionally, post-disaster recovery of highway networks is generally divided into emergency bridge repair (EBR) in the response phase and long-term bridge repair (LBR) in the recovery phase, and both of EBR and LBR are different in terms of restoration objectives, restoration duration, budget, etc. Distinguish these two phases are important to precisely quantify highway network resilience and generate suitable restoration schedules for highway networks in the recovery phase. To address the above issues, this study proposes a novel resilience quantification method for the optimization of long-term bridge repair schedules (LBRS) taking into account the impact of EBR activities and restoration downtime on a highway network’s functionality. A time-dependent integer program with recursive functions is formulated for optimally scheduling LBR activities. Moreover, since uncertainty always exists in the LBRS problem, this paper extends the optimization model from the deterministic case to the stochastic case. A hybrid genetic algorithm that integrates a heuristic approach into a traditional genetic algorithm to accelerate the evolution process is developed. The proposed methods are tested using data from the 2008 Wenchuan earthquake, based on a regional highway network in Sichuan, China, consisting of 168 highway bridges on 36 highways connecting 25 cities/towns. The results show that, in this case, neglecting the bridge restoration downtime can lead to approximately 15% overestimation of highway network resilience. Moreover, accounting for the impact of EBR on network functionality can help to generate a more specific and reasonable LBRS. The theoretical and practical values are as follows. First, the proposed network recovery curve contributes to comprehensive quantification of highway network resilience by accounting for the impact of both restoration downtime and EBR activities on the recovery curves. Moreover, this study can improve the highway network resilience from the organizational dimension by providing bridge managers with optimal LBR strategies.

Keywords: disaster management, highway network, long-term bridge repair schedule, resilience, restoration downtime

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Authors: Małgorzata Golonka, Jadwiga Laska

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Self-healing polymers are one of the most investigated groups of smart materials. As materials engineering has recently focused on the design, production and research of modern materials and future technologies, researchers are looking for innovations in structural, construction and coating materials. Based on available scientific articles, it can be concluded that most of the research focuses on the self-healing of cement, concrete, asphalt and anticorrosion resin coatings. In our study, a method of obtaining and testing the properties of several types of microcapsules for use in self-healing polymer materials was developed. A method to obtain microcapsules exhibiting various mechanical properties, especially compressive strength was developed. The effect was achieved by using various polymer materials to build the shell: urea-formaldehyde resin (UFR), melamine-formaldehyde resin (MFR), melamine-urea-formaldehyde resin (MUFR). Dicyclopentadiene (DCPD) was used as the core material due to the possibility of its polymerization according to the ring-opening olefin metathesis (ROMP) mechanism in the presence of a solid Grubbs catalyst showing relatively high chemical and thermal stability. The ROMP of dicyclopentadiene leads to a polymer with high impact strength, high thermal resistance, good adhesion to other materials and good chemical and environmental resistance, so it is potentially a very promising candidate for the self-healing of materials. The capsules were obtained by condensation polymerization of formaldehyde with urea, melamine or copolymerization with urea and melamine in situ in water dispersion, with different molar ratios of formaldehyde, urea and melamine. The fineness of the organic phase dispersed in water, and consequently the size of the microcapsules, was regulated by the stirring speed. In all cases, to establish such synthesis conditions as to obtain capsules with appropriate mechanical strength. The microcapsules were characterized by determining the diameters and their distribution and measuring the shell thickness using digital optical microscopy and scanning electron microscopy, as well as confirming the presence of the active substance in the core by FTIR and SEM. Compression tests were performed to determine mechanical strength of the microcapsules. The highest repeatability of microcapsule properties was obtained for UFR resin, while the MFR resin had the best mechanical properties. The encapsulation efficiency of MFR was much lower compared to UFR, though. Therefore, capsules with a MUFR shell may be the optimal solution. The chemical reaction between the active substance present in the capsule core and the catalyst placed outside the capsules was confirmed by FTIR spectroscopy. The obtained autonomous repair systems (microcapsules + catalyst) were introduced into polyethylene in the extrusion process and tested for the self-repair of the material.

Keywords: autonomic self-healing system, dicyclopentadiene, melamine-urea-formaldehyde resin, microcapsules, thermoplastic materials

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Authors: Lesly Y Carmona-Sarabia, Luisa Barraza-Vergara, Vilmalí López-Mejías, Wandaliz Torres-García, Maribella Domenech-Garcia, Madeline Torres-Lugo

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Biosensors are used in many applications providing real-time monitoring to treat long-term conditions. Thus, understanding the physicochemical properties and biological side effects on the skin of polymers (e. g., poly(methyl methacrylate), PMMA) employed in the fabrication of wearable biosensors is crucial for the selection of manufacturing materials within this field. The PMMA (hydrophobic and thermoplastic polymer) is commonly employed as a coating material or substrate in the fabrication of wearable devices. The cytotoxicityof PMMA (including residual monomers or degradation products) on the skin, in terms of cells and tissue, is required to prevent possible adverse effects (cell death, skin reactions, sensitization) on human health. Within this work, accelerated aging of PMMA (Mw ~ 15000) through thermal and photochemical degradation was under-taken. The accelerated aging of PMMA was carried out by thermal (200°C, 1h) and photochemical degradation (UV-Vis, 8-15d) adapted employing ISO protocols (ISO-10993-12, ISO-4892-1:2016, ISO-877-1:2009, ISO-188: 2011). In addition, in vitro cytotoxicity evaluation of PMMA degradation products was performed using NIH3T3 fibroblast cells to assess the response of skin tissues (in terms of cell viability) exposed with polymers utilized to manufacture wearable biosensors, such as PMMA. The PMMA (Mw ~ 15000) before and after accelerated aging experiments was characterized by thermal gravimetric analysis (TGA), differential scanning calorimetric (DSC), powder X-ray diffractogram (PXRD), and scanning electron microscopy-energy dispersive spectroscopy (SEM-EDS) to determine and verify the successful degradation of this polymer under the specific conditions previously mention. The degradation products were characterized through nuclear magnetic resonance (NMR) to identify possible byproducts generated after the accelerated aging. Results demonstrated a percentage (%) weight loss between 1.5-2.2% (TGA thermographs) for PMMA after accelerated aging. The EDS elemental analysis reveals a 1.32 wt.% loss of carbon for PMMA after thermal degradation. These results might be associated with the amount (%) of PMMA degrade after the accelerated aging experiments. Furthermore, from the thermal degradation products was detected the presence of the monomer and methyl formate (low concentrations) and a low molecular weight radical (·COOCH3) in higher concentrations by NMR. In the photodegradation products, methyl formate was detected in higher concentrations. These results agree with the proposed thermal or photochemical degradation mechanisms found in the literature.1,2 Finally, significant cytotoxicity on the NIH3T3 cells was obtained for the thermal and photochemical degradation products. A decrease in cell viability by > 90% (stock solutions) was observed. It is proposed that the presence of byproducts (e.g. methyl formate or radicals such as ·COOCH₃) from the PMMA degradation might be responsible for the cytotoxicity observed in the NIH3T3 fibroblast cells. Additionally, experiments using skin models will be employed to compare with the NIH3T3 fibroblast cells model.

Keywords: biosensors, polymer, skin irritation, degradation products, cell viability

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Authors: Orit Wolf

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Classical music performance is undergoing a profound transformation, marked by a confluence of technological advancements and evolving cultural dynamics. This academic paper explores the multifaceted changes and challenges faced by classical music performance, considering the impact of artificial intelligence (AI) along with other vital factors shaping this evolution. In the contemporary era, classical music is experiencing shifts in performance practices. This paper delves into these changes, emphasizing the need for adaptability within the classical music world. From repertoire selection and concert formats to artistic expression, performers and institutions navigate a delicate balance between tradition and innovation. We explore how these changes impact the authenticity and vitality of classical music performances. Furthermore, the influence of AI in the classical music concert world cannot be underestimated. AI technologies are making inroads into various aspects, from composition assistance to rehearsal and live performances. This paper examines the transformative effects of AI, considering how it enhances precision, adaptability, and creative exploration for musicians. We explore the implications for composers, performers, and the overall concert experience while addressing ethical concerns and creative opportunities. In addition to AI, there is the importance of cross-genre interactions within the classical music sphere. Mash-ups and collaborations with artists from diverse musical backgrounds are redefining the boundaries of classical music and creating works that resonate with a wider and more diverse audience. The benefits of cross-pollination in classical music seem crucial, offering a fresh perspective to listeners. As an active concert artist, Orit Wolf will share how the expectations of classical music audiences are evolving. Modern concertgoers seek not only exceptional musical performances but also immersive experiences that may involve technology, multimedia, and interactive elements. This paper examines how classical musicians and institutions are adapting to these changing expectations, using technology and innovative concert formats to deliver a unique and enriched experience to their audiences. As these changes and challenges reshape the classical music world, the need for a harmonious coexistence of tradition, technology, and innovation becomes evident. Musicians, composers, and institutions are striving to find a balance that ensures classical music remains relevant in a rapidly changing cultural landscape while maintaining the value it brings to compositions and audiences. This paper, therefore, aims to explore the evolving trends in classical music performance. It considers the influence of AI as one element within the broader context of change, highlighting the necessity of adaptability, cross-genre interactions, and a response to evolving audience expectations. By doing so, the classical music world can navigate this transformative period while preserving its timeless traditions and adding value to both performers and listeners. Orit Wolf, an international concert pianist, fulfils her vision to bring this music in new ways to mass audiences and will share her personal and professional experience as an artist who goes on stage and makes disruptive concerts.

Keywords: cross culture collaboration, music performance and ai, classical music in the digital age, classical concerts, innovation and technology, performance innovation, audience engagement in classical concerts

Procedia PDF Downloads 35

Authors: Biao Sun, Tejas Bhatelia, Vishnu Pareek, Ranjeet Utikar, Moses Tadé

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Additive manufacturing (AM), commonly known as 3D printing, with the continuing advances in parallel processing and computational modeling, has created a paradigm shift (with significant radical thinking) in the design and operation of chemical processing plants, especially LNG plants. With the rising energy demands, environmental pressures, and economic challenges, there is a continuing industrial need for disruptive technologies such as AM, which possess capabilities that can drastically reduce the cost of manufacturing and operations of chemical processing plants in the future. However, the continuing challenge for 3D printing is its lack of adaptability in re-designing the process plant equipment coupled with the non-existent theory or models that could assist in selecting the optimal candidates out of the countless potential fabrications that are possible using AM. One of the most common packings used in the LNG process is structured packing in the packed column (which is a unit operation) in the process. In this work, we present an example of an optimum strategy for the application of AM to this important unit operation. Packed columns use a packing material through which the gas phase passes and comes into contact with the liquid phase flowing over the packing, typically performing the necessary mass transfer to enrich the products, etc. Structured packing consists of stacks of corrugated sheets, typically inclined between 40-70° from the plane. Computational Fluid Dynamics (CFD) was used to test and model various geometries to study the governing hydrodynamic characteristics. The results demonstrate that the costly iterative experimental process can be minimized. Furthermore, they also improve the understanding of the fundamental physics of the system at the multiscale level. SpiroPak, patented by Curtin University, represents an innovative structured packing solution currently at a technology readiness level (TRL) of 5~6. This packing exhibits remarkable characteristics, offering a substantial increase in surface area while significantly enhancing hydrodynamic and mass transfer performance. Recent studies have revealed that SpiroPak can reduce pressure drop by 50~70% compared to commonly used commercial packings, and it can achieve 20~50% greater mass transfer efficiency (particularly in CO2 absorption applications). The implementation of SpiroPak has the potential to reduce the overall size of columns and decrease power consumption, resulting in cost savings for both capital expenditure (CAPEX) and operational expenditure (OPEX) when applied to retrofitting existing systems or incorporated into new processes. Furthermore, pilot to large-scale tests is currently underway to further advance and refine this technology.

Keywords: Additive Manufacturing (AM), 3D printing, Computational Fluid Dynamics (CFD, structured packing (SpiroPak)

Procedia PDF Downloads 36

Authors: Arsyam Mawardi, Sony Suhandono, Azzania Fibriani, Fifi Fitriyah Masduki

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Malaria is an infectious disease caused by Plasmodium sp. This disease has a high prevalence in Indonesia, especially in Jayapura. The vaccine that is currently being developed has not been effective in overcoming malaria. This is due to the high polymorphism in the Plasmodium genome especially in areas that encode Plasmodium surface proteins. Merozoite Surface Protein 1 (MSP1) Plasmodium falciparum is a surface protein that plays a role in the invasion process in human erythrocytes through the interaction of Glycophorin A protein receptors and sialic acid in erythrocytes with Reticulocyte Binding Proteins (RBP) and Duffy Adhesion Protein (DAP) ligands in merozoites. MSP1 can be targeted to be a specific antigen and predicted epitope area which will be used for the development of diagnostic and malaria vaccine therapy. MSP1 consists of 17 blocks, each block is dimorphic, and has been marked as the K1 and MAD20 alleles. Exceptions only in block 2, because it has 3 alleles, among others K1, MAD20 and RO33. These polymorphisms cause allelic variations and implicate the severity of patients infected P. falciparum. In addition, polymorphism of MSP1 in Jayapura isolates has not been reported so it is interesting to be further identified and projected as a specific antigen. Therefore, in this study, we analyzed the allele polymorphism as well as detected the MSP1 epitope antigen candidate on block 2 P. falciparum. Clinical samples of selected malaria patients followed the consecutive sampling method, examining malaria parasites with blood preparations on glass objects observed through a microscope. Plasmodium DNA was isolated from the blood of malarial positive patients. The block 2 MSP1 gene was amplified using PCR method and cloned using the pGEM-T easy vector then transformed to TOP'10 E.coli. Positive colonies selection was performed with blue-white screening. The existence of target DNA was confirmed by PCR colonies and DNA sequencing methods. Furthermore, DNA sequence analysis was done through alignment and formation of a phylogenetic tree using MEGA 6 software and insilico analysis using IEDB software to predict epitope candidate for P. falciparum. A total of 15 patient samples have been isolated from Plasmodium DNA. PCR amplification results show the target gene size about ± 1049 bp. The results of MSP1 nucleotide alignment analysis reveal that block 2 MSP1 genes derived from the sample of malarial patients were distributed in four different allele family groups, K1 (7), MAD20 (1), RO33 (0) and MSP1_Jayapura (10) alleles. The most commonly appears of the detected allele is MSP1_Jayapura single allele. There was no significant association between sex variables, age, the density of parasitemia and alel variation (Mann Whitney, U > 0.05), while symptomatic signs have a significant difference as a trigger of detectable allele variation (U < 0.05). In this research, insilico study shows that there is a new epitope antigen candidate from the MSP1_Jayapura allele and it is predicted to be recognized by B cells with 17 amino acid lengths in the amino acid sequence 187 to 203.

Keywords: epitope candidate, insilico analysis, MSP1 P. falciparum, polymorphism

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Authors: Kamolvara Sirisuksakulchai, Soamwadee Chaianansutcharit, Kazunori Sato

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Solid Oxide Fuel Cells (SOFCs) have been considered as one of the most efficient large unit power generators for household and industrial applications. The efficiency of an electronic cell depends mainly on the electrochemical reactions in the anode. The development of anode materials has been intensely studied to achieve higher kinetic rates of redox reactions and lower internal resistance. Recent studies have introduced an efficient cermet (ceramic-metallic) material for its ability in fuel oxidation and oxide conduction. This could expand the reactive site, also known as the triple-phase boundary (TPB), thus increasing the overall performance. In this study, a bimetallic catalyst Ni₀.₇₅Co₀.₂₅Oₓ was combined with Gd₀.₁Ce₀.₉O₁.₉₅ (GDC) to be used as a cermet anode (NiCo-GDC) for an anode-supported type SOFC. The synthesis of Ni₀.₇₅Co₀.₂₅Oₓ was carried out by ball milling NiO and Co3O4 powders in ethanol and calcined at 1000 °C. The Gd₀.₁Ce₀.₉O₁.₉₅ was prepared by a urea co-precipitation method. Precursors of Gd(NO₃)₃·6H₂O and Ce(NO₃)₃·6H₂O were dissolved in distilled water with the addition of urea and were heated subsequently. The heated mixture product was filtered and rinsed thoroughly, then dried and calcined at 800 °C and 1500 °C, respectively. The two powders were combined followed by pelletization and sintering at 1100 °C to form an anode support layer. The fabrications of an electrolyte layer and cathode layer were conducted. The electrochemical performance in H₂ was measured from 800 °C to 600 °C while for CH₄ was from 750 °C to 600 °C. The maximum power density at 750 °C in H₂ was 13% higher than in CH₄. The difference in performance was due to higher polarization resistances confirmed by the impedance spectra. According to the standard enthalpy, the dissociation energy of C-H bonds in CH₄ is slightly higher than the H-H bond H₂. The dissociation of CH₄ could be the cause of resistance within the anode material. The results from lower temperatures showed a descending trend of power density in relevance to the increased polarization resistance. This was due to lowering conductivity when the temperature decreases. The long-term stability was measured at 750 °C in CH₄ monitoring at 12-hour intervals. The maximum power density tends to increase gradually with time while the resistances were maintained. This suggests the enhanced stability from charge transfer activities in doped ceria due to the transition of Ce⁴⁺ ↔ Ce³⁺ at low oxygen partial pressure and high-temperature atmosphere. However, the power density started to drop after 60 h, and the cell potential also dropped from 0.3249 V to 0.2850 V. These phenomena was confirmed by a shifted impedance spectra indicating a higher ohmic resistance. The observation by FESEM and EDX-mapping suggests the degradation due to mass transport of ions in the electrolyte while the anode microstructure was still maintained. In summary, the electrochemical test and stability test for 60 h was achieved by NiCo-GDC cermet anode. Coke deposition was not detected after operation in CH₄, hence this confirms the superior properties of the bimetallic cermet anode over typical Ni-GDC.

Keywords: bimetallic catalyst, ceria-based SOFCs, methane oxidation, solid oxide fuel cell

Procedia PDF Downloads 127

Authors: Gerald Gwamba

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Formation and oil well sand production is one of the greatest and oldest concerns for the Oil and gas industry. The production of sand particles may vary from very small and limited amounts to far elevated levels which has the potential to block or plug the pore spaces near the perforated points to blocking production from surface facilities. Therefore, the timely and reliable investigation of conditions leading to the onset or quantifying sanding while producing is imperative. The challenges of sand production are even more elevated while producing in Waxy and Heavy wells with Clay Fine sands (WHFC). Existing research argues that both waxy and heavy hydrocarbons exhibit far differing characteristics with waxy more paraffinic while heavy crude oils exhibit more asphaltenic properties. Moreover, the combined effect of WHFC conditions presents more complexity in production as opposed to individual effects that could be attributed to a consolidation of a surmountable opposing force. However, research on a combined high WHFC system could depict a better representation of the surmountable effect which in essence is more comparable to field conditions where a one-sided view of either individual effects on sanding has been argued to some extent misrepresentative of actual field conditions since all factors act surmountably. In recognition of the limited customized research on sand production studies with the combined effect of WHFC however, our research seeks to apply the Design of Experiments (DOE) methodology based on latest literature to analyze the relationship between various interparticle factors in relation to selected sand control methods. Our research aims to unearth a better understanding of how the combined effect of interparticle factors including: strength, cementation, particle size and production rate among others could better assist in the design of an optimal sand control system for the WHFC well conditions. In this regard, we seek to answer the following research question: How does the combined effect of interparticle factors affect the optimization of sand control systems for WHFC wells? Results from experimental data collection will inform a better justification for a sand control design for WHFC. In doing so, we hope to contribute to earlier contrasts arguing that sand production could potentially enable well self-permeability enhancement caused by the establishment of new flow channels created by loosening and detachment of sand grains. We hope that our research will contribute to future sand control designs capable of adapting to flexible production adjustments in controlled sand management. This paper presents results which are part of an ongoing research towards the authors' PhD project in the optimization of sand control systems for WHFC wells.

Keywords: waxy-heavy oils, clay-fine sands, sand control optimization, interparticle factors, design of experiments

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Authors: Elena Selezneva

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Over the last two decades, an unprecedented growth in uncertainty and volatility in all aspects of the business environment has caused major global supply chain disruptions and malfunctions. The effects of one failed company in a supply chain can ripple up and down the chain, causing a number of entities or an entire supply chain to collapse. The complicating factor is that an increasingly unstable and unpredictable business environment fuels the growing complexity of global supply chain networks. That makes supply chain operations extremely unpredictable and hard to manage with the established methods and strategies. It has caused the premature demise of many companies around the globe as they could not withstand or adapt to the storm of change. Solutions to this problem are not easy to come by. There is a lack of new empirically tested theories and practically viable supply chain resilience strategies. The mainstream organizational approach to managing supply chain resilience is rooted in well-established theories developed in the 1960-1980s. However, their effectiveness is questionable in currently extremely volatile business environments. The systems thinking approach offers an alternative view of supply chain resilience. Still, it is very much in the development stage. The aim of this explorative research is to investigate supply chain management strategies that are successful in taming complexity in volatile business environments and creating resilience in supply chains. The design of this research methodology was guided by an interpretivist paradigm. A literature review informed the selection of the systems thinking approach to supply chain resilience. Therefore, an explorative single case study of Ventilator Challenge UK was selected as a case study for its extremely resilient performance of its supply chain during a period of national crisis. Ventilator Challenge UK is intensive care ventilators supply project for the NHS. It ran for 3.5 months and finished in 2020. The participants moved on with their lives, and most of them are not employed by the same organizations anymore. Therefore, the study data includes documents, historical interviews, live interviews with participants, and social media postings. The data analysis was accomplished in two stages. First, data were thematically analyzed. In the second stage, pattern matching and pattern identification were used to identify themes that formed the findings of the research. The findings from the Ventilator Challenge UK case study supply management practices demonstrated all the features of an adaptive dynamic system. They cover all the elements of supply chain and employ an entire arsenal of adaptive dynamic system strategies enabling supply chain resilience. Also, it is not a simple sum of parts and strategies. Bonding elements and connections between the components of a supply chain and its environment enabled the amplification of resilience in the form of systemic emergence. Enablers are categorized into three subsystems: supply chain central strategy, supply chain operations, and supply chain communications. Together, these subsystems and their interconnections form the resilient supply chain system framework conceptualized by the author.

Keywords: enablers of supply chain resilience, supply chain resilience strategies, systemic approach in supply chain management, resilient supply chain system framework, ventilator challenge UK

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Authors: Rozelle Labuschagne, Ronel Roos

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Individuals often experience a reduction in physical function, quality of life and basic activities of daily living after surgery. This is exponentially true for high-risk patients, especially the elderly and frail individuals. Not much is known about the physical function, physical activity preferences and factors associated with the six-minute walk test of elderly individuals who would undergo elective abdominal surgery in South Africa. Such information is important to design effective prehabilitation physiotherapy programs prior to elective surgery. The purpose of the study was to describe the demographic profile and physical function of elderly patients who would undergo elective surgery and to determine factors associated with their six-minute walk test distance findings. A cross-sectional descriptive study in elderly patients older than 60 years of age who would undergo elective abdominal surgery were consecutively sampled at a private hospital in Pretoria, South Africa. Participants’ demographics were collected and physical function assessed with the Functional Comorbidity Index (FCI), DeMorton Mobility Index (DEMMI), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) and six-minute walk test (6MWT). Descriptive and inferential statistics were used for data analysis with IBM SPSS 25. A p-value ≤ 0.05 were deemed statistically significant. The pilot study consisted of 12 participants (female (n=11, 91.7%), male (n=1, 8.3%) with a mean age of 65.8 (±4.5) years, body mass index of 28 (±4.2) kg.m2 with one (8.3%) participant being a current smoker and four (33.3%) participants having a smoking history. Nine (75%) participants lived independently at home and three (25%) had caregivers. Participants reported walking (n=6, 50%), stretching exercises (n=1, 8.3%), household chores & gardening (n=2, 16.7%), biking/swimming/running (n=1, 8.3%) as physical activity preferences. Physical function findings of the sample were: mean FCI score 3 (±1.1), DEMMI score 81.1 (±14.9), IADL 95 (±17.3), 6MWT 435.50 (IQR 364.75-458.50) with percentage 6MWT distance achieved 81.8% (IQR 64.4%-87.5%). A strong negative correlation was observed between 6MWT distance walked and FCI (r = -0.729, p=0.007). The majority of study participants reported incorporating some form of physical activity into their daily life as form of exercise. Most participants did not achieve their predicted 6MWT distance indicating less than optimal levels of physical function capacity. The number of comorbidities as determined by the FCI was associated with the distance that participants could walk with the 6MWT. The results of this pilot study could be used to indicate which elderly individuals would benefit most from a pre-surgical rehabilitation program. The main goal of such a program would be to improve physical function capacity as measured by the 6MWT. Surgeons could refer patients based on age and number of comorbidities, as determined by the FCI, to potentially improve surgical outcomes.

Keywords: abdominal surgery, elderly, physical function, six-minute walk test

Procedia PDF Downloads 173

Authors: Inbal Zuriely, Yonit Weiss, Hilla Zaharoni, Hadas Lewkowicz, Tatiana Vander, Tarif Bader

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early active movement, along with adjusting optimal nutrition, prevents aggravation of muscle degeneracy and functional decline. Eating is a basic activity of daily life, which reflects the patient's independence. When eating and feeding are experienced successfully, they lead to a sense of pleasure and satisfaction. However, when they are experienced as a difficulty, they might evoke feelings of helplessness and frustration. This stresses the essential process of gradual weaning off the enteral feeding tube. the work describes the collaboration of a dietitian, determining the nutritional needs of patients undergoing enteral tube weaning as part of the rehabilitation process, with the suited treatment of an occupational therapist. Occupational therapy intervention regarding eating capabilities focuses on improving the required motor and cognitive components, along with environmental adjustments and aids, imparting eating strategies and training to patients and their families. The project was conducted in the long-term, ventilated patients’ department at the Herzfeld Rehabilitation Geriatric Medical Center on patients undergoing enteral tube weaning with the staff’s assistance. Establishing continuous collaboration between the dietician and the occupational therapist, starting from the beginning of the feeding-tube weaning process: 1.The dietician updates the occupational therapist about the start of the process and the approved diet. 2.The occupational therapist performs cognitive, motor, and functional assessments and treatments regarding the patient’s eating capabilities and recommends the required adjustments for independent eating according to the FIM (Functional Independence Measure) scale. 3.The occupational therapist closely follows up on the patient’s degree of independence in eating and provides a repeated update to the dietician. 4.The dietician accordingly guides the ward staff on whether and how to feed the patient or allow independent eating. The project aimed to promote patients toward independent feeding, which leads to a sense of empowerment, enjoyment of the eating experience, and progress of functional ability, along with performing active movements that will motivate mobilization. From the beginning of 2022, 26 patients participated in the project. 79% of all patients who started the weaning process from tube feeding achieved different levels of independence in feeding (independence levels ranged from supervision (FIM-5) to complete independence (FIM-7). The integration of occupational therapy and dietary treatment is based on a patient-centered approach while considering the patient’s personal needs, preferences, and goals. This interdisciplinary partnership is essential for meeting the complex needs of prolonged mechanically ventilated patients and promotes independent functioning and quality of life.

Keywords: dietary, mechanical ventilation, occupational therapy, tube feeding weaning

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Authors: M. P. Leroux, C. Coulombe

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Projects are popular vehicles through which international aid is delivered in developing countries. To achieve their objectives, many northern organizations develop projects with local partner organizations in the developing countries through technical assistance projects. International aid and international development projects precisely have long been criticized for poor results although billions are spent every year. Little empirical research in the field of project management has the focus on knowledge transfer in international development context. This paper focuses particularly on personal dimensions of international assignees participating in project within local team members in the host country. We propose to explore the possible links with a human resource management perspective in order to shed light on the less research problematic of knowledge transfer in development cooperation projects. The process leading to capacity building being far complex, involving multiple dimensions and far from being linear, we propose here to assess if traditional research on expatriate in multinational corporations pertain to the field of project management in developing countries. The following question is addressed: in the context of international development project cooperation, what personal determinants should the selection process focus when looking to fill a technical assistance position in a developing country? To answer that question, we first reviewed the literature on expatriate in the context of inter organizational knowledge transfer. Second, we proposed a theoretical framework combining perspectives of development studies and management to explore if parallels can be draw between traditional international assignment and technical assistance project assignment in developing countries. We conducted an exploratory study using case studies from technical assistance initiatives led in Haiti, a country in Central America. Data were collected from multiple sources following qualitative study research methods. Direct observations in the field were allowed by local leaders of six organization; individual interviews with present and past international assignees, individual interview with local team members, and focus groups were organized in order to triangulate information collected. Contrary from empirical research on knowledge transfer in multinational corporations, results tend to show that technical expertise rank well behind many others characteristics. Results tend to show the importance of soft skills, as a prerequisite to succeed in projects where local team have to collaborate. More importantly, international assignees who were talking knowledge sharing instead of knowledge transfer seemed to feel more satisfied at the end of their mandate than the others. Reciprocally, local team members who perceived to have participated in a project with an expat looking to share instead of aiming to transfer knowledge seemed to describe the results of project in more positive terms than the others. Results obtained from this exploratory study open the way for a promising research agenda in the field of project management. It emphasises the urgent need to achieve a better understanding on the complex set of soft skills project managers or project chiefs would benefit to develop, in particular, the ability to absorb knowledge and the willingness to share one’s knowledge.

Keywords: international assignee, international project cooperation, knowledge transfer, soft skills

Procedia PDF Downloads 119

Authors: S. Nishat Fatima Rizvi, Tulika Chandra, Abbas Ali Mahdi, Devisha Agarwal

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Introduction: Blood components are an unexplored area prone to numerous discoveries which influence patient’s care. Experiments at different levels will further change the present concept of blood banking. Hyperlipidemia is a condition of elevated plasma level of low-density lipoprotein (LDL) as well as decreased plasma level of high-density lipoprotein (HDL). Studies show that platelets play a vital role in the progression of atherosclerosis and thrombosis, a major cause of death worldwide. They are activated by many triggers like elevated LDL in the blood resulting in aggregation and formation of plaques. Hyperlipidemic platelets are frequently transfused to patients with various disorders. Screening the random donor platelets for hyperlipidemia and correlating the condition with other donor criteria such as lipid rich diet, oral contraceptive pills intake, weight, alcohol intake, smoking, sedentary lifestyle, family history of heart diseases will lead to further deciding the exclusion criteria for donor selection. This will help in making the patients safe as well as the donor deferral criteria more stringent to improve the quality of blood supply. Technical evaluation and assessment will enable blood bankers to supply safe blood and improve the guidelines for blood safety. Thus, we try to study the correlation between hyperlipidemic platelets with platelets parameters, weight, and specific history of the donors. Methodology: This case control study included 100 blood samples of Blood donors, out of 100 only 30 samples were found to be hyperlipidemic and were included as cases, while rest were taken as controls. Lipid Profile were measured by fully automated analyzer (TRIGL:triglycerides),(LDL-C:LDL –Cholesterol plus 2nd generation),CHOL 2: Cholesterol Gen 2), HDL C 3: HDL-Cholesterol plus 3rdgeneration)-(Cobas C311-Roche Diagnostic).And Platelets parameters were analyzed by the Sysmex KX21 automated hematology analyzer. Results: A significant correlation was found amongst hyperlipidemic level in single time donor. In which 80% donors have history of heart disease, 66.66% donors have sedentary life style, 83.3% donors were smokers, 50% donors were alcoholic, and 63.33% donors had taken lipid rich diet. Active physical activity was found amongst 40% donors. We divided donors sample in two groups based on their body weight. In group 1, hyperlipidemic samples: Platelet Parameters were 75% in normal 25% abnormal in >70Kg weight while in 50-70Kg weight 90% were normal 10% were abnormal. In-group 2, Non Hyperlipidemic samples: platelet Parameters were 95% normal and 5% abnormal in >70Kg weight, while in 50-70Kg Weight, 66.66% normal and 33.33% abnormal. Conclusion: The findings indicate that Hyperlipidemic status of donors may affect the platelet parameters and can be distinguished on history by their weight, Smoking, Alcoholic intake, Sedentary lifestyle, Active physical activity, Lipid rich diet, Oral contraceptive pills intake, and Family history of heart disease. However further studies on a large sample size will affirm this finding.

Keywords: blood donors, hyperlipidemia, platelet, weight

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Authors: Mirosław Krzemieniewski, Marcin Zieliński, Marcin Dębowski

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Electrokinetic disintegration is one of the high-voltage electric methods. The design of systems is exceptionally simple. Biomass flows through a system of pipes with alongside mounted electrodes that generate an electric field. Discharges in the electric field deform cell walls and lead to their successive perforation, thereby making their contents easily available to bacteria. The spark-over occurs between electrode surface and pipe jacket which is the second pole and closes the circuit. The value of voltage ranges from 10 to 100kV. Electrodes are supplied by normal “power grid” monophase electric current (230V, 50Hz). Next, the electric current changes into direct current of 24V in modules serving for particular electrodes, and this current directly feeds the electrodes. The installation is completely safe because the value of generated current does not exceed 250mA and because conductors are grounded. Therefore, there is no risk of electric shock posed to the personnel, even in the case of failure or incorrect connection. Low values of the electric current mean small energy consumption by the electrode which is extremely low – only 35W per electrode – compared to other methods of disintegration. Pipes with electrodes with diameter of DN150 are made of acid-proof steel and connected from both sides with 90º elbows ended with flanges. The available S and U types of pipes enable very convenient fitting with system construction in the existing installations and rooms or facilitate space management in new applications. The system of pipes for electrokinetic disintegration may be installed horizontally, vertically, askew, on special stands or also directly on the wall of a room. The number of pipes and electrodes is determined by operating conditions as well as the quantity of substrate, type of biomass, content of dry matter, method of disintegration (single or circulatory), mounting site etc. The most effective method involves pre-treatment of substrate that may be pumped through the disintegration system on the way to the fermentation tank or recirculated in a buffered intermediate tank (substrate mixing tank). Biomass structure destruction in the process of electrokinetic disintegration causes shortening of substrate retention time in the tank and acceleration of biogas production. A significant intensification of the fermentation process was observed in the systems operating in the technical scale, with the greatest increase in biogas production reaching 18%. The secondary, but highly significant for the energetic balance, effect is a tangible decrease of energy input by agitators in tanks. It is due to reduced viscosity of the biomass after disintegration, and may result in energy savings reaching even 20-30% of the earlier noted consumption. Other observed phenomena include reduction in the layer of surface scum, reduced sewage capability for foaming and successive decrease in the quantity of bottom sludge banks. Considering the above, the system for electrokinetic disintegration seems a very interesting and valuable solutions meeting the offer of specialist equipment for the processing of plant biomass, including Virginia fanpetals, before the process of methane fermentation.

Keywords: electrokinetic disintegration, biomass, biogas production, fermentation, Virginia fanpetals

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Authors: Puzanova Zhanna Vasilyevna, Larina Tatiana Igorevna, Tertyshnikova Anastasia Gennadyevna

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In this day and age, extremism in various forms of its manifestation is a real threat to the world community, the national security of a state and its territorial integrity, as well as to the constitutional rights and freedoms of citizens. Extremism, as it is known, in general terms described as a commitment to extreme views and actions, radically denying the existing social norms and rules. Supporters of extremism in the ideological and political struggles often adopt methods and means of psychological warfare, appeal not to reason and logical arguments, but to emotions and instincts of the people, to prejudices, biases, and a variety of mythological designs. They are dissatisfied with the established order and aim at increasing this dissatisfaction among the masses. Youth extremism holds a specific place among the existing forms and types of extremism. In this context in 2015, we conducted a survey among Moscow college and high school students. The aim of this study was to determine how great or small is the difference in understanding and attitudes towards extremism manifestations, inclination and readiness to take part in extremist activities and what causes this predisposition, if it exists. We performed multivariate analysis and found the Russian college and high school students' opinion about the extremism and terrorism situation in our country and also their cognition on these topics. Among other things, we showed, that the level of aggressiveness of young people were not above the average for the whole population. The survey was conducted using the questionnaire method. The sample included college and high school students in Moscow (642 and 382, respectively) by method of random selection. The questionnaire was developed by specialists of RUDN University Sociological Laboratory and included both original questions (projective questions, the technique of incomplete sentences), and the standard test Dayhoff S. to determine the level of internal aggressiveness. It is also used as an experiment, the technique of study option using of FACS and SPAFF to determine the psychotypes and determination of non-verbal manifestations of emotions. The study confirmed the hypothesis that in respondents’ opinion, the level of aggression is higher today than a few years ago. Differences were found in the understanding of and respect for such social phenomena as extremism, terrorism, and their danger and appeal for the two age groups of young people. Theory of psychotypes, SPAFF (specific affect cording system) and FACS (facial action cording system) are considered as additional techniques for the diagnosis of a tendency to extreme views. Thus, it is established that diagnostics of acceptance of extreme views among young people is possible thanks to simultaneous use of knowledge from the different fields of socio-humanistic sciences. The results of the research can be used in a comparative context with other countries and as a starting point for further research in the field, taking into account its extreme relevance.

Keywords: extremism, youth extremism, diagnostics of extremist manifestations, forecast of behavior, sociological polls, theory of psychotypes, FACS, SPAFF

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Authors: Qurat Ul Ain Saleem, Kanwal Ameen

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The library and information science discipline is universally known as a feminist profession. It is considered a suitable field for females in Pakistan like a few other fields such as teaching and healthcare. It is also reflected through the uneven enrollment at graduate levels in library schools across the country as there are more females as compared to males. However, that uneven ratio does not really translate in the profession after passing out. There are more males in the professional as compared to females, as well as males can be seen on managerial and administrative posts majorly. A few females who joined the perception remain underrated and are hardly seen at managerial or administrative positions in the academic libraries. Therefore, this study was designed to highlight the perceptions of those females who have joined the profession to identify the issues related to equality faced by them as a professional. A qualitative research design based on a semi-structured interview was selected as an appropriate method to achieve the objectives of this study. Female librarians working in the higher education commission’s recognized public and private sector universities of Punjab, Pakistan, were selected as the population for this study. Female librarians shared that inequalities and discrimination based on face value, experience, communication, and relationship with the manager are common at their workplaces. They added that managers prefer male professionals to deal with delegation or presentations though we both can do that. Female professionals from the private sector believed that library managers make final hiring and selection decisions based on job duties and gender. However, the one with strong references will be preferred for the job. Also, private-sector employees suffered more prejudice due to the non-availability of proper patterns of promotions and increments. The government personnel said there is always a proper board/procedure for hiring and promotions; therefore, it is difficult for them to identify any inequality. Participants were dissatisfied with their managers for not allowing them to attend training and conferences. The majority of participants from the private sector said they wouldn't speak up to prejudice because they are afraid of losing their jobs and their voice is lost in a male-dominated society where males hold numerous authoritative positions and females are considered less competent. Nonetheless, the discrimination and inequalities affected the work motivation and enthusiasm of employees. Therefore, organizations should not discriminate against the staff in terms of facilities and benefits. The sample may not represent the true picture of gender equality in university libraries of Pakistan due to less number of participants and limited geographical boundaries. It is also assumed that some females may refrain from disclosing factual information or some may exaggerate the facts as a large number of participants requested to become part of the study. Equal opportunities should be offered to female library professionals to uplift and involve them to mitigate the perception of gender dominance. The organizations or immediate authorities should allow their staff to participate in training opportunities to learn modern practices to better serve the community.

Keywords: equality-workplace, libraries as workplace, female professionals, librarians-Pakistan

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Authors: Nabamita Nath, Sanghamitra Sarkar

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Urban development in traditional neighbourhoods of cities is undergoing a sea change due to imposition of irregular development patterns on a predominantly inclusive urban fabric. In recent times, traditional neighbourhoods of Kolkata have experienced irregular urban development which has resulted in transformation of its immediate urban character. The goal is to study and analyse impact of new urban developments within traditional neighbourhoods of Kolkata and establish development guidelines to balance the old with the new. Various cities predominantly in third world countries are also experiencing similar development patterns in their traditional neighbourhoods. Existing literature surveys of development patterns in such neighbourhoods have established 9 major parameters viz. edge, movement, node, landmark, size-density, pattern-grain-texture, open spaces, urban spaces, urban form and views-vistas of the neighbourhood. To evaluate impact of urban development in traditional neighbourhoods of Kolkata, 3 different areas have been chronologically selected based on their settlement patterns. Parameters established through literature surveys have been applied to the selected areas to study and analyse the existing patterns of development. The main sources of this study included extensive on-site surveys, academic archive, census data, organisational records and informational websites. Applying the established parameters, 5 major conclusions were derived. Firstly, it was found that pedestrian friendly neighbourhoods of the city were becoming more car-centric. This has resulted in loss of interactive and social spaces which defined the cultural heritage of Kolkata. Secondly, the urban pattern which was composed of dense and compact fabric is gradually losing its character due to incorporation of new building typologies. Thirdly, the new building typologies include gated communities with private open spaces which is a stark departure from the existing built typology. However, these open spaces have not contributed in creation of inclusive public places for the community which are a significant part of such heritage neighbourhood precincts. Fourthly, commercial zones that primarily developed along major access routes have now infiltrated within these neighbourhoods. Gated communities do not favour formation of on-street commercial activities generating haphazard development patterns. Lastly, individual residential buildings that reflected Indo-saracenic and Neo-gothic architectural styles are converting into multi-storeyed residential apartments. As a result, the axis that created a definite visual identity for a neighbourhood is progressively following an irregular pattern. Thus, uniformity of the old skyline is gradually becoming inconsistent. The major issue currently is threat caused by irregular urban development to heritage zones and buildings of traditional neighbourhoods. Streets, lanes, courtyards, open spaces and buildings of old neighbourhoods imparted a unique cultural identity to the city that is disappearing with emerging urban development patterns. It has been concluded that specific guidelines for urban development should be regulated primarily based on existing urban form of traditional neighbourhoods. Such neighbourhood development strategies should be formulated for various cities of third world countries to control irregular developments thereby balancing heritage and development.

Keywords: heritage, Kolkata, traditional neighbourhood, urban development

Procedia PDF Downloads 153

Authors: Natalie A. Sterk, Bernard van Vuuren, Petrie Marais, Bongani Mthombeni

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Injuries to the internal structures of the thorax and abdomen remain a leading cause of death among soldiers. Body armour is a standard issue piece of military equipment designed to protect the vital organs against ballistic and stab threats. When configured for maximum protection, the excessive weight and size of the armour may limit soldier mobility and increase physical fatigue and discomfort. Providing soldiers with more armour than necessary may, therefore, hinder their ability to react rapidly in life-threatening situations. The capability to determine the optimal trade-off between the amount of essential anatomical coverage and hindrance on soldier performance may significantly enhance the design of armour systems. The current study aimed to develop and pilot a methodology for relating internal anatomical structures with actual armour plate coverage in real-time using low-dose diagnostic X-ray scanning. Several pilot scanning sessions were held at Lodox Systems (Pty) Ltd head-office in South Africa. Testing involved using the Lodox eXero-dr to scan dummy trunk rigs at various degrees and heights of measurement; as well as human participants, wearing correctly fitted body armour while positioned in supine, prone shooting, seated and kneeling shooting postures. The verification of sizing and metrics obtained from the Lodox eXero-dr were then confirmed through a verification board with known dimensions. Results indicated that the low-dose diagnostic X-ray has the capability to clearly identify the vital internal structures of the aortic arch, heart, and lungs in relation to the position of the external armour plates. Further testing is still required in order to fully and accurately identify the inferior liver boundary, inferior vena cava, and spleen. The scans produced in the supine, prone, and seated postures provided superior image quality over the kneeling posture. The X-ray-source and-detector distance from the object must be standardised to control for possible magnification changes and for comparison purposes. To account for this, specific scanning heights and angles were identified to allow for parallel scanning of relevant areas. The low-dose diagnostic X-ray provides a non-invasive, safe, and rapid technique for relating vital internal structures with external structures. This capability can be used for the re-evaluation of anatomical coverage required for essential protection while optimising armour design and fit for soldier performance.

Keywords: body armour, low-dose diagnostic X-ray, scanning, vital organ coverage

Procedia PDF Downloads 100

Authors: Hsiao-Lin Fang

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Every life is precious, and comprehensive care should be provided to individuals who are in the final stages of their lives. Hospice-shared care aims to provide optimal symptom control and palliative care to terminal (cancer) patients through the implementation of shared care, and to support patients and their families in making various physical and psychological adjustments in the face of death. This report examines a 10-year-boy diagnosed with Out-of-Hospital Cardiac Arrest (OHCA). The individual fainted when swimming at school and underwent 31 minutes of cardiopulmonary resuscitation (CPR). While receiving treatment at the hospital, the individual received extracorporeal membrane oxygenation(ECMO) due to unstable hemodynamics. Urgent cardiac catheterization found: Suspect acute fulminant myocarditis or underlying cardiomyopathy with acute decompensation, After the active rescue by the medical team, hemodynamics still showed only mean pressure value. With respect to the patient, interdepartmental hospice-shared care was implemented and a do-not-resuscitate (DNR) order was signed after family discussions were conducted. Assistance and instructions were provided as part of the comfort care process. A farewell gathering attended by the patient’s relatives, friends, teachers, and classmates was organized in an intensive care unit (ICU) in order to look back on the patient’s life and the beautiful memories that were created, as well as to alleviate the sorrow felt by family members, including the patient’s father and sister. For example, the patient was presented with drawings and accompanied to a garden to pick flowers. In this manner, the patient was able to say goodbye before death. Finally, the patient’s grandmother and father participated in the clinical hospice care and post-mortem care processes. A hospice-shared care clinician conducted regular follow-ups and provided care to the family of the deceased, supporting family members through the sorrowful period. Birth, old age, sickness, and death are the natural phases of human life. In recent years, growing attention has been paid to human-centered hospice care. Hospice care is individual holistic care provided by a professional team and it involves the provision of comprehensive care to a terminal patient. Hospice care aims to satisfy the physical, psychological, mental, and social needs of patients and their families. It does not involve the cessation of treatment but rather avoids the exacerbation or extension of the suffering endured by patients, thereby preserving the dignity and quality of life during the end-of-life period. Patients enjoy the company of others as they complete the last phase of their lives, and their families also receive guidance on how they can move on with their own lives after the patient’s death.

Keywords: hospice-shared care, extracorporeal membrane oxygenation (ECMO), hospice-shared care, child patient

Procedia PDF Downloads 118