Search results for: emergency response

Authors: Rotchanaphan Hengaroonprasan, Malinee Sriariyanun, Prapakorn Tantayotai, Supacharee Roddecha, Kraipat Cheenkachorn

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Lignocellolusic material is a substance that is resistant to be degraded by microorganisms or hydrolysis enzymes. To be used as materials for biofuel production, it needs pretreatment process to improve efficiency of hydrolysis. In this work, chemical pretreatments on rice straw using three diluted organic acids, including acetic acid, citric acid, oxalic acid, were optimized. Using Response Surface Methodology (RSM), the effect of three pretreatment parameters, acid concentration, treatment time, and reaction temperature, on pretreatment efficiency were statistically evaluated. The results indicated that dilute oxalic acid pretreatment led to the highest enhancement of enzymatic saccharification by commercial cellulase and yielded sugar up to 10.67 mg/ml when using 5.04% oxalic acid at 137.11 oC for 30.01 min. Compared to other acid pretreatment by acetic acid, citric acid, and hydrochloric acid, the maximum sugar yields are 7.07, 6.30, and 8.53 mg/ml, respectively. Here, it was demonstrated that organic acids can be used for pretreatment of lignocellulosic materials to enhance of hydrolysis process, which could be integrated to other applications for various biorefinery processes.

Keywords: lignocellolusic biomass, pretreatment, organic acid response surface methodology, biorefinery

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Authors: Prasad Pokkunuri

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Visco-elastic materials combine the stress response properties of both solids and fluids and have found use in a variety of damping applications – both vibrational and acoustic. Defense and automotive applications, in particular, are subject to high impact and shock loading – for example: aircraft landing gear, firearms, and shock absorbers. Field responsive fluids – a class of smart materials – are the preferred choice of energy absorbents because of their controllability. These fluids’ stress response can be controlled by the application of a magnetic or electric field, in a closed loop. Their rheological properties – elasticity, plasticity, and viscosity – can be varied all the way from that of a liquid such as water to a hard solid. This work presents a simplified model to study the impulse response behavior of such fluids for use in recoil damping systems. The well-known Burger’s equation, in conjunction with various visco-elastic constitutive models, is used to represent fluid behavior. The Kelvin-Voigt, Upper Convected Maxwell (UCM), and Oldroyd-B constitutive models are implemented in this study. Using these models in a one-dimensional framework eliminates additional complexities due to geometry, pressure, body forces, and other source terms. Using a finite difference formulation to numerically solve the governing equation(s), the response to an initial impulse is studied. The disturbance is confined within the problem domain with no-inflow, no-outflow boundary conditions, and its decay characteristics studied. Visco-elastic fluids typically involve a time-dependent stress relaxation which gives rise to interesting behavior when subjected to an impulsive load. For particular values of viscous damping and elastic modulus, the fluid settles into a stable oscillatory state, absorbing and releasing energy without much decay. The simplified formulation enables a comprehensive study of different modes of system response, by varying relevant parameters. Using the insights gained from this study, extension to a more detailed multi-dimensional model is considered.

Keywords: Burgers Equation, Impulse Response, Recoil Damping Systems, Visco-elastic Fluids

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Authors: Sarah Ullrich, Juliane Rolle, Christian Beste, Nicole Wolff

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Inhibition and cognitive flexibility are essential parts of executive functions in our daily lives, as they enable the avoidance of unwanted responses or selectively switch between mental processes to generate appropriate behavior. There is growing interest in improving inhibition and response selection through brief mindfulness-based meditations. Arguably, open-monitoring meditation (OMM) improves inhibitory and flexibility performance by optimizing cognitive control and information processing. Yet, the underlying neurophysiological processes have been poorly studied. Using the Simon-Go/Nogo paradigm, the present work examined the effect of a single 15-minute smartphone app-based OMM on inhibitory performance and response selection in meditation novices. We used both behavioral and neurophysiological measures (event-related potentials, ERPs) to investigate which subprocesses of response selection and inhibition are altered after OMM. The study was conducted in a randomized crossover design with N = 32 healthy adults. We thereby investigated Go and Nogo trials in the paradigm. The results show that as little as 15 minutes of OMM can improve response selection and inhibition at behavioral and neurophysiological levels. More specifically, OMM reduces the rate of false alarms, especially during Nogo trials regardless of congruency. It appears that OMM optimizes conflict processing and response inhibition compared to no meditation, also reflected in the ERP N2 and P3 time windows. The results may be explained by the meta control model, which argues in terms of a specific processing mode with increased flexibility and inclusive decision-making under OMM. Importantly, however, the effects of OMM were only evident when there was the prior experience with the task. It is likely that OMM provides more cognitive resources, as the amplitudes of these EKPs decreased. OMM novices seem to induce finer adjustments during conflict processing after familiarization with the task.

Keywords: EEG, inhibition, meditation, Simon Nogo

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Authors: Sarah Al-Lumai, Fatima Al-Attar, Nour Jamal, Badria Al-Dabbous, Manal Abdulla

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Today, many commonly used Industrial Engineering tools and techniques are being used in hospitals around the world for the goal of producing a more efficient and effective healthcare system. A common quality improvement methodology known as Lean Six-Sigma has been successful in manufacturing industries and recently in healthcare. The objective of our project is to use the Lean Six-Sigma methodology to reduce waiting time in the Emergency Department (ED), in a local private hospital. Furthermore, a comprehensive literature review was conducted to evaluate the success of Lean Six-Sigma in the ED. According to the study conducted by Ibn Sina Hospital, in Morocco, the most common problem that patients complain about is waiting time. To ensure patient satisfaction many hospitals such as North Shore University Hospital were able to reduce waiting time up to 37% by using Lean Six-Sigma. Other hospitals, such as John Hopkins’s medical center used Lean Six-Sigma successfully to enhance the overall patient flow that ultimately decreased waiting time. Furthermore, it was found that capacity constraints, such as staff shortages and lack of beds were one of the main reasons behind long waiting time. With the use of Lean Six-Sigma and bed management, hospitals like Memorial Hermann Southwest Hospital were able to reduce patient delays. Moreover, in order to successfully implement Lean Six-Sigma in our project, two common methodologies were considered, DMAIC and DMADV. After the assessment of both methodologies, it was found that DMAIC was a more suitable approach to our project because it is more concerned with improving an already existing process. With many of its successes, Lean Six-Sigma has its limitation especially in healthcare; but limitations can be minimized if properly approached.

Keywords: lean six sigma, DMAIC, hospital, methodology

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Authors: S. H. Kazmi, T. Ahmed, K. Javed, A. Ghani

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In this paper static scheme of under-frequency based load shedding is considered for chemical and petrochemical industries with islanded distribution networks relying heavily on the primary commodity to ensure minimum production loss, plant downtime or critical equipment shutdown. A simplistic methodology is proposed for in-house implementation of this scheme using underfrequency relays and a step by step guide is provided including the techniques to calculate maximum percentage overloads, frequency decay rates, time based frequency response and frequency based time response of the system. Case study of FFL electrical system is utilized, presenting the actual system parameters and employed load shedding settings following the similar series of steps. The arbitrary settings are then verified for worst overload conditions (loss of a generation source in this case) and comprehensive system response is then investigated.

Keywords: islanding, under-frequency load shedding, frequency rate of change, static UFLS

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Authors: B. X. Tchomeni, A. A. Alugongo, L. M. Masu

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This paper presents a 4-DOF nonlinear model of a cracked of Laval rotor established based on Energy Principles. The model has been used to simulate coupled torsional-lateral response of the cracked rotor stator-system with multiple parametric excitations, namely, rotor-stator-rub, a breathing transverse crack, unbalanced mass, and an axial force. Nonlinearity due to a “breathing” crack is incorporated by considering a simple hinge model which is suitable for small breathing crack. The vibration response of a cracked rotor passing through its critical speed with rotor-stator interaction is analyzed, and an attempt for crack detection and monitoring explored. Effects of unbalanced eccentricity with phase and acceleration are investigated. By solving the motion equations, steady-state vibration response is obtained in presence of several rotor faults. The presence of a crack is observable in the power spectrum despite the excitation by the axial force and rotor-stator rub impact. Presented results are consistent with existing literature and could be adopted into rotor condition monitoring strategies

Keywords: rotor, crack, rubbing, axial force, non linear

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Authors: Marcia Teresa Gildo

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The United Nations High Commissioner for Refugees (UNHCR) is responsible to provide international protection and humanitarian assistance to refugees and to seek permanent solutions to their situation. To fulfil this mandate, the agency works in collaboration with its partners and governments. This paper aims to analyse the agency's actions to protect and provide assistance to Mozambican refugees in Malawi. Since July 2015, approximately 12.000 people have fled Mozambique to neighbouring Malawi due to the political-military conflict between the government of Mozambique and RENAMO (the country’s largest opposition party). This led to a series of military clashes between the two parties and the consequent flight of some Mozambicans to Malawi, in search of asylum. Most arrived from the province of Tete, in the central region of Mozambique, and, to a lesser extent, from the province of Zambezia. The asylum seekers arrived in small groups and settled in the village of Kapise in the Mwanza district of Thambani, as well as in Chikwawa and Nsanje districts in Malawi. UNHCR led an interinstitutional response action to manage the flow of Mozambican asylum seekers to Malawi. In view of these aspects and the ongoing challenge of protecting refugees and finding permanent solutions to their situation, UNHCR remains an indispensable international organization. However, there are significant gaps in the international refugee protection regime, and there have been many occasions when UNHCR has failed to fulfill its mandate. The analysis was carried out through qualitative research methods and techniques based essentially on consultation of books, newspapers and scientific articles, television and journalistic reports and interviews with the people who were involved in the process. From the data obtained, it was concluded that UNHCR worked in coordination with its partners and the government of Malawi to provide protection and emergency assistance to the refugees. However, existing funds covered only the immediate needs of refugees, more funds had to be allocated. That was made through an interinstitutional appeal. Although the funds allocated were not sufficient, they allowed the agency to protect and assist the refugees until a permanent solution was found. UNHCR also worked in coordination with the governments of Malawi and Mozambique so that a tripartite agreement was signed between the parties for the voluntary repatriation of Mozambican refugees, since security conditions were guaranteed and the refugees had expressed their willingness to return to their country of origin. UNHCR's actions to protect Mozambican refugees in Malawi have enabled humanitarian conditions to be respected and the rights of refugees to be guaranteed. Cooperation with the different actors involved in the response has allowed UNHCR to fulfil its mandate.

Keywords: assistance , cooperation, international protection, refugees

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Authors: David Koren, Vojko Kilar

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The modern energy-efficient houses are often founded on a thermal insulation (TI) layer placed under the building’s RC foundation slab. The purpose of the paper is to identify the potential problems of the buildings founded on TI layer from the seismic point of view. The two main goals of the study were to assess the seismic behavior of such buildings, and to search for the critical structural parameters affecting the response of the superstructure as well as of the extruded polystyrene (XPS) layer. As a test building a multi-storeyed RC frame structure with and without the XPS layer under the foundation slab has been investigated utilizing nonlinear dynamic (time-history) and static (pushover) analyses. The structural response has been investigated with reference to the following performance parameters: i) Building’s lateral roof displacements, ii) Edge compressive and shear strains of the XPS, iii) Horizontal accelerations of the superstructure, iv) Plastic hinge patterns of the superstructure, v) Part of the foundation in compression, and vi) Deformations of the underlying soil and vertical displacements of the foundation slab (i.e. identifying the potential uplift). The results have shown that in the case of higher and stiff structures lying on firm soil the use of XPS under the foundation slab might induce amplified structural peak responses compared to the building models without XPS under the foundation slab. The analysis has revealed that the superstructure as well as the XPS response is substantially affected by the stiffness of the foundation slab.

Keywords: extruded polystyrene (XPS), foundation on thermal insulation, energy-efficient buildings, nonlinear seismic analysis, seismic response, soil–structure interaction

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Authors: Ibrahim Abouelkhir

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Background: Prior to this project, the number of CT aorta requests from our Emergency Department (ED) was reported by the radiology department to be high with a low positive event rate: only 1- 2% of CT aortas performed were positive for acute aortic syndrome. This trend raised concerns about the time required to process and report these scans, potentially impacting the timely reporting of other high-priority imaging, such as trauma-related scans. Other harms identified were unnecessary radiation, patients spending longer in ED contributing to overcrowding, and, most importantly, the patient not getting the right care the first time. The radiology department also raised the problem of reporting bias because they expected our CT aortas to be normal. Aim: The main aim of this project was to reduce the number of unnecessary CT aortas requested, which would be shown by 1. Number of CT aortas requested and 2. Positive event rate. Methodology: This was a quality improvement project carried out in the ED at Frimley Park Hospital, UK. Starting from 1 st January 2024, we recorded the number of days required to reach 35 CT aorta requests. We looked at all patients presenting to the ED over the age of 16 for whom a CT aorta was requested by the ED team. We looked at how many of these scans were positive for acute aortic syndrome. The intervention was a change in practice: all CT aortas should be approved by an ED consultant or ST4+ registrar (5th April 2024). We then reviewed the number of days it took to reach a total of 35 CT aorta requests following the intervention and again reviewed how many were positive. Results: Prior to the intervention, 35 CT Aorta scans were performed over a 20-day period. Following the implementation of the ED senior doctor vetting process, the same number of CT Aorta scan requests was observed over 50 days - more than twice the pre-intervention period. This indicates a significant reduction in the rate of CT Aorta scans being requested. During the pre-intervention phase, there were two positive cases of acute aortic syndrome. In the post-intervention period, there were zero. Conclusion: The mandatory review of CT Aorta scan requested by the ED consultant effectively reduced the number of scans requested. However, this intervention did not lead to an increase in positive scan results. We noted that post-intervention, approximately 50% of scans had been approved by registrar-grade doctors and, only 50% had been approved by ED consultants, and the majority were not in-person reviews. We wonder if restricting the approval to consultant grade only might improve the results, and furthermore, in person reviews should be the gold standard.

Keywords: quality improvement project, CT aorta scans, emergency department, radiology department, aortic dissection, scan request vetting, clinical outcomes, imaging efficiency

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Authors: Jiří. J. Urbánek, Hana Malachová, Josef Krahulec, Jitka Johanidisová

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The paper deals with crisis situations investigation and modelling within the organizations of critical infrastructure. Every crisis situation has an origin in the emergency event occurrence in the organizations of energetic critical infrastructure especially. Here, the emergency events can be both the expected events, then crisis scenarios can be pre-prepared by pertinent organizational crisis management authorities towards their coping or the unexpected event (Black Swan effect) – without pre-prepared scenario, but it needs operational coping of crisis situations as well. The forms, characteristics, behaviour and utilization of crisis scenarios have various qualities, depending on real critical infrastructure organization prevention and training processes. An aim is always better organizational security and continuity obtainment. This paper objective is to find and investigate critical/ crisis zones and functions in critical situations models of critical infrastructure organization. The DYVELOP (Dynamic Vector Logistics of Processes) method is able to identify problematic critical zones and functions, displaying critical interfaces among actors of crisis situations on the DYVELOP maps named Blazons. Firstly, for realization of this ability is necessary to derive and create identification algorithm of critical interfaces. The locations of critical interfaces are the flags of crisis situation in real organization of critical infrastructure. Conclusive, the model of critical interface will be displayed at real organization of Czech energetic crisis infrastructure subject in Black Out peril environment. The Blazons need live power Point presentation for better comprehension of this paper mission.

Keywords: algorithm, crisis, DYVELOP, infrastructure

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Authors: Bohuslava Juhasova, Martin Juhas, Renata Masarova, Zuzana Sutova

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The article deals with the tool in Matlab GUI form that is designed to analyse a mechatronic system sensitivity and tolerance. In the analysed mechatronic system, a torque is transferred from the drive to the load through a coupling containing flexible elements. Different methods of control system design are used. The classic form of the feedback control is proposed using Naslin method, modulus optimum criterion and inverse dynamics method. The cascade form of the control is proposed based on combination of modulus optimum criterion and symmetric optimum criterion. The sensitivity is analysed on the basis of absolute and relative sensitivity of system function to the change of chosen parameter value of the mechatronic system, as well as the control subsystem. The tolerance is analysed in the form of determining the range of allowed relative changes of selected system parameters in the field of system stability. The tool allows to analyse an influence of torsion stiffness, torsion damping, inertia moments of the motor and the load and controller(s) parameters. The sensitivity and tolerance are monitored in terms of the impact of parameter change on the response in the form of system step response and system frequency-response logarithmic characteristics. The Symbolic Math Toolbox for expression of the final shape of analysed system functions was used. The sensitivity and tolerance are graphically represented as 2D graph of sensitivity or tolerance of the system function and 3D/2D static/interactive graph of step/frequency response.

Keywords: mechatronic systems, Matlab GUI, sensitivity, tolerance

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Authors: Fatemeh Deldarabdolmaleki, Nur Dalilah Dahlan, Farzad Hejazi

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Human individual physiological and psycho-physical responses widely affect thermal comfort and preferences. They should be carefully researched to help improve the design and comfort of indoor environments. This paper aims to explore and test the degree and importance of individual physiological and psycho-physical differences, reviewing the most preferred, neutral, and comfortable temperature in previous studies conducted across the world. Basic individual physiological differences like gender, age, BMI and etc., have been the focus of this research. There is no unique consensus in the literature to date in regard to providing a universal thermal comfort formula that meets all individual physiological and psycho-physical needs. In order to achieve a balanced, thermally comfortable indoor environment, studying and evaluating individual needs in different parts of the world could be helpful. Even though personalized comfort systems in indoor environments sound promising, they might not be easily achieved in bigger office interiors, considering the cost and current open-plan office trends.

Keywords: thermal comfort, indoor environments, occupants' physiological response, occupants psycho-physical response

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Authors: Wei Wang, Yaohua Zhao, Yanhua Diao

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The exponential growth of the lighting industry has rendered traditional thermal technologies inadequate for addressing the thermal management challenges inherent to high-power light-emitting diode (LED) technology. To enhance the thermal management of LEDs, this study proposes a heat sink configuration that integrates a miniature heat pipe array based on phase change technology with rectangular channels. The thermal performance of the heat sink was evaluated through experimental testing, and the results demonstrated that when the input power was 100W, 150W, and 200W, the temperatures of the LED substrate were 47.64℃, 56.78℃, and 69.06℃, respectively. Additionally, the maximum temperature difference of the MHPA in the vertical direction was observed to be 0.32℃, 0.30℃, and 0.30℃, respectively. The results demonstrate that the heat sink not only effectively dissipates the heat generated by the LEDs, but also exhibits excellent temperature uniformity. In consideration of the experimental measurement outcomes, a corresponding numerical model was developed as part of this study. Following the model validation, the effect of the structural parameters of the heat sink on its heat dissipation efficacy was examined through the use of response surface methodology (RSM) analysis. The rectangular channel width, channel height, channel length, number of channel cross-sections, and channel cross-section spacing were selected as the input parameters, while the LED substrate temperature and the total mass of the heat sink were regarded as the response variables. Subsequently, the response was subjected to an analysis of variance (ANOVA), which yielded a regression model that predicted the response based on the input variables. This offers some direction for the design of the radiator.

Keywords: light-emitting diodes, heat transfer, heat pipe, natural convection, response surface methodology

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Authors: Mohieddine Benghersallah, Lakhdar Boulanouar, Salim Belhadi

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Currently, higher production rate with required quality and low cost is the basic principle in the competitive manufacturing industry. This is mainly achieved by using high cutting speed and feed rates. Elevated temperatures in the cutting zone under these conditions shorten tool life and adversely affect the dimensional accuracy and surface integrity of component. Thus it is necessary to find optimum cutting conditions (cutting speed, feed rate, machining environment, tool material and geometry) that can produce components in accordance with the project and having a relatively high production rate. Response surface methodology is a collection of mathematical and statistical techniques that are useful for modelling and analysis of problems in which a response of interest is influenced by several variables and the objective is to optimize this response. The work presented in this paper examines the effects of cutting parameters (cutting speed, feed rate and depth of cut) on to the surface roughness through the mathematical model developed by using the data gathered from a series of milling experiments performed.

Keywords: Statistical analysis (RSM), Bearing steel, Coating inserts, Tool life, Surface Roughness, End milling.

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Authors: Dawid Jakimiuk, Krzysztof Mitura, Leszek Szpakowski, Sławomir Pilip, Daniel Celiński

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The Emergency Medical Teams (EMS) of the Ambulance Service in Siedlce serve the population living in the Mazowieckie Voivodeship (the area of eastern Poland with approximately 550,000 inhabitants). They provide health services at the pre-hospital stage to all life-threatening patients. The analysis covered the interventions of emergency medical teams in cases of suicide attempts that occurred in the years 2015-2018. The study was retrospective. The data was obtained on the basis of digital medical records of completed call-outs. When defining the disease entity, the International Statistical Classification of Diseases and Health Problems ICD-10 prepared by WHO was used. The relationship between selected disease entities and the area of EMT intervention, the patient's sex and age, and the time of occurrence of the event were investigated. Non-urban area was defined as the area inhabited by a population below 10,000 residents. Statistical analysis was performed using Pearson's Chi ^ 2 test and presenting the percentage of cases in the study group. Of all the suicide attempts, drug abuse cases were the most frequent, including: X60 (Intentional self-poisoning by and exposure to nonopioid analgesics, antipyretics and antirheumatics); X61 (Intentional self-poisoning by and exposure to antiepileptic, sedative-hypnotic, antiparkinsonian and psychotropic drugs, not elsewhere classified); X62 (Intentional self-poisoning by and exposure to narcotics and psycholeptics [hallucinogens], not elsewhere classified); X63 (Intentional self-poisoning by and exposure to other drugs acting on the autonomic nervous system); X64 (Intentional self-poisoning by and exposure to other and unspecified drugs, medicaments and biological substance) oraz X70 (Intentional self-harm by hanging, strangulation and suffocation). In total, they accounted for 69.4% of all interventions to suicide attempts in the studied period. Statistical analysis shows significant differences (χ2 = 39.30239, p <0.0001, n = 561) between the area of EMT intervention and the type of suicide attempt. In non-urban areas, a higher percentage of X70 diagnoses was recorded (55.67%), while in urban areas, X60-X64 (72.53%). In non-urban areas, a higher proportion of patients attempting suicide was observed compared to patients living in urban areas. For X70 and X60 - X64 in total, the incidence rates in non-urban areas were 80.8% and 56%, respectively. Significant differences were found (χ2 = 119.3304, p <0.0001, n = 561) depending on the method of attempting suicide in relation to the patient's sex. The percentage of women diagnosed with X60-X64 versus X70 was 87.50%, which was the largest number of patients (n = 154) as compared to men. In the case of X70 in relation to X60-X64, the percentage of men was 62.08%, which was the largest number of patients (n = 239) as compared to women (n = 22). In the case of X70, the percentage of men compared to women was as high as 92%. Significant differences were observed (χ2 = 14.94848, p <0.01058) between the hour of EMT intervention and the type of suicide attempt. The highest percentage of X70 occurred between 04:01 - 08:00 (64.44%), while X60-X64 between 00:01 - 04:00 (70.45%). The largest number of cases of all tested suicide attempts was recorded between 16:01 - 20:00 for X70 (n = 62), X60 - X64 (n = 82), respectively. The highest percentage of patients undertaking all suicide attempts studied at work was observed in the age range of 18-30 (31.5%), while the lowest was in the age group over 60 years of age. (11%). There was no significant correlation between the day of the week or individual months of the year and the type of suicide attempt - respectively (χ2 = 6.281729, p <0.39238, n = 561) and (χ2 = 3.348913, p <0.9857, n = 561). There were also no significant differences in the incidence of suicide attempts for each year in the study period (χ2 = 3.348913, p <0.9857 n = 561). The obtained results suggest the necessity to undertake preventive measures in order to minimize the number of suicide attempts. Such activities should be directed especially at young patients living in non-urban areas.

Keywords: emergency med, emergency medical team, attempted suicide, pre-hospital

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Authors: Ananya Gupta, Sangeeta Bhaskar

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Mycobacterium indicus pranii (MIP) is a saprophytic mycobacterium. It is a predecessor of M. avium complex (MAC). Whole genome analysis and growth kinetics studies have placed MIP in between pathogenic and non-pathogenic species. It shares significant antigenic repertoire with M. tuberculosis and have unique immunomodulatory properties. MIP provides better protection than BCG against pulmonary tuberculosis in animal models. Immunization with MIP by aerosol route provides significantly higher protection as compared to immunization by subcutaneous (s.c.) route. However, mechanism behind differential protection has not been studied. In this study, using mice model we have evaluated and compared the M.tb specific immune response in lung compartments (airway lumen / lung interstitium) as well as spleen following MIP immunization via nasal (i.n.) and s.c. route. MIP i.n. vaccination resulted in increased seeding of memory T cells (CD4+ and CD8+ T-cells) in the airway lumen. Frequency of CD4+ T cells expressing Th1 migratory marker (CXCR3) and activation marker (CD69) were also high in airway lumen of MIP i.n. group. Significantly high ex vivo secretion of cytokines- IFN-, IL-12, IL-17 and TNF- from cells of airway luminal spaces provides evidence of antigen-specific lung immune response, besides generating systemic immunity comparable to MIP s.c. group. Analysis of T cell response on per cell basis revealed that antigen specific T-cells of MIP i.n. group were functionally superior as higher percentage of these cells simultaneously secreted IFN-gamma, IL-2 and TNF-alpha cytokines as compared to MIP s.c. group. T-cells secreting more than one of the cytokines simultaneously are believed to have robust effector response and crucial for protection, compared with single cytokine secreting T-cells. Adoptive transfer of airway luminal T-cells from MIP i.n. group into trachea of naive B6 mice revealed that MIP induced CD8 T-cells play crucial role in providing long term protection. Thus the study demonstrates that MIP intranasal vaccination induces M.tb specific memory T-cells in the airway lumen that results in an early and robust recall response against M.tb infection.

Keywords: airway lumen, Mycobacterium indicus pranii, Th1 migratory markers, vaccination

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Authors: Priyanka Bharti

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Decades ago designs were based on common sense and tradition, but after an enhancement in visualization technology and research, we are now able to comprehend the cognitive ability involved in the decoding of the visual information. However, many fields in visuals need intense research to deliver an efficient explanation for the events. Visuals are an information representation mode through images, symbols and graphics. It plays an impactful role in decision making by facilitating quick recognition, comprehension, and analysis of a situation. They enhance problem-solving capabilities by enabling the processing of more data without overloading the decision maker. As research proves that, visuals offer an improved learning environment by a factor of 400 compared to textual information. Visual information engages learners at a cognitive level and triggers the imagination, which enables the user to process the information faster (visuals are processed 60,000 times faster in the brain than text). Appropriate information, visualization, and its presentation are known to aid and intensify the decision-making process for the users. However, most literature discusses the role of visual aids in comprehension and decision making during normal conditions alone. Unlike emergencies, in a normal situation (e.g. our day to day life) users are neither exposed to stringent time constraints nor face the anxiety of survival and have sufficient time to evaluate various alternatives before making any decision. An emergency is an unexpected probably fatal real-life situation which may inflict serious ramifications on both human life and material possessions unless corrective measures are taken instantly. The situation demands the exposed user to negotiate in a dynamic and unstable scenario in the absence or lack of any preparation, but still, take swift and appropriate decisions to save life/lives or possessions. But the resulting stress and anxiety restricts cue sampling, decreases vigilance, reduces the capacity of working memory, causes premature closure in evaluating alternative options, and results in task shedding. Limited time, uncertainty, high stakes and vague goals negatively affect cognitive abilities to take appropriate decisions. More so, theory of natural decision making by experts has been understood with far more depth than that of an ordinary user. Therefore, in this study, the author aims to understand the role of visual aids in supporting rapid comprehension to take appropriate decisions during an emergency situation.

Keywords: cognition, visual, decision making, graphics, recognition

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Authors: Pamela Chia, Tay Yoong Chuan

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Introduction: Severe pulmonary hypertension (PH) patients requiring non-cardiac surgery risk have increased mortality rates ranging. These patients are plagued with cardiorespiratory failure, dysrhythmias and anticoagulation potentially with concurrent sepsis and renal insufficiency, perioperative morbidity. We present a deaf-mute patient with severe idiopathic PH emergently prepared for ruptured ectopic laparotomy. Case Report: A 20 year-old female, 62kg (BMI 25 kg/m2) with severe idiopathic PH (2DE Ejection Fraction was 41%, Pulmonary Artery Systolic Pressure (PASP) 105 mmHg, Right ventricle strain and hypertrophy) and selective mutism was rushed in for emergency laparotomy after presenting to the emergency department for abdominal pain. The patient had an NYHA Class II with room air SpO2 93-95%. While awaiting lung transplant, the patient takes warfarin, Sildanefil, Macitentan and even Selexipag for rising PASP. At presentation, vital signs: BP 95/63, HR 119 SpO2 88% (room air). Despite decreasing haemoglobin 14 to 10g/dL, INR 2.59 was reversed with prothrombin concentrate, and Vitamin K. ECG revealed Right Bundle Branch Block with right ventricular strain and x-ray showed cardiomegaly, dilated Right Ventricle, Pulmonary Arteries, basal atelectasis. Arterial blood gas showed compensated metabolic acidosis pH 7.4 pCO2 32 pO2 53 HCO3 20 BE -4 SaO2 88%. The cardiothoracic surgeon concluded no role for Extracorporeal Membrane Oxygenation (ECMO). We inserted invasive arterial and central venous lines with blood transfusion via an 18G cannula before the patient underwent a midline laparotomy, haemostasis of ruptured ovarian cyst with 2.4L of clots under general anesthesia and FloTrac cardiac output monitoring. Rapid sequence induction was done with Midazolam/Propofol, remifentanil infusion, and rocuronium. The patient was maintained on Desflurane. Blood products and colloids were transfused for further 1.5L blood loss. Postoperatively, the patient was transferred to the intensive care unit and was extubated uneventfully 7hours later. The patient went home a week later. Discussion: Emergency hemostasis laparotomy in anticoagulated WHO Class I PH patient awaiting lung transplant with no ECMO backup poses tremendous stress on the deaf-mute patient and the anesthesiologist. Balancing hemodynamics avoiding hypotension while awaiting hemostasis in the presence of pulmonary arterial dilators and anticoagulation requires close titration of volatiles, which decreases RV contractility. We review the contraindicated anesthetic agents (ketamine, N2O), choice of vasopressors in hypotension to maintain Aortic-right ventricular pressure gradients and nitric oxide use perioperatively. Conclusion: Interdisciplinary communication with a deaf-mute moribund patient and anesthesia considerations pose many rare challenges worth sharing.

Keywords: pulmonary hypertension, case report, warfarin reversal, emergency surgery

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Authors: Kulin Dave, Kapil Mohan

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Earthquakes are considered to be the most destructive rapid-onset disasters human beings are exposed to. The amount of loss it brings in is sufficient to take careful considerations for designing of structures and facilities. Seismic Hazard Analysis is one such tool which can be used for earthquake resistant design. Ground Response Analysis is one of the most crucial and decisive steps for seismic hazard analysis. Rapar district of Kutch, Gujarat falls in Zone 5 of earthquake zone map of India and thus has high seismicity because of which it is selected for analysis. In total 8 bore-log data were studied at different locations in and around Rapar district. Different soil engineering properties were analyzed and relevant empirical correlations were used to calculate maximum shear modulus (Gmax) and shear wave velocity (Vs) for the soil layers. The soil was modeled using Pressure-Dependent Modified Kodner Zelasko (MKZ) model and the reference curve used for fitting was Seed and Idriss (1970) for sand and Darendeli (2001) for clay. Both Equivalent linear (EL), as well as Non-linear (NL) ground response analysis, has been carried out with Masing Hysteretic Re/Unloading formulation for comparison. Commercially available DEEPSOIL v. 7.0 software is used for this analysis. In this study an attempt is made to quantify ground response regarding generated acceleration time-history at top of the soil column, Response spectra calculation at 5 % damping and Fourier amplitude spectrum calculation. Moreover, the variation of Peak Ground Acceleration (PGA), Maximum Displacement, Maximum Strain (in %), Maximum Stress Ratio, Mobilized Shear Stress with depth is also calculated. From the study, PGA values estimated in rocky strata are nearly same as bedrock motion and marginal amplification is observed in sandy silt and silty clays by both analyses. The NL analysis gives conservative results of maximum displacement as compared to EL analysis. Maximum strain predicted by both studies is very close to each other. And overall NL analysis is more efficient and realistic because it follows the actual hyperbolic stress-strain relationship, considers stiffness degradation and mobilizes stresses generated due to pore water pressure.

Keywords: DEEPSOIL v 7.0, ground response analysis, pressure-dependent modified Kodner Zelasko model, MKZ model, response spectra, shear wave velocity

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Authors: Meng-Huan Wu, Wei-Er Wang, Tsu-Nai Wang, Wei-Jian Hsu, Vincent Chin-Hung Chen

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Objective: Studies have reported a strong link between asthma and bipolar disorder. We conducted a 17-year community-based large cohort study to examine the relationship between asthma, early smoking initiation, and bipolar disorder during adolescence and early adulthood. Methods: A total of 162,766 participants aged 11–16 years were categorized into asthma and non-asthma groups at baseline and compared within the observation period. Covariates during late childhood or adolescence included parental education, cigarette smoking by family members of participants, and participant’s gender, age, alcohol consumption, smoking, and exercise habits. Data for urbanicity, prednisone use, allergic comorbidity, and Charlson comorbidity index were acquired from the National Health Insurance Research Database. The Cox proportional-hazards model was used to evaluate the association between asthma and bipolar disorder. Results: Our findings revealed that asthma increased the risk of bipolar disorder after adjustment for key confounders in the Cox proportional hazard regression model (adjusted HR: 1.31, 95% CI: 1.12-1.53). Hospitalizations or visits to the emergency department for asthma exhibited a dose–response effect on bipolar disorder (adjusted HR: 1.59, 95% CI: 1.22-2.06). Patients with asthma with onset before 20 years of age who smoked during late childhood or adolescence had the greatest risk for bipolar disorder (adjusted HR: 3.10, 95% CI: 1.29-7.44). Conclusions: Patients newly diagnosed with asthma had a 1.3 times higher risk of developing bipolar disorder. Smoking during late childhood or adolescence increases the risk of developing bipolar disorder in patients with asthma.

Keywords: adolescence, asthma, smoking, bipolar disorder, early adulthood

Procedia PDF Downloads 337

Authors: Jiraporn Rojtinnakorn

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ICAM-2 (intercellular adhesion molecule 2) or CD102 (Cluster of Differentiation 102) is type I trans-membrane glycoproteins, composing 2-9 immunoglobulin-like C2-type domains. ICAM-2 plays the particular role in immune response and cell surveillance. It is concerned in innate and specific immunity, cell survival signal, apoptosis, and anticancer. EST clone of ICAM-2, from P. gigas blood cell EST libraries, showed high identity to human ICAM-2 (92%) with conserve region of ICAM N-terminal domain and part of Ig superfamily. Gene and protein of ICAM-2 has been founded in mammals. This is the first report of ICAM-2 in fish.

Keywords: ICAM-2, CD102, Pangasianodon gigas, antitumor

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Authors: Fatima Zehra Allahverdi, Nukhet Bayer

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Objective: Three questions were formulated to examine stressful working units (intensive care units, emergency unit nurses) utilizing the self-perception theory and social support theory. This study provides a distinctive input by inspecting the combination of variables regarding stressful working environments. Method: The descriptive research was conducted with the participation of 400 nurses working at Ankara City Hospital. The study used Multivariate Analysis of Variance (MANOVA), regression analysis, and a mediation model. Hypothesis one used MANOVA followed by a Scheffe post hoc test. Hypothesis two utilized regression analysis using a hierarchical linear regression model. Hypothesis three used a mediation model. Result: The study utilized mediation analyses. Findings supported the hypotheses that intensive care units have significantly high scores in virtual communication and virtual tolerance. The number of years on the job, virtual communication, virtual tolerance, and phubbing significantly predicted 51% of the variance of perception of addiction. Interestingly, the number of years on the job, while significant, was negatively related to perception of addiction. Conclusion: The reasoning behind these findings and the lack of significance in the emergency unit is discussed. Around 7% of the variance of phubbing was accounted for through working in intensive care units. The model accounted for 26.80 % of the differences in the perception of addiction.

Keywords: phubbing, social media, working units, years on the job, stress

Procedia PDF Downloads 53

Authors: P. Kumar, D. Eisenhauer, M. M. K. Yousef, Q. Shi, A. S. G. Khalil, M. R. Saber, C. Becker, T. Pullerits, K. J. Karki

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In impedance spectroscopy (IS) the response of a photo-active device is analysed as a function of ac bias. It is widely applied in a broad class of material systems and devices. It gives access to fundamental mechanisms of operation of solar cells. We have implemented a method of IS where we modulate the light instead of the bias. This scheme allows us to analyze not only carrier dynamics but also impedance of device locally. Here, using this scheme, we have measured the frequency-dependent photocurrent response of the thin-film planar and nano-textured Si solar cells using this method. Photocurrent response is measured in range of 50 Hz to 50 kHz. Bode and Nyquist plots are used to determine characteristic lifetime of both the cells. Interestingly, the carrier lifetime of both planar and nano-textured solar cells depend on back and front contact positions. This is due to either heterogeneity of device or contacts are not optimized. The estimated average lifetime is found to be shorter for the nano-textured cell, which could be due to the influence of the textured interface on the carrier relaxation dynamics.

Keywords: carrier lifetime, impedance, nano-textured, photocurrent

Procedia PDF Downloads 233

Authors: Daud Muhammad

Abstract:

Introduction: Ankle radiographs are frequently requested in Emergency Departments (ED) for patients presenting with traumatic ankle pain. The Ottawa Ankle Rules (OAR) serve as a clinical guideline to determine the necessity of these radiographs, aiming to reduce unnecessary imaging. This audit was conducted to evaluate the adequacy of clinical information provided in radiograph requests in relation to the OAR. Methods: A retrospective analysis was performed on 50 consecutive ankle radiograph requests under ED clinicians' names for patients aged above 5 years, specifically excluding follow-up radiographs for known fractures. The study assessed whether the provided clinical information met the criteria outlined by the OAR. Results: The audit revealed that none of the 50 radiograph requests contained sufficient information to satisfy the Ottawa Ankle Rules. Furthermore, 10 out of the 50 radiographs (20%) identified fractures. Discussion: The findings indicate a significant lack of adherence to the OAR, suggesting potential overuse of radiography and unnecessary patient exposure to radiation. This non-compliance may also contribute to increased healthcare costs and resource utilization, as well as possible delays in diagnosis and treatment. Recommendations: To address these issues, the following recommendations are proposed: (1) Education and Training: Enhance awareness and training among ED clinicians regarding the OAR. (2) Standardised Request Forms: Implement changes to imaging request forms to mandate relevant information according to the OAR. (3) Scan Vetting: Promote awareness among radiographers to discuss the appropriateness of scan requests with clinicians. (4) Regular re-audits should be conducted to monitor improvements in compliance.

Keywords: Ottawa ankle rules, ankle radiographs, emergency department, traumatic pain

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Authors: Sandhya Devi A

Abstract:

The protein content of the cranberry squash (protein: 0g) may be increased by extracting protein from the lentils (9 g), which is particularly linked to a lower risk of developing heart disease. Using the technique of alkaline extraction from the lentils flour, protein may be extracted. Alkaline extraction of protein from lentil flour was optimized utilizing response surface approach in order to maximize both protein content and yield. Cranberry squash may be taken if a protein fortification syrup is prepared and processed into the squash.

Keywords: alkaline extraction, cranberry squash, protein fortification, response surface methodology

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Authors: Rehana Khan

Abstract:

Background: The study investigates the experiences of Tiger Teams within the Sydney Local Health District during the COVID-19 pandemic. Aim: The aims were to understand the experiences of the Tiger Team members, to evaluate the effectiveness of Tiger Teams, and to elicit any learnings for future implementation of Tiger Teams in a similar context. Methods: Tiger Team members who worked from March 2020 to January 2022 were approached, with 23 members agreeing to participate in the study. Individual interviews were undertaken by a researcher on a virtual platform. Thematic analysis was used to analyse the data. Saturation was deemed to have been reached when no new themes or subthemes arose within the final three interviews. Results: Four themes emerged: diversity worked well in Tiger Teams; fear of the unknown and challenging conversations were the main challenges of Tiger Teams; improved use of resources and more structure around the strategy of the Tiger Team model would help in future implementations; and Sydney Local Health District’s response to the pandemic was uniformly considered effective in keeping the community safe. In relation to Sydney Local Health District’s response in future pandemics, participants suggested having a pool of staff in readiness to undertake Tiger Team duties when required; prioritise staff welfare at all levels of involvement during a pandemic; maintaining transparent communication and relationship building between Executive level, Tiger Team members and clinical floor level in relation to decision making; and improve documentation, including evaluations of the COVID-19 pandemic response. Implications: The study provides constructive insights into the experiences of Tiger Team members, and these findings will help inform future planning for surge and secondment of staff in public health emergencies.

Keywords: Tiger Team, pandemic response, future planning, COVID-19

Procedia PDF Downloads 79

Authors: Azin Shakibabarough, Mojtaba Valinejadshoubi, Ashutosh Bagchi

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Structural vibration means repetitive motion that causes fatigue and reduction of the performance of a structure. An earthquake may release high amount of energy that can have adverse effect on all components of a structure. Therefore, decreasing of vibration or maintaining performance of structures such as bridges, dams, roads and buildings is important for life safety and reducing economic loss. When earthquake or any vibration happens, investigation on parts of a structure which sustain the seismic loads is mandatory to provide a safe condition for the occupants. One of the solutions for reducing the earthquake vibration in a structure is using of vibration control devices such as dampers and base isolators. The objective of this study is to investigate the optimal positions of friction dampers and base isolators for better seismic response of 2D frame. For this purpose, a two bay and six story frame with different distribution formats was modeled and some of their responses to earthquake such as inter-story drift, max joint displacement, max axial force and max bending moment were determined and compared using non-linear dynamic analysis.

Keywords: fast nonlinear analysis, friction damper, base isolator, seismic vibration control, seismic response

Procedia PDF Downloads 321

Authors: Beilei Xu, Wencheng Wu, Lei Lin, Rachel Melnyk, Ahmed Ghazi

Abstract:

In operating rooms, excessive cognitive stress can impede the performance of a surgeon, while low engagement can lead to unavoidable mistakes due to complacency. As a consequence, there is a strong desire in the surgical community to be able to monitor and quantify the cognitive stress of a surgeon while performing surgical procedures. Quantitative cognitiveload-based feedback can also provide valuable insights during surgical training to optimize training efficiency and effectiveness. Various physiological measures have been evaluated for quantifying cognitive stress for different mental challenges. In this paper, we present a study using the cognitive stress measured by the task evoked pupillary response extracted from the time series eye-tracking measurements to predict task difficulties in a virtual reality based robotic surgery training environment. In particular, we proposed a differential-task-difficulty scale, utilized a comprehensive feature extraction approach, and implemented a multitask learning framework and compared the regression accuracy between the conventional single-task-based and three multitask approaches across subjects.

Keywords: surgical metric, task evoked pupillary response, multitask learning, TSFresh

Procedia PDF Downloads 146

Authors: A. Chellil, A. Nour, S. Lecheb, H. Mechakra, A. Bouderba, H. Kebir

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In this paper, the dynamic response for the instability of a composite rotor is presented, under dynamic loading response in the harmonic analysis condition. The analysis of the stress which operates the rotor is done. Calculations of different energies and the virtual work of the aerodynamic loads from the rotor blade is developed. The use of the composite material for the rotor, offers a good stability. Numerical calculations on the model develop of three dimensions prove that the damage effect has a negative effect on the stability of the rotor. The study of the composite rotor in transient system allowed to determine the vibratory responses due to various excitations.

Keywords: rotor, composite, damage, finite element, numerical

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Authors: Humayun R. H. Kabir

Abstract:

An analytical solution before used for static and free-vibration response has been extended for thermal buckling response on cylindrical panel with anti-symmetric laminations. The partial differential equations that govern kinematic behavior of shells produce five coupled differential equations. The basic displacement and rotational unknowns are similar to first order shear deformation theory---three displacement in spatial space, and two rotations about in-plane axes. No drilling degree of freedom is considered. Boundary conditions are considered as complete hinge in all edges so that the panel respond on thermal inductions. Two sets of double Fourier series are considered in the analytical solution process. The sets are selected that satisfy mixed type of natural boundary conditions. Numerical results are presented for the first 10 eigenvalues, and first 10 mode shapes for Ux, Uy, and Uz components. The numerical results are compared with a finite element based solution.

Keywords: higher order shear deformation, composite, thermal buckling, angle-ply laminations

Procedia PDF Downloads 373