Search results for: acute renal failure
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3449

Search results for: acute renal failure

2729 The Role Collagen VI Plays in Heart Failure: A Tale Untold

Authors: Summer Hassan, David Crossman

Abstract:

Myocardial fibrosis (MF) has been loosely defined as the process occurring in the pathological remodeling of the myocardium due to excessive production and deposition of extracellular matrix (ECM) proteins, including collagen. This reduces tissue compliance and accelerates progression to heart failure, as well as affecting the electrical properties of the myocytes resulting in arrhythmias. Microscopic interrogation of MF is key to understanding the molecular orchestrators of disease. It is well-established that recruitment and stimulation of myofibroblasts result in Collagen deposition and the resulting expansion in the ECM. Many types of Collagens have been identified and implicated in scarring of tissue. In a series of experiments conducted at our lab, we aim to elucidate the role collagen VI plays in the development of myocardial fibrosis and its direct impact on myocardial function. This was investigated through an animal experiment in Rats with Collagen VI knockout diseased and healthy animals as well as Collagen VI wild diseased and healthy rats. Echocardiogram assessments of these rats ensued at four-time points, followed by microscopic interrogation of the myocardium aiming to correlate the role collagen VI plays in myocardial function. Our results demonstrate a deterioration in cardiac function as represented by the ejection fraction in the knockout healthy and diseased rats. This elucidates a potential protective role that collagen-VI plays following a myocardial insult. Current work is dedicated to the microscopic characterisation of the fibrotic process in all rat groups, with the results to follow.

Keywords: heart failure, myocardial fibrosis, collagen, echocardiogram, confocal microscopy

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2728 Determination of Failure Modes of Screwed Connections in Cold-Formed Steel Structures

Authors: Mahyar Maali, Merve Sagiroglu

Abstract:

Steel, which is one of the base materials we prefer in the building construction, is the material with the highest ratio to weight of carrying capacity. Due to the carrying capacity, lighter and better quality steel in smaller sections and sizes has recently been used as a frame system in cold-formed steel structures. While light steel elements used as secondary frame elements during the past, they have nowadays started to be preferred as the main frame in low/middle story buildings and detached houses with advantages such as quick and easy installation, time-saving, and small amount of scrap. It is also economically ideal because the weight of structure is lighter than other steel profiles. Structural performances and failure modes of cold-formed structures are different from conventional ones due to their thin-walled structures. One of the most important elements of light steel structures to ensure stability is the connection. The screwed connections, which have self-drilling properties with special drilling tools, are widely used in the installation of cold-formed profiles. The length of the screw is selected according to the total thickness of the elements after the screw thickness is determined according to the elements of connections. The thickness of the material depends on the length of the drilling portion at the end of the screw. The shear tests of plates connected with self-drilling screws are carried out depending on the screw length, and their failure modes were evaluated in this study.

Keywords: cold-formed steel, screwed connection, connection, screw length

Procedia PDF Downloads 171
2727 Performance Evaluation and Cost Analysis of Standby Systems

Authors: Mohammed A. Hajeeh

Abstract:

Pumping systems are an integral part of water desalination plants, their effective functioning is vital for the operation of a plant. In this research work, the reliability and availability of pressurized pumps in a reverse osmosis desalination plant are studied with the objective of finding configurations that provides optimal performance. Six configurations of a series system with different number of warm and cold standby components were examined. Closed form expressions for the mean time to failure (MTTF) and the long run availability are derived and compared under the assumption that the time between failures and repair times of the primary and standby components are exponentially distributed. Moreover, a cost/ benefit analysis is conducted in order to identify a configuration with the best performance and least cost. It is concluded that configurations with cold standby components are preferable especially when the pumps are of the size.

Keywords: availability, cost/benefit, mean time to failure, pumps

Procedia PDF Downloads 273
2726 Cardio-respiratory Rehabilitation in Patients With Chronic or Post-acute Cardiomyopathy and COPD

Authors: Ledi Neçaj

Abstract:

Introduction: Cardio-respiratory rehabilitation is the set of coordinated interventions needed to provide the best physical, psychological, and social conditions so that patients with chronic or post-acute cardiopulmonary disease, with their efforts, maintain or resume optimal functioning in society through improved health behaviors. Purpose: To study the effectiveness of the application of Cardio-Respiratory Rehabilitation in the typology of patients with chronic or post-acute cardiomyopathy and chronic respiratory diseases in order to facilitate their therapeutic use and to improve the overall quality of life. Material and Method: This is a prospective study including patients with COPD and cardiac disease who were included in the rehabilitation program during the period January 2019 - November 2021. The study was conducted at the University Hospital Center "Mother Teresa" in Tirana, University Hospital "SHEFQET NDROQI", AMERICAN Hospital, HYGEA Hospital, and "Our Lady of Good Counsel, Tirana". An individual chart was used to collect sociodemographic, physical, clinical, and functional examinations for each patient. Results: The study included 253 patients, with a mean age of 62.1 (± 7.9) years, ranging from 48 to 82 years. (67.6%) of the patients were males, and (32.4%) female. Male patients predominated in all age groups, with a statistically significant difference with females (p<0.01). The most common cardiac pathologies are coronary artery bypass (24%), cerebral stroke (9%), myocardial infarction (17%), Stent placement (8%) (p<0.01). Correlation matrix of risk factors found a significant correlation of alcohol consumption with diabetes, smoking, dyslipidemia, sedentary life, obesity, AVC, and hypertension. Functional capacity estimated by change in metabolic equivalents (MET) improved by 46% from 4. ±2.2 to 7.2± .8 METs (p<0.01). Duration of exercise after rehabilitation was increased by 21% compared to baseline (p<0.01). The mean score of all three subscales of the questionnaire: symptoms (p=0.03), activity (p<0.01), and impact (p<0.01) after rehabilitation, was lower compared to pre-rehabilitation. Conclusions: The rehabilitation program has impacted on improving the quality of life, reducing symptoms, reducing the impact of negative factors on daily life, and reducing dyspnea during daily activities.

Keywords: cardio-respiratory rehabilitation, physical exercise, quality of life, diseases

Procedia PDF Downloads 87
2725 Failure Analysis of Pipe System at a Hydroelectric Power Plant

Authors: Ali Göksenli, Barlas Eryürek

Abstract:

In this study, failure analysis of pipe system at a micro hydroelectric power plant is investigated. Failure occurred at the pipe system in the powerhouse during shut down operation of the water flow by a valve. This locking had caused a sudden shock wave, also called “Water-hammer effect”, resulting in noise and inside pressure increase. After visual investigation of the effect of the shock wave on the system, a circumference crack was observed at the pipe flange weld region. To establish the reason for crack formation, calculations of pressure and stress values at pipe, flange and welding seams were carried out and concluded that safety factor was high (2.2), indicating that no faulty design existed. By further analysis, pipe system and hydroelectric power plant was examined. After observations it is determined that the plant did not include a ventilation nozzle (air trap), that prevents the system of sudden pressure increase inside the pipes which is caused by water-hammer effect. Analyses were carried out to identify the influence of water-hammer effect on inside pressure increase and it was concluded that, according Jowkowsky’s equation, shut down time is effective on inside pressure increase. The valve closing time was uncertain but by a shut down time of even one minute, inside pressure would increase by 7.6 bar (working pressure was 34.6 bar). Detailed investigations were also carried out on the assembly of the pipe-flange system by considering technical drawings. It was concluded that the pipe-flange system was not installed according to the instructions. Two of five weld seams were not applied and one weld was carried out faulty. This incorrect and inadequate weld seams resulted in; insufficient connection of the pipe to the flange constituting a strong notch effect at weld seam regions, increase in stress values and the decrease of strength and safety factor

Keywords: failure analysis, hydroelectric plant, crack, shock wave, welding seam

Procedia PDF Downloads 337
2724 Etiology and Postnatal Management of Prenatal Hydronephrosis: A Study of Two Teaching Hospitals of Khyber Pakhtunkhwa

Authors: Saima Ali, Liaqat Ali, Nasir Orakzai

Abstract:

Background: Hydronephrosis is the most common abnormal finding in the urinary tract on prenatal screening with Ultrasonography. The prenatal hydronephrosis is a diagnostic dilemma in differentiating between obstructive variant versus physiologic hydronephrosis. The assessment and prompt diagnosis of prenatal hydronephrosis is important because of the fact that untreated obstructive hydronephrosis usually leads to recurrent UTI, Urosepsis, deterioration of renal functions, non-functioning kidneys, and even end-stage renal disease. Objectives: To determine the etiology and outcome of postnatal treatment of children with prenatal hydronephrosis in two teaching hospitals of Khyber Pakhtunkhwa (KPK) Methods: It is a multicentric descriptive study that was conducted in department of Paediatrics in Kuwait teaching hospital Peshawar and Department of Urology in Institute of Kidney Diseases Hayatabad Medical Complex Peshawar from January 2008 till December 2010. Total numbers of 64 neonates were included in the study with the mean follow-up of 14.5 months. All the diagnostic data in prenatal, postnatal data, and operative and non-operative data were collected on structured Proforma and was analyzed on SPSS version 17. Results: Out of 64 patients, 39 (60.9 %) were male while 25 were female. 52 patients had unilateral while 12 patients had bilateral hydronephrosis. Based upon prenatal USG in term of AP diameter, 37 (57 %) patients had mild hydronephrosis (5-10 mm AP diameter), 14 patients had moderate hydronephrosis (10-15 mm AP diameter) while 13 patients had gross hydronephrosis (More than 15mm). Regarding etiology, 44(76 %) patients were labeled as physiologic hydronephrosis, 11 patients (9.3%) with PUJ obstruction, 5 patients with Vesicoureteric reflux (VUR) and 4 patients with posterior urethral valves. Surgery was performed in total of 15 (23.4%) patients that included open Pyeloplasty in 11 patients, Vesicostomy followed by posterior valve fulguration in 4 patients. All the patients of VUR treated medically. The severity in the grade of prenatal hydronephrosis is significantly associated with the need for definitive urological surgery p < 0.005. Ancillary procedures like percutaneous nephrostomy (PCN) were inserted 7 patients. Conclusions: Prenatal hydronephrosis is a common ailment associated with significant morbidity. Physiological Hydronephrosis and VUR can be successfully treated with medical treatment. However obstructive PUJ obstructions and posterior urethral valves require surgical correction with a good success rate.

Keywords: prenatal hydronephrosis, Pelviureteric Junction (PUJ) Obstruction, vesicoureteric reflux, posterior urethral valve, renography

Procedia PDF Downloads 239
2723 Shear Behavior of Steel-Fiber-Reinforced Precast/Prestressed Concrete Hollow Core Slabs

Authors: Thi Nguyet Hang Nguyen, Kang Hai Tan

Abstract:

Precast/prestressed concrete hollow core (PCHC) slabs, especially ones with depth more than 300 mm, are susceptible to web-shear failure. The reasons lie on the fact that the production process of PCHC slabs, i.e., the extrusion method (the most common method to cast PCHC slabs nowadays), does not allow them to contain any shear reinforcement. Moreover, due to the presence of the longitudinal voids, cross sections of PCHC slabs are reduced. Therefore, the shear capacity of the slabs depends solely on the tensile strength of concrete which is relatively low. Given that shear is a major concern in using hollow-core slabs, this paper investigates the possibility of adopting steel fibers in PCHC slabs produced by the extrusion method to enhance the shear capacity of the slabs. Three full-scale PCHC slabs with and without hooked-steel fibers were cast and tested until failure. Three different volumetric fiber contents of 0, 0.51 and 0.89% were investigated. The test results showed that there were substantial increases in shear capacity and ductility with the use of hooked-steel fibers. Ultimate shear strength increased with fiber content. In addition, while the specimen without steel fibers and the one with the steel-fiber volume fraction of 0.51% failed in web-shear mode, the specimen with the higher fiber content (0.89%) collapsed in flexural-shear mode. However, as the hooked-steel fibers with the fiber content of 0.89% were used, difficulties in concrete consolidation were observed while concrete was being cast. This could lead to a lower ultimate shear capacity due to a poorer bond between the concrete and the steel fibers.

Keywords: hollow-core slabs, shear strength, steel fibers, web-shear failure

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2722 Finite Element Simulation of RC Exterior Beam-Column Joints Using Damage Plasticity Model

Authors: A. M. Halahla, M. H. Baluch, M. K. Rahman, A. H. Al-Gadhib, M. N. Akhtar

Abstract:

In the present study, 3D simulation of a typical exterior (RC) beam–column joint (BCJ) strengthened with carbon fiber-reinforced plastic (CFRP) sheet are carried out. Numerical investigations are performed using a nonlinear finite element ( FE) analysis by incorporating damage plasticity model (CDP), for material behaviour the concrete response in compression, tension softening were used, linear plastic with isotropic hardening for reinforcing steel, and linear elastic lamina material model for CFRP sheets using the commercial FE software ABAQUS. The numerical models developed in the present study are validated with the results obtained from the experiment under monotonic loading using the hydraulic Jack in displacement control mode. The experimental program includes casting of deficient BCJ loaded to failure load for both un-strengthened and strengthened BCJ. The failure mode, and deformation response of CFRP strengthened and un-strengthened joints and propagation of damage in the components of BCJ are discussed. Finite element simulations are compared with the experimental result and are noted to yield reasonable comparisons. The damage plasticity model was able to capture with good accuracy of the ultimate load and the mode of failure in the beam column joint.

Keywords: reinforced concrete, exterior beam-column joints, concrete damage plasticity model, computational simulation, 3-D finite element model

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2721 Practical Method for Failure Prediction of Mg Alloy Sheets during Warm Forming Processes

Authors: Sang-Woo Kim, Young-Seon Lee

Abstract:

An important concern in metal forming, even at elevated temperatures, is whether a desired deformation can be accomplished without any failure of the material. A detailed understanding of the critical condition for crack initiation provides not only the workability limit of a material but also a guide-line for process design. This paper describes the utilization of ductile fracture criteria in conjunction with the finite element method (FEM) for predicting the onset of fracture in warm metal working processes of magnesium alloy sheets. Critical damage values for various ductile fracture criteria were determined from uniaxial tensile tests and were expressed as the function of strain rate and temperature. In order to find the best criterion for failure prediction, Erichsen cupping tests under isothermal conditions and FE simulations combined with ductile fracture criteria were carried out. Based on the plastic deformation histories obtained from the FE analyses of the Erichsen cupping tests and the critical damage value curves, the initiation time and location of fracture were predicted under a bi-axial tensile condition. The results were compared with experimental results and the best criterion was recommended. In addition, the proposed methodology was used to predict the onset of fracture in non-isothermal deep drawing processes using an irregular shaped blank, and the results were verified experimentally.

Keywords: magnesium, AZ31 alloy, ductile fracture, FEM, sheet forming, Erichsen cupping test

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2720 Transboundary Pollution after Natural Disasters: Scenario Analyses for Uranium at Kyrgyzstan-Uzbekistan Border

Authors: Fengqing Li, Petra Schneider

Abstract:

Failure of tailings management facilities (TMF) of radioactive residues is an enormous challenge worldwide and can result in major catastrophes. Particularly in transboundary regions, such failure is most likely to lead to international conflict. This risk occurs in Kyrgyzstan and Uzbekistan, where the current major challenge is the quantification of impacts due to pollution from uranium legacy sites and especially the impact on river basins after natural hazards (i.e., landslides). By means of GoldSim, a probabilistic simulation model, the amount of tailing material that flows into the river networks of Mailuu Suu in Kyrgyzstan after pond failure was simulated for three scenarios, namely 10%, 20%, and 30% of material inputs. Based on Muskingum-Cunge flood routing procedure, the peak value of uranium flood wave along the river network was simulated. Among the 23 TMF, 19 ponds are close to the river networks. The spatiotemporal distributions of uranium along the river networks were then simulated for all the 19 ponds under three scenarios. Taking the TP7 which is 30 km far from the Kyrgyzstan-Uzbekistan border as one example, the uranium concentration decreased continuously along the longitudinal gradient of the river network, the concentration of uranium was observed at the border after 45 min of the pond failure and the highest value was detected after 69 min. The highest concentration of uranium at the border were 16.5, 33, and 47.5 mg/L under scenarios of 10%, 20%, and 30% of material inputs, respectively. In comparison to the guideline value of uranium in drinking water (i.e., 30 µg/L) provided by the World Health Organization, the observed concentrations of uranium at the border were 550‒1583 times higher. In order to mitigate the transboundary impact of a radioactive pollutant release, an integrated framework consisting of three major strategies were proposed. Among, the short-term strategy can be used in case of emergency event, the medium-term strategy allows both countries handling the TMF efficiently based on the benefit-sharing concept, and the long-term strategy intends to rehabilitate the site through the relocation of all TMF.

Keywords: Central Asia, contaminant transport modelling, radioactive residue, transboundary conflict

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2719 Multi Attribute Failure Mode Analysis of the Catering Systems: A Case Study of Sefako Makgatho Health Sciences University in South Africa

Authors: Mokoena Oratilwe Penwell, Seeletse Solly Matshonisa

Abstract:

The demand for quality products is a vital factor determining the success of a producing company, and the reality of this demand influences customer satisfaction. In Sefako Makgatho Health Sciences University (SMU), concerns over the quality of food being sold have been raised by mostly students and staff who are primary consumers of food being sold by the cafeteria. Suspicions of food poisoning and the occurrence of diarrhea-related to food from the cafeteria, amongst others, have been raised. However, minimal measures have been taken to resolve the issue of food quality. New service providers have been appointed, and still, the same trends are being observed, the quality of food seems to depreciate continuously. This paper uses multi-attribute failure mode analysis (MAFMA) for failure detection and minimization on the machines used for food production by SMU catering company before being sold to both staff, and students so as to improve production plant reliability, and performance. Analytical Hierarchy Process (AHP) will be used for the severity ranking of the weight criterions and development of the hierarchical structure for the cafeteria company. Amongst other potential issues detected, maintenance of the machines and equipment used for food preparations was of concern. Also, the staff lacked sufficient hospitality skills, supervision, and management in the cafeteria needed greater attention to mitigate some of the failures occurring in the food production plant.

Keywords: MAFMA, food quality, maintenance, supervision

Procedia PDF Downloads 123
2718 Landslide Susceptibility Analysis in the St. Lawrence Lowlands Using High Resolution Data and Failure Plane Analysis

Authors: Kevin Potoczny, Katsuichiro Goda

Abstract:

The St. Lawrence lowlands extend from Ottawa to Quebec City and are known for large deposits of sensitive Leda clay. Leda clay deposits are responsible for many large landslides, such as the 1993 Lemieux and 2010 St. Jude (4 fatalities) landslides. Due to the large extent and sensitivity of Leda clay, regional hazard analysis for landslides is an important tool in risk management. A 2018 regional study by Farzam et al. on the susceptibility of Leda clay slopes to landslide hazard uses 1 arc second topographical data. A qualitative method known as Hazus is used to estimate susceptibility by checking for various criteria in a location and determine a susceptibility rating on a scale of 0 (no susceptibility) to 10 (very high susceptibility). These criteria are slope angle, geological group, soil wetness, and distance from waterbodies. Given the flat nature of St. Lawrence lowlands, the current assessment fails to capture local slopes, such as the St. Jude site. Additionally, the data did not allow one to analyze failure planes accurately. This study majorly improves the analysis performed by Farzam et al. in two aspects. First, regional assessment with high resolution data allows for identification of local locations that may have been previously identified as low susceptibility. This then provides the opportunity to conduct a more refined analysis on the failure plane of the slope. Slopes derived from 1 arc second data are relatively gentle (0-10 degrees) across the region; however, the 1- and 2-meter resolution 2022 HRDEM provided by NRCAN shows that short, steep slopes are present. At a regional level, 1 arc second data can underestimate the susceptibility of short, steep slopes, which can be dangerous as Leda clay landslides behave retrogressively and travel upwards into flatter terrain. At the location of the St. Jude landslide, slope differences are significant. 1 arc second data shows a maximum slope of 12.80 degrees and a mean slope of 4.72 degrees, while the HRDEM data shows a maximum slope of 56.67 degrees and a mean slope of 10.72 degrees. This equates to a difference of three susceptibility levels when the soil is dry and one susceptibility level when wet. The use of GIS software is used to create a regional susceptibility map across the St. Lawrence lowlands at 1- and 2-meter resolutions. Failure planes are necessary to differentiate between small and large landslides, which have so far been ignored in regional analysis. Leda clay failures can only retrogress as far as their failure planes, so the regional analysis must be able to transition smoothly into a more robust local analysis. It is expected that slopes within the region, once previously assessed at low susceptibility scores, contain local areas of high susceptibility. The goal is to create opportunities for local failure plane analysis to be undertaken, which has not been possible before. Due to the low resolution of previous regional analyses, any slope near a waterbody could be considered hazardous. However, high-resolution regional analysis would allow for more precise determination of hazard sites.

Keywords: hazus, high-resolution DEM, leda clay, regional analysis, susceptibility

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2717 Analysis of Sentinel Epidemiological Surveillance of Severe Acute Respiratory Infections in the Republic of Kazakhstan during Seasons 2014/2015 - 2015/2016

Authors: Ardak Myrzabekova

Abstract:

Sentinel epidemiological surveillance (SES) of severe acute respiratory infections (SARI) was introduced in the Republic of Kazakhstan in 2008. The purpose of this study was to analyze SES of flu among SARI patients in the Republic of Kazakhstan during last two flu seasons. Comparative analysis was conducted of SARI morbidity during 40 – 23 weeks of 2014/2015 (season 2014) and 2015/2016 (season 2015) in online base (http:\\ses.dec.kz). In the database during season 2014 were 1,398 SARI patients and 1,985 patients during season 2015. Individual data (clinical, epidemiological and laboratory) of SARI cases were collected based on the questionnaire and were put into the flu electronic system. The studied population was residents of the Republic of Kazakhstan who addressed for medical help in 24 sentinel in-patient clinics in 9 sentinel regions of the country. Swabs from nose and throat were taken for laboratory testing from SARI patients who met the standard case definition. The samples were examined in virology labs of sentinel regions using PCR and 'AmpliSens' test systems made in Russia. The first positive results for flu during season 2014 were obtained on 48 week, during season 2015 – on 46 week. The increase of the number of hospitalized SARI patients was observed during 42 week of 2015 – 01 week of 2016, and during 03 - 06 weeks of 2016, with fluctuating SARI incidence rate from 171 to 444 per 1,000 hospitalized. The highest SARI incidence rate during season 2014 were observed during 01 - 03 weeks of 2015: from 389 to 466 per 1,000 hospitalized. Patients admitted to the ICU during season 2015 were 3.0% (60) SARI patients, compared to 2.7% (38) in 2014 (p=0.3), obtaining oxygen therapy 1.0% (21) compared to 0.3% (5), accordingly, (р=0.009); with shortness of breath 74.8% (1,486) compared to 72.6% (1,015), (р=0.07); with impairment of consciousness 1.0% (21) compared to 0.6% (9), (р=0.11); with muscle pain 19.3% (384) compared to 13.6% (191), (р < 0.001); with joint pain 13.3% (265) compared to 9.3% (131), (p < 0.001). During season 2015 the prevailing subtype of flu А was А/Н1N1-09, it was observed mainly in the age group 30-64: 32.5% (169/520). During season 2014 flu А/Н3N2 was observed mainly in the age group 15-29: 43.6% (106/243). Among children under 14 flu А/Н1N1-09 during season 2015 was 37.3% (194/520), during season 2014 flu А/Н3N2 – 34.9% (85/243). Earlier beginning of the flu season was noted in 2015-2016 and a longer period of hospitalization of SARI patients, with high SARI morbidity rates, unlike season 2014-2015. Season 2015-2016 was characterized by prevailing circulation of virus of flu А/Н1N1-09, mainly in the age group 30-64, and also among children under 14. During season 2014-2015 the virus circulating in the country was А/Н3N2, which was observed mainly in the age group 15-29 and among children under 14.

Keywords: flu, electronic system, sentinel epidemiological surveillance, severe acute respiratory infections

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2716 Financial Benefits after the Implementation of Antimicrobial Copper in Intensive Care Units (ICUs)

Authors: P. Efstathiou, E. Kouskouni, S. Papanikolaou, K. Karageorgou, Z. Manolidou, Tseroni Maria, A. Efstathiou, V. Karyoti, I. Agrafa

Abstract:

Aim: Aim of this study was to evaluate the reduction on Intensive Care Unit (ICU) microbial flora after the antimicrobial copper alloy (Cu+) implementation as well as the effect on financial-epidemiological operation parameters. Methods: Medical, epidemiological and financial data in two time periods, before and after the implementation of copper (Cu 63% - Zn 37%, low lead) were recorded and analyzed in a general ICU. The evaluated parameters were: the importance of patients' admission (Acute Physiology and Chronic Health Evaluation - APACHE II and Simplified Acute Physiology Score - SAPS), microbial flora's record in the ICU before and after the implementation of Cu+ as well as the impact on epidemiological and ICU's operation financial parameters. Results: During December 2010 and March 2011 and respectively during December 2011 and March 2012 comparative results showed statistically significant reduction on the microbial flora (CFU/ml) by 95% and the use of antimicrobial medicine (per day per patient) by 30% (p = 0,014) as well as patients hospitalization time and cost. Conclusions: The innovative implementation of antimicrobial copper in ICUs contributed to their microbial flora significant reduction and antimicrobial drugs use reduction with the apparent positive effect (decrease) in both patient’s hospitalization time and cost. Under the present circumstances of economic crisis, survey results are of highest importance and value.

Keywords: antimicrobial copper, financial benefits, ICU, cost reduction

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2715 The Acute Impact of the Intake of Breadsticks from Different Durum Wheat Flour Mixtures on Postprandial Inflammation, Oxidative Stress, and Antiplatelet Activity in Healthy Volunteers: A Pilot Cross-Over Nutritional Intervention

Authors: O. I. Papagianni, P. Potsaki, K. Almpounioti, D. Chatzicharalampous, A. Voutsa, O. Katira, A. Michalaki, H. C. Karantonis, A. E. Koutelidakis

Abstract:

High intakes of carbohydrates and fats have been associated with an increased risk of chronic diseases due to the role of postprandial oxidative stress. This pilot nutritional intervention aimed to examine the acute effect of consuming two different types of breadsticks prepared from durum wheat flour mixtures differing in total phenolic content on postprandial inflammatory and oxidant responses in healthy volunteers. A cross-over, controlled, and single-blind clinical trial was designed, and two isocaloric high-fat and high-carbohydrate meals were tested. Serum total, HDL- and LDL-cholesterol, triglycerides, glucose, CRP, uric acid, plasma total antioxidant capacity, and antiplatelet activity were determined in fasting and 30, 60, and 120 min after consumption. The results showed a better postprandial HDL-cholesterol and total antioxidant activity response in the intervention group. The choice of durum wheat flours with higher phenolic content and antioxidant activity is presented as promising for human health, and clinical studies will expand to draw safer conclusions.

Keywords: breadsticks, durum wheat flours, postprandial inflammation, postprandial oxidative stress, ex vivo antiplatelet activity

Procedia PDF Downloads 65
2714 Measurement of Project Success in Construction Using Performance Indices

Authors: Annette Joseph

Abstract:

Background: The construction industry is dynamic in nature owing to the increasing uncertainties in technology, budgets, and development processes making projects more complex. Thus, predicting project performance and chances of its likely success has become difficult. The goal of all parties involved in construction projects is to successfully complete it on schedule, within planned budget and with the highest quality and in the safest manner. However, the concept of project success has remained ambiguously defined in the mind of the construction professionals. Purpose: This paper aims to study the analysis of a project in terms of its performance and measure the success. Methodology: The parameters for evaluating project success and the indices to measure success/performance of a project are identified through literature study. Through questionnaire surveys aimed at the stakeholders in the projects, data is collected from two live case studies (an ongoing and completed project) on the overall performance in terms of its success/failure. Finally, with the help of SPSS tool, the data collected from the surveys are analyzed and applied on the selected performance indices. Findings: The score calculated by using the indices and models helps in assessing the overall performance of the project and interpreting it to find out whether the project will be a success or failure. This study acts as a reference for firms to carry out performance evaluation and success measurement on a regular basis helping projects to identify the areas which are performing well and those that require improvement. Originality & Value: The study signifies that by measuring project performance; a project’s deviation towards success/failure can be assessed thus helping in suggesting early remedial measures to bring it on track ensuring that a project will be completed successfully.

Keywords: project, performance, indices, success

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2713 Failure Detection in an Edge Cracked Tapered Pipe Conveying Fluid Using Finite Element Method

Authors: Mohamed Gaith, Zaid Haddadin, Abdulah Wahbe, Mahmoud Hamam, Mahmoud Qunees, Mohammad Al Khatib, Mohammad Bsaileh, Abd Al-Aziz Jaber, Ahmad Aqra’a

Abstract:

The crack is one of the most common types of failure in pipelines that convey fluid, and early detection of the crack may assist to avoid the piping system from experiencing catastrophic damage, which would otherwise be fatal. The influence of flow velocity and the presence of a crack on the performance of a tapered simply supported pipe containing moving fluid is explored using the finite element approach in this study. ANSYS software is used to simulate the pipe as Bernoulli's beam theory. In this paper, the fluctuation of natural frequencies and matching mode shapes for various scenarios owing to changes in fluid speed and the presence of damage is discussed in detail.

Keywords: damage detection, finite element, tapered pipe, vibration characteristics

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2712 AI-Driven Strategies for Sustainable Electronics Repair: A Case Study in Energy Efficiency

Authors: Badiy Elmabrouk, Abdelhamid Boujarif, Zhiguo Zeng, Stephane Borrel, Robert Heidsieck

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In an era where sustainability is paramount, this paper introduces a machine learning-driven testing protocol to accurately predict diode failures, merging reliability engineering with failure physics to enhance repair operations efficiency. Our approach refines the burn-in process, significantly curtailing its duration, which not only conserves energy but also elevates productivity and mitigates component wear. A case study from GE HealthCare’s repair center vividly demonstrates the method’s effectiveness, recording a high prediction of diode failures and a substantial decrease in energy consumption that translates to an annual reduction of 6.5 Tons of CO2 emissions. This advancement sets a benchmark for environmentally conscious practices in the electronics repair sector.

Keywords: maintenance, burn-in, failure physics, reliability testing

Procedia PDF Downloads 55
2711 The acute effects caffeine on testosterone and cortisol in young football players after One Session Anaerobic exercise

Authors: S. Rostami, S. H. Hosseini, A. A. Torabi, M. Bekhradi

Abstract:

Introduction: Interest in the use of caffeine as an ergogenic aid has increased since the International Olympic Committee lifted the partial ban on its use. Caffeine has beneficial effects on various aspects of athletic performance, but its effects on training have been neglected. The purpose of this study was to investigate the acute effect of caffeine on testosterone and cortisole in young futsal players. Methods: Twenty-four professional futsal players with 18.3± 1.9 years ingested caffeine doses of 0, 200 and 800 mg in random order 1 hr before an anaerobic-exercise session (RAST test). Samples were taken at the time of caffeine ingestion and 30 min after the session. Data were log-transformed to estimate percent effects with mixed modeling, and effects were standardized to assess magnitudes. fects on training have been neglected. Results: Testosterone concentration showed a small increase of 15% (90% confidence limits, ± 19%) during exercise. Caffeine raised this concentration in a dose-dependent manner by a further small 21% (± 24%) at the highest dose. The 800-mg dose also produced a moderate 52% (± 44%) increase in cortisol. The effect of caffeine on the testosterone: cortisol ratio was a small decline (14%; ± 21%). Discussion and Conclusion: Caffeine has some potential to benefit training outcomes via the anabolic effects of the increase in testosterone concentration, but this benefit might be counteracted by the opposing catabolic effects of the increase in cortisol and resultant decline in the testosterone: cortisol ratio.

Keywords: anabolic, catabolic, performance, testosterone, cortisol ratio, RAST test

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2710 Size Effect on Shear Strength of Slender Reinforced Concrete Beams

Authors: Subhan Ahmad, Pradeep Bhargava, Ajay Chourasia

Abstract:

Shear failure in reinforced concrete beams without shear reinforcement leads to loss of property and life since a very little or no warning occurs before failure as in case of flexural failure. Shear strength of reinforced concrete beams decreases as its depth increases. This phenomenon is generally called as the size effect. In this paper, a comparative analysis is performed to estimate the performance of shear strength models in capturing the size effect of reinforced concrete beams made with conventional concrete, self-compacting concrete, and recycled aggregate concrete. Four shear strength models that account for the size effect in shear are selected from the literature and applied on the datasets of slender reinforced concrete beams. Beams prepared with conventional concrete, self-compacting concrete, and recycled aggregate concrete are considered for the analysis. Results showed that all the four models captured the size effect in shear effectively and produced conservative estimates of the shear strength for beams made with normal strength conventional concrete. These models yielded unconservative estimates for high strength conventional concrete beams with larger effective depths ( > 450 mm). Model of Bazant and Kim (1984) captured the size effect precisely and produced conservative estimates of shear strength of self-compacting concrete beams at all the effective depths. Also, shear strength models considered in this study produced unconservative estimates of shear strength for recycled aggregate concrete beams at all effective depths.

Keywords: reinforced concrete beams; shear strength; prediction models; size effect

Procedia PDF Downloads 147
2709 The Importance of Zenithal Lighting Systems for Natural Light Gains and for Local Energy Generation in Brazil

Authors: Ana Paula Esteves, Diego S. Caetano, Louise L. B. Lomardo

Abstract:

This paper presents an approach on the advantages of using adequate coverage in the zenithal lighting typology in various areas of architectural production, while at the same time to encourage to the design concerns inherent in this choice of roofing in Brazil. Understanding that sustainability needs to cover several aspects, a roofing system such as zenithal lighting system can contribute to the provision of better quality natural light for the interior of the building, which is related to the good health and welfare; it will also be able to contribute for the sustainable aspects and environmental needs, when it allows the generation of energy in semitransparent or opacity photovoltaic solutions and economize the artificial lightning. When the energy balance in the building is positive, that is, when the building generates more energy than it consumes, it may fit into the Net Zero Energy Building concept. The zenithal lighting systems could be an important ally in Brazil, when solved the burden of heat gains, participate in the set of pro-efficiency actions in search of "zero energy buildings". The paper presents comparative three cases of buildings that have used this feature in search of better environmental performance, both in light comfort and sustainability as a whole. Two of these buildings are examples in Europe: the Notley Green School in the UK and the Isofóton factory in Spain. The third building with these principles of shed´s roof is located in Brazil: the Ipel´s factory in São Paulo.

Keywords: natural lighting, net zero energy building, sheds, semi-transparent photovoltaics

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2708 Acute Severe Hyponatremia in Patient with Psychogenic Polydipsia, Learning Disability and Epilepsy

Authors: Anisa Suraya Ab Razak, Izza Hayat

Abstract:

Introduction: The diagnosis and management of severe hyponatremia in neuropsychiatric patients present a significant challenge to physicians. Several factors contribute, including diagnostic shadowing and attributing abnormal behavior to intellectual disability or psychiatric conditions. Hyponatraemia is the commonest electrolyte abnormality in the inpatient population, ranging from mild/asymptomatic, moderate to severe levels with life-threatening symptoms such as seizures, coma and death. There are several documented fatal case reports in the literature of severe hyponatremia secondary to psychogenic polydipsia, often diagnosed only in autopsy. This paper presents a case study of acute severe hyponatremia in a neuropsychiatric patient with early diagnosis and admission to intensive care. Case study: A 21-year old Caucasian male with known epilepsy and learning disability was admitted from residential living with generalized tonic-clonic self-terminating seizures after refusing medications for several weeks. Evidence of superficial head injury was detected on physical examination. His laboratory data demonstrated mild hyponatremia (125 mmol/L). Computed tomography imaging of his brain demonstrated no acute bleed or space-occupying lesion. He exhibited abnormal behavior - restlessness, drinking water from bathroom taps, inability to engage, paranoia, and hypersexuality. No collateral history was available to establish his baseline behavior. He was loaded with intravenous sodium valproate and leveritircaetam. Three hours later, he developed vomiting and a generalized tonic-clonic seizure lasting forty seconds. He remained drowsy for several hours and regained minimal recovery of consciousness. A repeat set of blood tests demonstrated profound hyponatremia (117 mmol/L). Outcomes: He was referred to intensive care for peripheral intravenous infusion of 2.7% sodium chloride solution with two-hourly laboratory monitoring of sodium concentration. Laboratory monitoring identified dangerously rapid correction of serum sodium concentration, and hypertonic saline was switched to a 5% dextrose solution to reduce the risk of acute large-volume fluid shifts from the cerebral intracellular compartment to the extracellular compartment. He underwent urethral catheterization and produced 8 liters of urine over 24 hours. Serum sodium concentration remained stable after 24 hours of correction fluids. His GCS recovered to baseline after 48 hours with improvement in behavior -he engaged with healthcare professionals, understood the importance of taking medications, admitted to illicit drug use and drinking massive amounts of water. He was transferred from high-dependency care to ward level and was initiated on multiple trials of anti-epileptics before achieving seizure-free days two weeks after resolution of acute hyponatremia. Conclusion: Psychogenic polydipsia is often found in young patients with intellectual disability or psychiatric disorders. Patients drink large volumes of water daily ranging from ten to forty liters, resulting in acute severe hyponatremia with mortality rates as high as 20%. Poor outcomes are due to challenges faced by physicians in making an early diagnosis and treating acute hyponatremia safely. A low index of suspicion of water intoxication is required in this population, including patients with known epilepsy. Monitoring urine output proved to be clinically effective in aiding diagnosis. Early referral and admission to intensive care should be considered for safe correction of sodium concentration while minimizing risk of fatal complications e.g. central pontine myelinolysis.

Keywords: epilepsy, psychogenic polydipsia, seizure, severe hyponatremia

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2707 Evaluating the Cost of Quality: A Case Study of a South African Foundry Business

Authors: Chipo Mugova, Zuko Mjobo

Abstract:

The aim of this study was to evaluate the cost of quality (COQ) at a local foundry business to identify the contribution of its units and processes to quality costs within the foundry’s operations. The foundry selected for detailed case study is one of major businesses that have been targeted by the government to produce components for building and re-furbishing wagons and trains. The study aimed at identifying areas in the foundry’s processes in which investment needs to be made to reduce quality costs. This is in alignment with government’s vision of promoting local business to support local markets leading to creation of jobs, and hence reduction of unemployment rate in South Africa. The methodology adopted used cost of quality models. Results from the study indicated that internal failure costs were significantly higher than all other cost of quality categories, taking more than 60% of the business’s income.

Keywords: appraisal costs, cost of quality, failure costs, local content, prevention costs

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2706 Prospective Randomized Trial of Na/K Citrate for the Prevention of Contrast-Induced Nephropathy in High-Risk Patients

Authors: Leili Iranirad, Mohammad Saleh Sadeghi, Seyed Fakhreddin Hejazi, Negar Vakili Razlighi

Abstract:

Objective: Contrast-induced nephropathy (CIN) or contrast-induced acute kidney injury (CI-AKI) is an unknown acute kidney injury (AKI) occurring after exposure to contrast media (CM). Contrast agents are most often used for diagnostic procedures or therapeutic angiographic interventions. Recently, Na/K citrate as a urine alkalinization has been evaluated for the prevention of CIN. We conducted this experiment to evaluate the efficiency of Na/K citrate on CIN in high-risk patients treated with cardiac catheterization. Methods: A prospective randomized clinical trial was conducted on 400 patients having moderate to high-risk factors for CIN treated with elective percutaneous coronary intervention (PCI) and were assigned randomly to the control group or the Na/K citrate group. The Na/K citrate group (n=200) received 5 g Na/K citrate solution, which was diluted in 200 mL water two h before and four hours after the first administration and intravenous hydration for two h prior to and six h after the procedure, while the control group (n=200) only received intravenous hydration. Serum creatinine (SCr) was calculated prior to the contrast exposure and after 48 h. CIN was described as a 25% increase in creatinine of serum (SCr) or >0.5 mg/dl 48 h after contrast administration. Results: CIN was observed in 33 patients (16.5%) in the control group and in 6 patients (3%) in the Na/K citrate group. A significant variation was recorded in the CIN incidence between the two groups 48 h after the radiocontrast agent administration (p < 0.001). Conclusion: Our results show that Na/K citrate is useful and substantially reduces the incidence of CIN.

Keywords: contrast media, citrate, PCI

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2705 Finite Element Analysis of Reinforced Structural Walls

Authors: Mintesinot Teshome Mengsha

Abstract:

Reinforced concrete structural walls are provided in structures to decrease horizontal displacements under seismic loads. The cyclic lateral load resistance capacity of a structural wall is controlled by two parameters, the strength and the ductility; it is better to have the shear strength somewhat greater than the compression to prevent shear failure, which is brittle, sudden and of serious consequence. Due to architectural and functional reasons, small openings are provided in this important structural part. The main objective of this study is to investigate the finite element of RC structural walls with small openings subjected to cyclic load using the finite element approach. The experimental results in terms of load capacity, failure mode, crack pattern, flexural strength, shear strength, and deformation capacity.

Keywords: ABAQUS, finite element method, small openings, reinforced concrete structural walls

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2704 Scoring System for the Prognosis of Sepsis Patients in Intensive Care Units

Authors: Javier E. García-Gallo, Nelson J. Fonseca-Ruiz, John F. Duitama-Munoz

Abstract:

Sepsis is a syndrome that occurs with physiological and biochemical abnormalities induced by severe infection and carries a high mortality and morbidity, therefore the severity of its condition must be interpreted quickly. After patient admission in an intensive care unit (ICU), it is necessary to synthesize the large volume of information that is collected from patients in a value that represents the severity of their condition. Traditional severity of illness scores seeks to be applicable to all patient populations, and usually assess in-hospital mortality. However, the use of machine learning techniques and the data of a population that shares a common characteristic could lead to the development of customized mortality prediction scores with better performance. This study presents the development of a score for the one-year mortality prediction of the patients that are admitted to an ICU with a sepsis diagnosis. 5650 ICU admissions extracted from the MIMICIII database were evaluated, divided into two groups: 70% to develop the score and 30% to validate it. Comorbidities, demographics and clinical information of the first 24 hours after the ICU admission were used to develop a mortality prediction score. LASSO (least absolute shrinkage and selection operator) and SGB (Stochastic Gradient Boosting) variable importance methodologies were used to select the set of variables that make up the developed score; each of this variables was dichotomized and a cut-off point that divides the population into two groups with different mean mortalities was found; if the patient is in the group that presents a higher mortality a one is assigned to the particular variable, otherwise a zero is assigned. These binary variables are used in a logistic regression (LR) model, and its coefficients were rounded to the nearest integer. The resulting integers are the point values that make up the score when multiplied with each binary variables and summed. The one-year mortality probability was estimated using the score as the only variable in a LR model. Predictive power of the score, was evaluated using the 1695 admissions of the validation subset obtaining an area under the receiver operating characteristic curve of 0.7528, which outperforms the results obtained with Sequential Organ Failure Assessment (SOFA), Oxford Acute Severity of Illness Score (OASIS) and Simplified Acute Physiology Score II (SAPSII) scores on the same validation subset. Observed and predicted mortality rates within estimated probabilities deciles were compared graphically and found to be similar, indicating that the risk estimate obtained with the score is close to the observed mortality, it is also observed that the number of events (deaths) is indeed increasing as the outcome go from the decile with the lowest probabilities to the decile with the highest probabilities. Sepsis is a syndrome that carries a high mortality, 43.3% for the patients included in this study; therefore, tools that help clinicians to quickly and accurately predict a worse prognosis are needed. This work demonstrates the importance of customization of mortality prediction scores since the developed score provides better performance than traditional scoring systems.

Keywords: intensive care, logistic regression model, mortality prediction, sepsis, severity of illness, stochastic gradient boosting

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2703 Relationship Between tcdA and tcdB Genes of Clostridium difficile with Duration of Diarrhea in Elderly Patients

Authors: Ni Luh Putu Harta Wedari

Abstract:

Background: Clostridium difficile has two main virulence factors, namely TcdA and TcdB. TcdA encoded by the tcdA gene acts as an enterotoxin, pro-inflammatory and fluid accumulation, while TcdB encoded by the tcdB gene is cytotoxic, causes disruption of the actin cytoskeleton, and causes disruption of tight junctions in colon cells. This study aims to explore the relationship between the tcdA and tcdB genes and the duration of diarrhea in elderly patients. Method: This research was an observational analytic with a prospective cross-sectional with samples of elderly diarrhea patients who met the inclusion criteria in Denpasar City health service facilities from 1 December 2022 until 30 June 2023, and then their feces were analyzed using the real-time PCR method. Results: In this study, 40 elderly diarrhea patients met the inclusion criteria and in accordance with the minimum sample size, 28 (70%) men and 12 (30%) women. 5 patients (12.5%) had a history of azithromycin, 4 (10%) levofloxacin, 17 (42.5%) ciprofloxacin, 8 (20%) metronidazole, 1 (2.5%) cefoperazone, 5 (12, 5%) doxycycline. Comorbids, namely 13 (32.5%) type II diabetes mellitus, 4 (10%) chronic kidney disease, 10 (25%) malignancies, 7 (17.5%) urinary tract infections, 3 (7.5%) %) immunocompromised, 2 (5%) cardiac heart failure, and 1 (2.5%) acute on chronic kidney disease. The overall diarrhea duration average was 5 days. 8 samples (20%) were positive for 16s rRNA, and there was no significant difference in diarrhea duration with negative samples (p=0.166). The relationship between the tcdA gene and the duration of diarrhea could not be performed because all samples were negative. Likewise, relationship analysis between the coexistence of tcdA and tcdB could not be performed. There was no significant difference between tcdB positive 3 (7.5%) and negative with diarrhea duration (p=0.739). Conclusion: There is no significant relationship between the presence of the 16s rRNA and tcdB C. difficile genes with the duration of diarrhea in elderly patients.

Keywords: clostridium, difficile, diarrhea, elderly, tcdA, tcdB

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2702 Replacement Time and Number of Preventive Maintenance Actions for Second-Hand Device

Authors: Wen Liang Chang

Abstract:

In this study, the optimal replacement time and number of preventive maintenance (PM) actions were investigated for a second-hand device. Suppose that a user intends to use a second-hand device for manufacturing products, and that the device is replaced with a new one. Any device failure is rectified through minimal repair, thereby incurring a fixed repair cost to the user. If the new device fails within the FRW period, minimal repair is performed at no cost to the user. After the FRW expires, a failed device is repaired and the cost of repair is incurred by the user. In this study, two profit models were developed, and the optimal replacement time and number of PM actions were determined to maximize profits. Finally, the influence of the optimal replacement time and number of PM actions were elaborated on, using numerical examples.

Keywords: second-hand device, preventive maintenance, replacement time, device failure

Procedia PDF Downloads 461
2701 Placebo Analgesia in Older Age: Evidence from Event-Related Potentials

Authors: Angelika Dierolf, K. Rischer, A. Gonzalez-Roldan, P. Montoya, F. Anton, M. Van der Meulen

Abstract:

Placebo analgesia is a powerful cognitive endogenous pain modulation mechanism with high relevance in pain treatment. Older people would benefit, especially from non-pharmacologic pain interventions, since this age group is disproportionately affected by acute and chronic pain, while pharmacological treatments are less suitable due to polypharmacy and age-related changes in drug metabolism. Although aging is known to affect neurobiological and physiological aspects of pain perception, as for example, changes in pain threshold and pain tolerance, its effects on cognitive pain modulation strategies, including placebo analgesia, have hardly been investigated so far. In the present study, we are assessing placebo analgesia in 35 older adults (60 years and older) and 35 younger adults (between 18 and 35 years). Acute pain was induced with short transdermal electrical pulses to the inner forearm, using a concentric stimulating electrode. Stimulation intensities were individually adjusted to the participant’s threshold. Next to the stimulation site, we applied sham transcutaneous electrical nerve stimulation (TENS). Participants were informed that sometimes the TENS device would be switched on (placebo condition), and sometimes it would be switched off (control condition). In reality, it was always switched off. Participants received alternating blocks of painful stimuli in the placebo and control condition and were asked to rate the intensity and unpleasantness of each stimulus on a visual analog scale (VAS). Pain-related evoked potentials were recorded with a 64-channel EEG. Preliminary results show a reduced placebo effect in older compared to younger adults in both behavioral and neurophysiological data. Older people experienced less subjective pain reduction under sham TENS treatment compared to younger adults, as evidenced by the VAS ratings. The N1 and P2 event-related potential components were generally reduced in the older group. While younger adults showed a reduced N1 and P2 under sham TENS treatment, this reduction was considerably smaller in older people. This reduced placebo effect in the older group suggests that cognitive pain modulation is altered in aging and may at least partly explain why older adults experience more pain. Our results highlight the need for a better understanding of the efficacy of non-pharmacological pain treatments in older adults and how these can be optimized to meet the specific requirements of this population.

Keywords: placebo analgesia, aging, acute pain, TENS, EEG

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2700 A Systematic Review on Factors/Predictors and Outcomes of Parental Distress in Childhood Acute Lymphoblastic Leukemia

Authors: Ana Ferraz, Martim Santos, M. Graça Pereira

Abstract:

Distress among parents of children with acute lymphoblastic leukemia (ALL) is common during treatment and can persist several years post-diagnosis, impacting the adjustment of children and parents themselves. Current evidence is needed to examine the scope and nature of parental distress in childhood ALL. This review focused on associated variables, predictors, and outcomes of parental distress following their ALL diagnosis of their child. PubMed, Web of Science, and PsycINFO databases were searched for English and Spanish papers published from 1983 to 2021. PRISMA statement was followed, and papers were evaluated through a standardized methodological quality assessment tool (NHLBI). Of the 28 papers included, 16 were evaluated as fair, eight as good, and four as poor. Regarding results, 11 papers reported subgroup differences, and 15 found potential predictors of parental distress, including sociodemographic, psychosocial, psychological, family, health, and ALL-specific variables. Significant correlations were found between parental distress, social support, illness cognitions, and resilience, as well as contradictory results regarding the impact of sociodemographic variables on parental distress. Family cohesion and caregiver burden were associated with distress, and the use of healthy coping strategies was associated with less anxiety. Caregiver strain contributed to distress, and the overall impact of illness positively predicted anxiety in mothers and somatization in fathers. Differences in parental distress were found regarding group risk, time since diagnosis, and treatment phases. Thirteen papers explored the outcomes of parental distress on psychological, family, health, and social/education outcomes. Parental distress was the most important predictor of family strain. Significant correlations were found between parental distress at diagnosis and further psychological adjustment of parents themselves and their children. Most papers reported correlations between parental distress on children’s adjustment and quality of life, although few studies reported no association. Correlations between maternal depression and child participation in education and social life were also found. Longitudinal studies are needed to better understand parental distress and its consequences on health outcomes, in particular. Future interventions should focus mainly on parents on distress reduction and psychological adjustment, both in parents and children over time.

Keywords: childhood acute lymphoblastic leukemia, family, parental distress, psychological adjustment, quality of life

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