Search results for: cross flow

Authors: Kambiz Rasoulkhani, Jeanne Cole, Sybil Sharvelle, Ali Mostafavi

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Dual water distribution systems have been proposed as solutions to enhance the sustainability and resilience of urban water systems by improving performance and decreasing energy consumption. The objective of this study was to evaluate the long-term resilience and robustness of dual water distribution systems versus singular water distribution systems under various stressors such as demand fluctuation, aging infrastructure, and funding constraints. To this end, the long-term dynamics of these infrastructure systems was captured using a simulation model that integrates institutional agency decision-making processes with physical infrastructure degradation to evaluate the long-term transformation of water infrastructure. A set of model parameters that varies for dual and singular distribution infrastructure based on the system attributes, such as pipes length and material, energy intensity, water demand, water price, average pressure and flow rate, as well as operational expenditures, were considered and input in the simulation model. Accordingly, the model was used to simulate various scenarios of demand changes, funding levels, water price growth, and renewal strategies. The long-term resilience and robustness of each distribution infrastructure were evaluated based on various performance measures including network average condition, break frequency, network leakage, and energy use. An ecologically-based resilience approach was used to examine regime shifts and tipping points in the long-term performance of the systems under different stressors. Also, Classification and Regression Tree analysis was adopted to assess the robustness of each system under various scenarios. Using data from the City of Fort Collins, the long-term resilience and robustness of the dual and singular water distribution systems were evaluated over a 100-year analysis horizon for various scenarios. The results of the analysis enabled: (i) comparison between dual and singular water distribution systems in terms of long-term performance, resilience, and robustness; (ii) identification of renewal strategies and decision factors that enhance the long-term resiliency and robustness of dual and singular water distribution systems under different stressors.

Keywords: complex systems, dual water distribution systems, long-term resilience performance, multi-agent modeling, sustainable and resilient water systems

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Authors: Keping Zuo, Foad Kabinejadian, Gideon Praveen Kumar Vijayakumar, Fangsen Cui, Pei Ho, Hwa Liang Leo

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Carotid artery stenting (CAS) is the standard procedure for patients with severe carotid stenosis at high risk for carotid endarterectomy (CAE). A major drawback of CAS is the higher incidence of procedure-related stroke compared with traditional open surgical treatment for carotid stenosis - CEA, even with the use of the embolic protection devices (EPD). As the currently available bare metal stents cannot address this problem, our research group developed a novel preferential covered-stent for carotid artery aims to prevent friable fragments of atherosclerotic plaques from flowing into the cerebral circulation, and yet maintaining the flow of the external carotid artery. The preliminary animal studies have demonstrated the potential of this novel covered-stent design for the treatment of carotid atherosclerotic stenosis. The purpose of this study is to evaluate the effect of membrane coating on the stent flexibility in order to improve the clinical performance of our novel covered stents. A total of 21 stents were evaluated in this study: 15 self expanding bare nitinol stents and 6 PTFE-covered stents. 10 of the bare stents were coated with 11%, 16% and 22% Polyurethane(PU), 4%, 6.25% and 11% EE, as well as 22% PU plus 5 μm Parylene. Different laser cutting designs were performed on 4 of the PTFE covert stents. All the stents, with or without the covered membrane, were subjected to a three-point flexural test. The stents were placed on two supports that are 30 mm apart, and the actuator is applying a force in the exact middle of the two supports with a loading pin with radius 2.5 mm. The loading pin displacement change, the force and the variation in stent shape were recorded for analysis. The flexibility of the stents was evaluated by the lumen area preservation at three displacement bending levels: 5mm, 7mm, and 10mm. All the lumen areas in all stents decreased with the increase of the displacement from 0 to 10 mm. The bare stents were able to maintain 0.864 ± 0.015, 0.740 ± 0.025 and 0.597 ± 0.031of original lumen area at 5 mm, 7 mm and 10mm displacement respectively. For covered stents, the stents with EE coating membrane showed the best lumen area preservation (0.839 ± 0.005, 0.7334 ± 0.043 and 0.559 ± 0.014), whereas, the stents with PU and Parylene coating were only 0.662, 0.439 and 0.305. Bending stiffness was also calculated and compared. These results provided optimal material information and it was crucial for enhancing clinical performance of our novel covered stents.

Keywords: carotid artery, covered stent, nonlinear, hyperelastic, stress, strain

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Authors: Markus Meyer, Bastian Maucher, Rolf Witzmann

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The ever increasing amount of distributed generation in low voltage distribution grids (mainly PV and micro-CHP) can lead to reverse load flows from low to medium/high voltage levels at times of high feed-in. Reverse load flow leads to rising voltages that may even exceed the limits specified in the grid codes. Furthermore, the share of electrical loads connected to low voltage distribution grids via switched power supplies continuously increases. In combination with inverter-based feed-in, this results in high harmonic levels reducing overall power quality. Especially high levels of third-order harmonic currents can lead to neutral conductor overload, which is even more critical if lines with reduced neutral conductor section areas are used. This paper illustrates a possible concept for smart grids in order to increase the feed-in capacity, improve power quality and to ensure safe operation of low voltage distribution grids at all times. The key feature of the concept is a hierarchically structured control strategy that is run on a superordinated controller, which is connected to several distributed grid analyzers and inverters via broad band powerline (BPL). The strategy is devised to ensure both quick response time as well as the technically and economically reasonable use of the available inverters in the grid (PV-inverters, batteries, stepless line voltage regulators). These inverters are provided with standard features for voltage control, e.g. voltage dependent reactive power control. In addition they can receive reactive power set points transmitted by the superordinated controller. To further improve power quality, the inverters are capable of active harmonic filtering, as well as voltage balancing, whereas the latter is primarily done by the stepless line voltage regulators. By additionally connecting the superordinated controller to the control center of the grid operator, supervisory control and data acquisition capabilities for the low voltage distribution grid are enabled, which allows easy monitoring and manual input. Such a low voltage distribution grid can also be used as a virtual power plant.

Keywords: distributed generation, distribution grid, power quality, smart grid, virtual power plant, voltage control

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Authors: Yamma Rose, Kone Martine, Yonli Arsène, Wanko Ngnien Adrien

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Artisanal gold mining has seen a resurgence in recent years in Burkina Faso with its corollary of soil and water pollution. Indeed, in addition to visible impacts, it generates discharges rich in trace metal elements and acids. This pollution has significant environmental consequences, making these lands unusable while the population depends on the natural environment for its survival. The goal of this study is to assess the decontamination potential of Chrysopogon zizanioides on two artisanal gold processing sites in Burkina Faso. The cyanidation sites of Nebia (1Ha) and Nimbrogo (2Ha) located respectively in the Central West and Central South regions were selected. The soils were characterized to determine the initial pollution levels before the implementation of phytoremediation. After development of the site, parallel trenches equidistant 6 m apart, 30 cm deep, 40 cm wide and opposite to the water flow direction were dug and filled with earth amended with manure. The Chrysopogon zizanioides plants were transplanted 5 cm equidistant into the trenches. The mere fact that Chrysopogon zizanioides grew in the polluted soil is an indication that this plant tolerates and resists the toxicity of trace elements present on the site. The characterization shows sites very polluted with free cyanide 900 times higher than the national standard, the level of Hg in the soil is 5 times more than the limit value, iron and Zn are respectively 1000 times and 200 more than the tolerated environmental value. At time T1 (6 months) and T2 (12 months) of culture, Chrysopogon zizanioides showed less development on the Nimbrogo site than that of the Nebia site. Plant shoots and associated soil samples were collected and analyzed for total As, Hg, Fe and Zn concentration. The trace element content of the soil, the bioaccumulation factor and the hyper accumulation thresholds were also determined to assess the remediation potential. The concentration of As and Hg in the soil was below international risk thresholds, while that of Fe and Zn was well above these thresholds. The CN removal efficiency at the Nebia site is respectively 29.90% and 68.62% compared to 6.6% and 60.8% at Nimbrogo at time T1 and T2.

Keywords: chrysopogon zizanioides, in-situ phytoremediation, polluted soils, micropollutants

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Authors: Tassadit Issaadi Hamitouche, Nicolas Gillard, Jean Petit, Valerie Lavaste, Celine Mayousse

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Water is a fundamental resource for the industry. It is taken from the environment either from municipal distribution networks or from various natural water sources such as the sea, ocean, rivers, aquifers, etc. Once used, water is discharged into the environment, reprocessed at the plant or treatment plants. These withdrawals and discharges have a direct impact on natural water resources. These impacts can apply to the quantity of water available, the quality of the water used, or to impacts that are more complex to measure and less direct, such as the health of the population downstream from the watercourse, for example. Based on the analysis of data (meteorological, river characteristics, physicochemical substances), we wish to predict water stress episodes and anticipate prefectoral decrees, which can impact the performance of plants and propose improvement solutions, help industrialists in their choice of location for a new plant, visualize possible interactions between companies to optimize exchanges and encourage the pooling of water treatment solutions, and set up circular economies around the issue of water. The development of a system for the collection, processing, and use of data related to water resources requires the functional constraints specific to the latter to be made explicit. Thus the system will have to be able to store a large amount of data from sensors (which is the main type of data in plants and their environment). In addition, manufacturers need to have 'near-real-time' processing of information in order to be able to make the best decisions (to be rapidly notified of an event that would have a significant impact on water resources). Finally, the visualization of data must be adapted to its temporal and geographical dimensions. In this study, we set up an infrastructure centered on the TICK application stack (for Telegraf, InfluxDB, Chronograf, and Kapacitor), which is a set of loosely coupled but tightly integrated open source projects designed to manage huge amounts of time-stamped information. The software architecture is coupled with the cross-industry standard process for data mining (CRISP-DM) data mining methodology. The robust architecture and the methodology used have demonstrated their effectiveness on the study case of learning the level of a river with a 7-day horizon. The management of water and the activities within the plants -which depend on this resource- should be considerably improved thanks, on the one hand, to the learning that allows the anticipation of periods of water stress, and on the other hand, to the information system that is able to warn decision-makers with alerts created from the formalization of prefectoral decrees.

Keywords: data mining, industry, machine Learning, shortage, water resources

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Authors: Mekroud Amel

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Emergency departments are known for the workload, the variety of pathologies and the difficulties in their management with the continuous influx of patients The role of our service in the management of patients with two or three mild to moderate organ failures, involving several disciplines at the same time, as well as the effect of this management on the skills and efficiency of our team has been demonstrated Borderline cases between two or three or even more disciplines, with instability of a vital function, which have been successfully managed in the emergency room, the therapeutic procedures adopted, the consequences on the quality and level of care delivered by our team, as well as that the logistical consequences, and the pedagogical consequences are demonstrated. The consequences found are Positive on the emergency teams, in rare situations are negative Regarding clinical situations, it is the entanglement of hemodynamic distress with right, left or global participation, tamponade, low flow with acute pulmonary edema, and/or state of shock With respiratory distress with more or less profound hypoxemia, with haematosis disorder related to a bacterial or viral lung infection, pleurisy, pneumothorax, bronchoconstrictive crisis. With neurological disorders such as recent stroke, comatose state, or others With metabolic disorders such as hyperkalaemia renal insufficiency severe ionic disorders with accidents with anti vitamin K With or without septate effusion of one or more serous membranes with or without tamponade It’s a Retrospective, monocentric, descriptive study Period 05.01.2022 to 10.31.2022 the purpose of our work: Search for a statistically significant link between the type of moderate to severe pathology managed in the emergency room whose problems are multivisceral on the efficiency of the healthcare team and its level of care and optional care offered for patients Statistical Test used: Chi2 test to prove the significant link between the resolution of serious multidisciplinary cases in the emergency room and the effectiveness of the team in the management of complicated cases Search for a statistically significant link : The management of the most difficult clinical cases for organ specialties has given general practitioner emergency teams a great perspective and has been able to improve their efficiency in the face of emergencies received

Keywords: emergency care teams, management of patients with dysfunction of more than one organ, learning curve, quality of care

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Authors: Sujata Yadav

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Public spaces are vital centers of community life, and urban areas are constantly being shaped by expanding populations, shifting economic conditions, and environmental issues. The process of transforming these areas is difficult and calls for solutions that manage the fast pace of urbanization while attending to contemporary urban demands. Urban regions deal with a variety of issues, such as environmental sustainability, conflicting interests, social change, and economic pressures. Creative approaches are required as cities deal with these problems in order to promote engagement and inclusivity. A strategy that uses short-term, inexpensive, and adaptable interventions, tactical urbanism has drawn interest as a means of addressing pressing urban problems and promoting long-term change. Before making long-term investments, tactical urbanism enables cities to test and improve urban changes, promoting experimentation and community involvement. This strategy has been successful in improving public spaces, pedestrian zones, and streetscapes. This strategy has been successful in enhancing accessibility and fostering social interaction by changing public areas, pedestrian zones, and streetscapes. Changes to New Road have caused controversy and discontent among stakeholders in Kathmandu, a city undergoing major urban transformation. The potential of tactical urbanism as a tool for urban transformation in public areas is examined in this study. The study intends to shed light on how cities can adjust to contemporary demands with little financial outlay by investigating how short-term interventions can spur more significant urban changes. The study employs a mixed-methods approach, integrating quantitative analysis of pedestrian flow, economic activity, and public space usage with qualitative data from stakeholder interviews. Future urban planning and policy-making will be informed by the findings, which show how tactical urbanism can solve issues like traffic, limited public space, and competing interests.

Keywords: tactical urbanism, urban transformation, inclusive planning, short-term interventions

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Authors: Ismail Bamidele Afolabi, Abdulmujeeb Babatunde Aremu, Lawal Abdurraheem Maidoki, Nnodimele Onuigbo Atulomah

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Background: Hepatitis B virus infection remains a significant global public health challenge with infectivity as well as the potential for transmission more than 50 to 100 times that of HIV. Annually, global HBV-related mortality is linked primarily to cirrhosis and liver carcinoma. The ever-increasing endemicity of HBV among children under-5-years, owing to vertical transmission and its lingering chronicity in developing countries, will hamper the global efforts concertedly endorsed towards eliminating viral hepatitis as a global public health threat by 2030. Objective: This study assessed information motivation behavioral skills model constructs as predictors of HBV infection prevention practices among consenting expectant mothers attending antenatal care in Central Uganda as a focal point of intervention towards breaking materno-foetal transmission of HBV. Methods: A cross-sectional study with a quantitative data collection approach based on the constructs of the IMB model was used to capture data on the study variables among 385 randomly selected pregnant women between September and October 2020. Data derived from the quantitative instrument were transformed into weighted aggregate scores using SPSS version 26. ANOVA and regression analysis were done to ascertain the study hypotheses with a significance level set as (p ≤ 0.05). Results: Relatively 60% of the respondents were aged between 18 and 28. Expectant mothers with secondary education (42.3%) were predominant. Furthermore, an average but inadequate knowledge (X ̅=5.97±6.61; B=0.57; p<.001), incorrect perception (X ̅=17.10±18.31; B=0.97; p=.014), and good behavioral skills (X ̅=12.39±13.37; B=0.56; p<.001) for adopting prevention practices all statistically predicted the unsatisfactory level of prevention practices (X ̅=15.03±16.20) among the study respondents as measured on rating scales of 12, 33, 21 and 30 respectively. Conclusion: Evidence from this study corroborates the imperativeness of IMB constructs in reducing the burden of HBV infection in developing countries. Therefore, the inadequate HBV knowledge and misperception among obstetric populations necessitate personalized health education during antenatal visits and subsequent health campaigns in order to inform better prevention practices and, in turn, reduce the lingering chronicity of HBV infection in developing countries.

Keywords: behavioral skills, HBV infection, knowledge, perception, pregnant women, prevention practices

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Authors: Srinivas Bathini, Duraichelvan Raju, Simona Badilescu, Muthukumaran Packirisamy

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A bio-sensing method, based on the plasmonic property of gold nano-islands, has been developed for detection of exosomes in a clinical setting. The position of the gold plasmon band in the UV-Visible spectrum depends on the size and shape of gold nanoparticles as well as on the surrounding environment. By adsorbing various chemical entities, or binding them, the gold plasmon band will shift toward longer wavelengths and the shift is proportional to the concentration. Exosomes transport cargoes of molecules and genetic materials to proximal and distal cells. Presently, the standard method for their isolation and quantification from body fluids is by ultracentrifugation, not a practical method to be implemented in a clinical setting. Thus, a versatile and cutting-edge platform is required to selectively detect and isolate exosomes for further analysis at clinical level. The new sensing protocol, instead of antibodies, makes use of a specially synthesized polypeptide (Vn96), to capture and quantify the exosomes from different media, by binding the heat shock proteins from exosomes. The protocol has been established and optimized by using a glass substrate, in order to facilitate the next stage, namely the transfer of the protocol to a microfluidic environment. After each step of the protocol, the UV-Vis spectrum was recorded and the position of gold Localized Surface Plasmon Resonance (LSPR) band was measured. The sensing process was modelled, taking into account the characteristics of the nano-island structure, prepared by thermal convection and annealing. The optimal molar ratios of the most important chemical entities, involved in the detection of exosomes were calculated as well. Indeed, it was found that the results of the sensing process depend on the two major steps: the molar ratios of streptavidin to biotin-PEG-Vn96 and, the final step, the capture of exosomes by the biotin-PEG-Vn96 complex. The microfluidic device designed for sensing of exosomes consists of a glass substrate, sealed by a PDMS layer that contains the channel and a collecting chamber. In the device, the solutions of linker, cross-linker, etc., are pumped over the gold nano-islands and an Ocean Optics spectrometer is used to measure the position of the Au plasmon band at each step of the sensing. The experiments have shown that the shift of the Au LSPR band is proportional to the concentration of exosomes and, thereby, exosomes can be accurately quantified. An important advantage of the method is the ability to discriminate between exosomes having different origins.

Keywords: exosomes, gold nano-islands, microfluidics, plasmonic biosensing

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Authors: Katarzyna Sobczak

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Over the last few years extensive research on the Lower Palaeozic of the Baltic region has been carried out, associated with growing interest in the unconventional hydrocarbon resources of the area. The present study contributes to this investigation by providing relevant microfacies analysis of Ordovician and Silurian carbonate and clastic deposits of the Polish part of the Baltic Syneclise, using data from the Kętrzyn IG-1, Henrykowo 1 and Babiak 1 boreholes. The analytical data, encompassing sedimentological, palaeontological, and petrographic indicators enables the interpretation of the sedimentary environments and their control factors. The main microfacies types distinguished within the studied interval are: bioclastic wackestone, bioclastic packstone, carbonate-rich mudstone, marlstone, nodular limestone and bituminous claystone. The Ordovician is represented by redeposited carbonate rocks formed in a relatively high-energy environment (middle shelf setting). The Upper Ordovician-Lower Silurian rocks of the studied basin represent sedimentary succession formed during a distinctive marine transgression. Considering the sedimentological and petrological data from the Silurian, a low-energy sedimentary environment (offshore setting) with intermittent high-energy events (tempestites) can be inferred for the sedimentary basin of NE Poland. Slow sedimentation of carbonate ooze and fine-grained siliciclastic rocks, formed under oxygen-deficient conditions of the seabed, favoured organic matter preservation. The presence of the storm beds suggests an episodic nature of seabed oxygenation. A significant part of the analysed depositional successions shows characteristics indicative of deposition from gravity flows, but lacks evidence of its turbidity origins. There is, however, evidence for storms acting as a mechanism of flow activation. The discussed Ordovician-Silurian transition of depositional environments in the Baltic area fits well to the global environmental changes encompassing the Upper Ordovician and the Lower Silurian.

Keywords: Baltic Syneclise, microfacies analysis, Ordovician, Silurian, unconventional hydrocarbons

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Authors: Vithya Veeramani, Karunanidhi Subbaiah

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Emotional problems were found to be the predominant cause of suicide and second leading cause of death among adolescents in India. Emotional problems seem to be the underlying cause for various other severe psycho-social problems experienced in adolescence and also in later years of life. The Corporation schools in Chennai city are named as Chennai High School or Chennai Higher Secondary School run by the Corporation of Chennai. These schools fulfill the educational needs of students who hail from lower socio-economic status living in slums of the Chennai city. Adolescent students of Chennai schools tend to lack basic needs like food, clothes, shelter, etc. Some of the other significant problems faced by them are broken family, lack of parental support, frequent quarrel between parents, alcoholic parents, drug abuse and substance abuse among parents and neighbors, extended family, illiterate parents, deprivation of love and care, and lack of sense of belongingness. This prevailing condition may affect them emotionally and could lead to maladaptive behaviour, aggressiveness, poor interpersonal relationship with others, school refusal behaviour, school drop-out, suicide, etc. Therefore, it is very important to investigate the emotional problems faced by the adolescent students studying in Chennai schools, Chennai. A cross-sectional survey design was used to find the prevalence of emotional problems among adolescent students. Cluster sampling technique was used to select the schools for the present study considering the school as a cluster. In total, there are 15 zones, under the control of Chennai Corporation, of which only 7 zones have Corporation Schools in Chennai city, comprising of 32 Chennai Higher Secondary Schools and 38 Chennai High Schools. Out of these 70 schools, 29 schools comprising of 17 high schools and 12 higher secondary schools were selected randomly using lottery method. A sample of 2594 adolescent students from 9th standard and 11th standard was chosen for the study. Percentage analysis was done to find out the prevalence rate of emotional problems among adolescents students studying in Chennai Schools. Results of the study revealed that, out of 2594 students surveyed, 21.04% adolescent students were found to have academic problems (n = 546), 15.99% adolescent students had social problems (n = 415), behaviour problems was found to be prevalent among 12.87% adolescent students (n = 334), depression was prevalent among 15.88% adolescent students (n = 412) and anxiety was prevalent among 14.42% adolescent students (n = 374). Prevalence of emotional problems among male and female revealed that academic problems were more prevalent compared to other problems. Behaviour problems were least prevalent among boys and anxiety was least prevalent among girls than other problems. The overall prevalence rate of emotional problems was found to be on an increasing trend among adolescent students of low socio-economic status in Chennai city. The findings indicated the need for intervention to prevent and rehabilitate these adolescent students.

Keywords: adolescents, corporation schools, emotional problems, prevalence

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Authors: Soheila Sadeghi

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In the dynamic landscape of project management, scope changes are an inevitable reality that can significantly impact project performance. These changes, whether initiated by stakeholders, external factors, or internal project dynamics, can lead to cost overruns and schedule delays. Accurately predicting the consequences of these changes is crucial for effective project control and informed decision-making. This study aims to develop predictive models to estimate the impact of scope changes on project cost and schedule using machine learning techniques. The research utilizes a comprehensive dataset containing detailed information on project tasks, including the Work Breakdown Structure (WBS), task type, productivity rate, estimated cost, actual cost, duration, task dependencies, scope change magnitude, and scope change timing. Multiple machine learning models are developed and evaluated to predict the impact of scope changes on project cost and schedule. These models include Linear Regression, Decision Tree, Ridge Regression, Random Forest, Gradient Boosting, and XGBoost. The dataset is split into training and testing sets, and the models are trained using the preprocessed data. Cross-validation techniques are employed to assess the robustness and generalization ability of the models. The performance of the models is evaluated using metrics such as Mean Squared Error (MSE) and R-squared. Residual plots are generated to assess the goodness of fit and identify any patterns or outliers. Hyperparameter tuning is performed to optimize the XGBoost model and improve its predictive accuracy. The feature importance analysis reveals the relative significance of different project attributes in predicting the impact on cost and schedule. Key factors such as productivity rate, scope change magnitude, task dependencies, estimated cost, actual cost, duration, and specific WBS elements are identified as influential predictors. The study highlights the importance of considering both cost and schedule implications when managing scope changes. The developed predictive models provide project managers with a data-driven tool to proactively assess the potential impact of scope changes on project cost and schedule. By leveraging these insights, project managers can make informed decisions, optimize resource allocation, and develop effective mitigation strategies. The findings of this research contribute to improved project planning, risk management, and overall project success.

Keywords: cost impact, machine learning, predictive modeling, schedule impact, scope changes

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Authors: Yun-Hsiang Lee

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Cancer is the main cause of death worldwide. With advances in medical technology, immunotherapy, which is a newly developed advanced treatment, is currently a crucial cancer treatment option. For better quality cancer care, the ability to communicate and critical thinking plays a central role in clinical oncology settings. However, few studies have explored the impact of communication skills on immunotherapy-related issues and their related factors. This study was to (i) explore the current status of communication skill ability for immunotherapy-related issues, self-efficacy for immunotherapy-related care, and critical thinking ability; and (ii) identify factors related to communication skill ability. This is a cross-sectional study. Oncology nurses were recruited from the Taiwan Oncology Nursing Society, in which nurses came from different hospitals distributed across four major geographic regions (North, Center, South, East) of Taiwan. A total of 123 oncology nurses participated in this study. A set of questionnaires were used for collecting data. Communication skill ability for immunotherapy issues, self-efficacy for immunotherapy-related care, critical thinking ability, and background information were assessed in this survey. Independent T-test and one-way ANOVA were used to examine different levels of communication skill ability based on nurses having done oncology courses (yes vs. no) and education years (< 1 year, 1-3 years, and > 3 years), respectively. Spearman correlation was conducted to understand the relationships between communication skill ability and other variables. Among the 123 oncology nurses in the current study, the majority of them were female (98.4%), and most of them were employed at a hospital in the North (46.8%) of Taiwan. Most of them possessed a university degree (78.9%) and had at least 3 years of prior work experience (71.7%). Forty-three of the oncology nurses indicated in the survey that they had not received oncology nurses-related training. Those oncology nurses reported moderate to high levels of communication skill ability for immunotherapy issues (mean=4.24, SD=0.7, range 1-5). Nurses reported moderate levels of self-efficacy for immunotherapy-related care (mean=5.20, SD=1.98, range 0-10) and also had high levels of critical thinking ability (mean=4.76, SD=0.60, range 1-6). Oncology nurses who had received oncology training courses had significantly better communication skill ability than those who had not received oncology training. Oncology nurses who had higher work experience (1-3 years, or > 3 years) had significantly higher levels of communication skill ability for immunotherapy-related issues than those with lower work experience (<1 year). When those nurses reported better communication skill ability, they also had significantly better self-efficacy (r=.42, p<.01) and better critical thinking ability (r=.47, p<.01). Taken altogether, courses designed to improve communication skill ability for immunotherapy-related issues can make a significant impact in clinical settings. Communication skill ability for oncology nurses is the major factor associated with self-efficacy and critical thinking, especially for those with lower work experience (< 1 year).

Keywords: communication skills, critical thinking, immunotherapy, oncology nurses, self-efficacy

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Authors: Obiageli Helen Ezeh, Chuks Clement Ezeh

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Background: It is estimated that more than 330 million persons are living with HIV-infection globally and in Nigeria about 3.4 persons are living with the infection, with an annual death rate of 180,000. Psychological morbidity often accompany chronic illnesses and may be associated with substance abuse, poor health seeking behavior and adherence to treatment program; it may worsen existing health problems and the overall quality of life. Until the burden is effectively identified, intervention cannot be planned. Until there is a cure, the goal is to manage and cope effectively with HIV-infection. Little if any studies have been done in this area in the North West geo-political zone of Nigeria. The study would help to identify high risk groups and prevent the progression and spread of the infection. Aim: To identify HIV-infected persons with psychological morbidity, accessing HIV- clinic at Shika Hospital, Zaria, Kaduna State; and analyze their socio-demographic profile. Methods: A cross sectional descriptive study was carried out to assess and analyze the socio-demographic characteristics of HIV-infected persons attending Shika hospital Zaria Nigeria, who screened positive for psychological morbidity. A total of 109 HIV-infected persons receiving HAART at Shika clinic, Zaria, Kaduna State, Nigeria, were administered questionnaires, the General Health Questionnaire (GHQ-12)measuring psychological morbidity and socio-demographic data. The participants ranged in age between 18 and 75 years. Results: Data were analyzed using SPSS software 15. Both descriptive and inferential Statistics were performed on the data. Results indicate a total prevalent rate of psychological morbidity of 78 percent among participants. Of this, about 16.2 percent were severely distressed, 25.1 percent moderately distressed and 36.7percent were mildly distressed. More females (65 percent of those with psychological morbidity) were found to be distressed than their male (55 percent) counterparts. It was (44 percent) for patients whose HIV-infection was of relatively shorter duration(2-4 years) than those of longer duration(5-9 years; and 10 years/above). The age group (21-30 years) was the most affected (35 percent). The rate was also 55 percent for Christians and 45 percent for Muslims. For married patients with partners it was 20 percent and for singles 30 percent; for the widowed (12 percent) and divorced (38 percent). At the level of tribal/ethnic groups, it was 13 percent for Ibos, 22 percent for Yorubas, 27 percent for Hausas and 33 percent for all the other minority tribes put together. Conclusion/Recommendation: The study has been able to identify the presence of psychological morbidity among HIV-infected persons as high and analyze the socio-demographic factors associated with it as significant. Periodic screening of HIV-infected persons for psychological morbidity and psychosocial intervention was recommended.

Keywords: socio-demographics, psychological morbidities, HIV-Infection, HAART

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Authors: Francisco J. Cedano, Laura M. Pinzón, Camila I. Castro, Felipe Salcedo, Juan P. Casas, Juan C. Briceño

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Complex fractures located in articular surfaces are challenging to treat and their reduction with conventional treatments could compromise the functionality of the affected limb. An adhesive material to treat those fractures is desirable for orthopedic surgeons. This adhesive must be biocompatible and have a high adhesion to bone surface in an aqueous environment. The proposed adhesive is based on chitosan, given its adhesive and biocompatibility properties. Chitosan is mixed with calcium carbonate and hydroxyapatite, which contribute to structural support and a gel like behavior, and glutaraldehyde is used as a cross-linking agent to keep the adhesive mechanical performance in aqueous environment. This work aims to evaluate the rheological, adhesion strength and biocompatibility properties of the proposed adhesive using in vitro tests. The gelification process of the adhesive was monitored by oscillatory rheometry in an ARG-2 TA Instruments rheometer, using a parallel plate geometry of 22 mm and a gap of 1 mm. Time sweep experiments were conducted at 1 Hz frequency, 1% strain and 37°C from 0 to 2400 s. Adhesion strength is measured using a butt joint test with bovine cancellous bone fragments as substrates. The test is conducted at 5 min, 20min and 24 hours after curing the adhesive under water at 37°C. Biocompatibility is evaluated by a cytotoxicity test in a fibroblast cell culture using MTT assay and SEM. Rheological results concluded that the average gelification time of the adhesive is 820±107 s, also it reaches storage modulus magnitudes up to 106 Pa; The adhesive show solid-like behavior. Butt joint test showed 28.6 ± 9.2 kPa of tensile bond strength for the adhesive cured for 24 hours. Also there was no significant difference in adhesion strength between 20 minutes and 24 hours. MTT showed 70 ± 23 % of active cells at sixth day of culture, this percentage is estimated respect to a positive control (only cells with culture medium and bovine serum). High vacuum SEM observation permitted to localize and study the morphology of fibroblasts presented in the adhesive. All captured fibroblasts presented in SEM typical flatted structure with filopodia growth attached to adhesive surface. This project reports an adhesive based on chitosan that is biocompatible due to high active cells presented in MTT test and these results were correlated using SEM. Also, it has adhesion properties in conditions that model the clinical application, and the adhesion strength do not decrease between 5 minutes and 24 hours.

Keywords: bioadhesive, bone adhesive, calcium carbonate, chitosan, hydroxyapatite, glutaraldehyde

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Authors: Wisam H. Muragaa, Kamaruzzaman Seman, Mohd Fadzli Marhusin

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Software Defined Networking (SDN) is a new norm of networks. It is designed to facilitate the way of managing, measuring, debugging and controlling the network dynamically, and to make it suitable for the modern applications. Generally, measurement methods can be divided into two categories: Active and passive methods. Active measurement method is employed to inject test packets into the network in order to monitor their behaviour (ping tool as an example). Meanwhile the passive measurement method is used to monitor the traffic for the purpose of deriving measurement values. The measurement methods, both active and passive, are useful for the collection of traffic statistics, and monitoring of the network traffic. Although there has been a work focusing on measuring traffic statistics in SDN environment, it was only meant for measuring packets and bytes rates for non-web traffic. In this study, a feasible method will be designed to measure the number of packets and bytes in a certain time, and facilitate obtaining statistics for both web traffic and non-web traffic. Web traffic refers to HTTP requests that use application layer; while non-web traffic refers to ICMP and TCP requests. Thus, this work is going to be more comprehensive than previous works. With a developed module on POX OpenFlow controller, information will be collected from each active flow in the OpenFlow switch, and presented on Command Line Interface (CLI) and wireshark interface. Obviously, statistics that will be displayed on CLI and on wireshark interfaces include type of protocol, number of bytes and number of packets, among others. Besides, this module will show the number of flows added to the switch whenever traffic is generated from and to hosts in the same statistics list. In order to carry out this work effectively, our Python module will send a statistics request message to the switch requesting its current ports and flows statistics in every five seconds; while the switch will reply with the required information in a message called statistics reply message. Thus, POX controller will be notified and updated with any changes could happen in the entire network in a very short time. Therefore, our aim of this study is to prepare a list for the important statistics elements that are collected from the whole network, to be used for any further researches; particularly, those that are dealing with the detection of the network attacks that cause a sudden rise in the number of packets and bytes like Distributed Denial of Service (DDoS).

Keywords: mininet, OpenFlow, POX controller, SDN

Procedia PDF Downloads 239

Authors: Natalia M. Acevedo, Luis M. Jimenez, Erick Lambis

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Imperfections in the capital market are used to argue the relevance of the corporate risk management function. With corporate hedge, the value of the company is increased by reducing the volatility of the expected cash flow and making it possible to face a lower bankruptcy costs and financial difficulties, without sacrificing tax advantages for debt financing. With the propose to avoid exchange rate troubles over cash flows of Colombian exporting firms, this dissertation uses financial options, over exchange rate between Peso and Dollar, for realizing a financial hedge. In this study, a strategy of hedge is designed for an exporting company in Colombia with the objective of preventing fluctuations because, if the exchange rate down, the number of Colombian pesos that obtains the company by exports, is less than agreed. The exchange rate of Colombia is measured by the TRM (Representative Market Rate), representing the number of Colombian pesos for an American dollar. First, the TMR is modelled through the Geometric Brownian Motion, with this, the project price is simulated using Montecarlo simulations and finding the mean of TRM for three, six and twelve months. For financial hedging, currency options were used. The 6-month projection was covered with financial options on European-type currency with a strike price of $ 2,780.47 for each month; this value corresponds to the last value of the historical TRM. In the compensation of the options in each month, the price paid for the premium, calculated with the Black-Scholes method for currency options, was considered. Finally, with the modeling of prices and the Monte Carlo simulation, the effect of the exchange hedging with options on the exporting company was determined, this by means of the unit price estimate to which the dollars in the scenario without coverage were changed and scenario with coverage. After using the scenarios: is determinate that the TRM will have a bull trend and the exporting firm will be affected positively because they will get more pesos for each dollar. The results show that the financial options manage to reduce the exchange risk. The expected value with coverage is approximate to the expected value without coverage, but the 5% percentile with coverage is greater than without coverage. The foregoing indicates that in the worst scenarios the exporting companies will obtain better prices for the sale of the currencies if they cover.

Keywords: currency hedging, futures, geometric Brownian motion, options

Procedia PDF Downloads 133

Authors: Hortènsia Curell, Ana Fernández-Montraveta

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This paper presents the creation, development, and analysis of a corpus designed to study the presence of attitude markers and author’s stance in research articles in two different areas of linguistics (theoretical linguistics and sociolinguistics). These two disciplines are expected to behave differently in this respect, given the disparity in their discursive conventions. Attitude markers in this work are understood as the linguistic elements (adjectives, nouns and verbs) used to convey the writer's stance towards the content presented in the article, and are crucial in understanding writer-reader interaction and the writer's position. These attitude markers are divided into three broad classes: assessment, significance, and emotion. In addition to them, we also consider first-person singular and plural pronouns and possessives, modal verbs, and passive constructions, which are other linguistic elements expressing the author’s stance. The corpus, Corpus of Attitude in Academic Writing (CAAW), comprises a collection of 21 articles, collected from six journals indexed in JCR. These articles were originally written in English by a single native-speaker author from the UK or USA and were published between 2022 and 2023. The total number of words in the corpus is approximately 222,400, with 106,422 from theoretical linguistics (Lingua, Linguistic Inquiry and Journal of Linguistics) and 116,022 from sociolinguistics journals (International Journal of the Sociology of Language, Language in Society and Journal of Sociolinguistics). Together with the corpus, we present the tool created for the creation and storage of the corpus, along with a tool for automatic annotation. The steps followed in the compilation of the corpus are as follows. First, the articles were selected according to the parameters explained above. Second, they were downloaded and converted to txt format. Finally, examples, direct quotes, section titles and references were eliminated, since they do not involve the author’s stance. The resulting texts were the input for the annotation of the linguistic features related to stance. As for the annotation, two articles (one from each subdiscipline) were annotated manually by the two researchers. An existing list was used as a baseline, and other attitude markers were identified, together with the other elements mentioned above. Once a consensus was reached, the rest of articles were annotated automatically using the tool created for this purpose. The annotated corpus will serve as a resource for scholars working in discourse analysis (both in linguistics and communication) and related fields, since it offers new insights into the expression of attitude. The tools created for the compilation and annotation of the corpus will be useful to study author’s attitude and stance in articles from any academic discipline: new data can be uploaded and the list of markers can be enlarged. Finally, the tool can be expanded to other languages, which will allow cross-linguistic studies of author’s stance.

Keywords: academic writing, attitude, corpus, english

Procedia PDF Downloads 78

Authors: Engin Berber, Nurettin Canakoglu, Ibrahim Sozdutmaz, Merve Caliskan, Shaikh Terkis Islam Pavel, Hazel Yetiskin, Aykut Ozdarendeli

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Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne virus in the family Bunyaviridae, genus Nairovirus. The CCHFV genome consists of three molecules of negative-sense single-stranded RNA, each encapsulated separately. The virion particle contains viral RNA polymerase (L segment), surface glycoproteins Gn and Gc (Msegment), and a nucleocapsid protein NP (S segment). CCHF is characterized by high case mortality, occurring in Asia, Africa, the Middle East and Eastern Europe. Clinical CCHF was first recognized in Turkey in 2002. The numbers of CCHF cases have gradually increased in Turkey making the virus a public health concern. Between 2002 and 2014, more than 8000 the CCHF cases have been reported in Turkey and mortality rate is around 5%. So, Turkey is one of the countries where the epidemy has become spread to the wider geography and the biggest outbreaks of CCHF have occurred in the world. We have recently developed an inactivated cell-culture based vaccine against CCHF. We have showed that the Balb/c mice immunized with the CCHF vaccine induced the high level of neutralizing antibodies. In this study, we aimed to determine the immunodominant regions of nucleoprotein (NP) CCHFV Kelkit06 strain which stimulate T cells. For this purpose, pools of overlapping NP were used for an IFN- γ ELISPOT assay. Balb/c mice were divided into two groups for the experiment. Two groups (n = 10 each) were immunized via the intraperitoneal route with 5, or 10μg of the cell culture-based vaccine. The control group (n = 6) was mock immunized with PBS. Booster injections with the same formulation were given on days 21 and 42 after the first immunization. The higher reactivity against the CCHFV NP pools 31-40 and 80-90 was determined in the two dose groups. In order to analyze the vaccine-induced T cell responses in Balb/c mice immunized with varying doses of the vaccine, we have been also currently working on CD4+, CD8+ and CD3 + T cells by flow cytometry.

Keywords: Crimean-Congo hemorrhagic fever virus, immunodominant regions of NP, T cell response, vaccine

Procedia PDF Downloads 349

Authors: Nicholas McNamara, John Brookes, Michael Williams, Manish Mathew, Elizabeth Brookes, Tristan Yan, Paul Bannon

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Objective: Pericardial effusions are an uncommon but potentially fatal complication after cardiac surgery. The goal of this study was to describe the incidence and risk factors associated with the development of pericardial effusion requiring drainage after coronary artery bypass graft surgery (CABG). Methods: A retrospective analysis was undertaken using prospectively collected data. All adult patients who underwent CABG at our institution between 1st January 2017 and 31st December 2018 were included. Pericardial effusion was diagnosed using transthoracic echocardiography (TTE) performed for clinical suspicion of pre-tamponade or tamponade. Drainage was undertaken if considered clinically necessary and performed via a sub-xiphoid incision, pericardiocentesis, or via re-sternotomy at the discretion of the treating surgeon. Patient demographics, operative characteristics, anticoagulant exposure, and postoperative outcomes were examined to identify those variables associated with the development of pericardial effusion requiring drainage. Tests of association were performed using the Fischer exact test for dichotomous variables and the Student t-test for continuous variables. Logistic regression models were used to determine univariate predictors of pericardial effusion requiring drainage. Results: Between January 1st, 2017, and December 31st, 2018, a total of 408 patients underwent CABG at our institution, and eight (1.9%) required drainage of pericardial effusion. There was no difference in age, gender, or the proportion of patients on preoperative therapeutic heparin between the study and control groups. Univariate analysis identified preoperative atrial arrhythmia (37.5% vs 8.8%, p = 0.03), reduced left ventricular ejection fraction (47% vs 56%, p = 0.04), longer cardiopulmonary bypass (130 vs 84 min, p < 0.01) and cross-clamp (107 vs 62 min, p < 0.01) times, higher drain output in the first four postoperative hours (420 vs 213 mL, p <0.01), postoperative atrial fibrillation (100% vs 32%, p < 0.01), and pleural effusion requiring drainage (87.5% vs 12.5%, p < 0.01) to be associated with development of pericardial effusion requiring drainage. Conclusion: In this study, the incidence of pericardial effusion requiring drainage was 1.9%. Several factors, mainly related to preoperative or postoperative arrhythmia, length of surgery, and pleural effusion requiring drainage, were identified to be associated with developing clinically significant pericardial effusions. High clinical suspicion and low threshold for transthoracic echo are pertinent to ensure this potentially lethal condition is not missed.

Keywords: coronary artery bypass, pericardial effusion, pericardiocentesis, tamponade, sub-xiphoid drainage

Procedia PDF Downloads 167

Authors: Sanjeet Patra, Soham Roychowdhury

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In recent times, functionally graded dielectric elastomer (FGDE) has gained significant attention within the realm of soft actuation due to its dual capacity to exert highly localized stresses while maintaining its compliant characteristics on application of electro-mechanical loading. Nevertheless, the full potential of dielectric elastomer (DE) has not been fully explored due to their susceptibility to instabilities when subjected to electro-mechanical loads. As a result, study and analysis of such instabilities becomes crucial for the design and realization of dielectric actuators. Prismatic bifurcation is a type of instability that has been recognized in a DE tube. Though several studies have reported on the analysis for prismatic bifurcation in an isotropic DE tube, there is an insufficiency in studies related to prismatic bifurcation of FGDE tubes. Therefore, this paper aims to determine the onset of prismatic bifurcations on an incompressible FGDE tube when subjected to electrical loading across the thickness of the tube and internal pressurization. The analysis has been conducted by imposing two axial boundary conditions on the tube, specifically axially free ends and axially clamped ends. Additionally, the rigidity modulus of the tube has been linearly graded in the direction of thickness where the inner surface of the tube has a lower stiffness than the outer surface. The static equilibrium equations for deformation of the axisymmetric tube are derived and solved using numerical technique. The condition for prismatic bifurcation of the axisymmetric static equilibrium solutions has been obtained by using the linearized incremental constitutive equations. Two modes of bifurcations, corresponding to two different non-circular cross-sectional geometries, have been explored in this study. The outcomes reveal that the FGDE tubes experiences prismatic bifurcation before the Hessian criterion of failure is satisfied. It is observed that the lower mode of bifurcation can be triggered at a lower critical voltage as compared to the higher mode of bifurcation. Furthermore, the tubes with larger stiffness gradient require higher critical voltages for triggering the bifurcation. Moreover, with the increase in stiffness gradient, a linear variation of the critical voltage is observed with the thickness of the tube. It has been found that on applying internal pressure to a tube with low thickness, the tube becomes less susceptible to bifurcations. A thicker tube with axially free end is found to be more stable than the axially clamped end tube at higher mode of bifurcation.

Keywords: critical voltage, functionally graded dielectric elastomer, linearized incremental approach, modulus of rigidity, prismatic bifurcation

Procedia PDF Downloads 84

Authors: Ochuko K. Overen, Edson L. Meyer

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Uncontrolled heat transfer between the inner and outer space of low-cost housings through the thermal envelope result in indoor thermal discomfort. As a result, an excessive amount of energy is consumed for space heating and cooling. Thermo-optical properties are the ability of paints to reduce the rate of heat transfer through the thermal envelope. The aim of this study is to analyze the thermal performance of a low-cost house with its walls inner surface coated with transparent infrared reflective paint. The thermo-optical properties of the paint were analyzed using Scanning Electron Microscopy/ Energy Dispersive X-ray spectroscopy (SEM/EDX), Fourier Transform Infra-Red (FTIR) and thermal photographic technique. Meteorological indoor and ambient parameters such as; air temperature, relative humidity, solar radiation, wind speed and direction of a low-cost house in Golf-course settlement, South Africa were monitored. The monitoring period covers both winter and summer period before and after coating. The thermal performance of the coated walls was evaluated using time lag and decrement factor. The SEM image shows that the coat is transparent to light. The presence of Al as Al2O and other elements were revealed by the EDX spectrum. Before coating, the average decrement factor of the walls in summer was found to be 0.773 with a corresponding time lag of 1.3 hours. In winter, the average decrement factor and corresponding time lag were 0.467 and 1.6 hours, respectively. After coating, the average decrement factor and corresponding time lag were 0.533 and 2.3 hour, respectively in summer. In winter, an average decrement factor of 1.120 and corresponding time lag of 3 hours was observed. The findings show that the performance of the coats is influenced by the seasons. With a 74% reduction in decrement factor and 1.4 time lag increase in winter, it implies that the coatings have more ability to retain heat within the inner space of the house than preventing heat flow into the house. In conclusion, the results have shown that transparent infrared reflective paint has the ability to reduce the propagation of heat flux through building walls. Hence, it can serve as a remedy to the poor thermal performance of low-cost housings in South Africa.

Keywords: energy efficiency, decrement factor, low-cost housing, paints, rural development, thermal comfort, time lag

Procedia PDF Downloads 286

Authors: Kevin De Castro Cogle, Mirian Kubo, Maria Anastasiadi, Fady Mohareb, Claire Rossi

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Background: The bioaccessibility of bioactive compounds is a critical determinant of the nutritional quality of various food products. Despite its importance, there is a limited number of comprehensive studies aimed at assessing how the composition of a food matrix influences the bioaccessibility of a compound of interest. This knowledge gap has prompted a growing need to investigate the intricate relationship between food matrix formulations and the bioaccessibility of bioactive compounds. One such class of bioactive compounds that has attracted considerable attention is curcuminoids. These naturally occurring phytochemicals, extracted from the roots of Curcuma longa, have gained popularity owing to their purported health benefits and also well known for their poor bioaccessibility Project aim: The primary objective of this research project is to systematically assess the influence of matrix composition on the bioaccessibility of curcuminoids. Additionally, this study aimed to develop a series of predictive models for bioaccessibility, providing valuable insights for optimising the formula for functional foods and provide more descriptive nutritional information to potential consumers. Methods: Food formulations enriched with curcuminoids were subjected to in vitro digestion simulation, and their bioaccessibility was characterized with chromatographic and spectrophotometric techniques. The resulting data served as the foundation for the development of predictive models capable of estimating bioaccessibility based on specific physicochemical properties of the food matrices. Results: One striking finding of this study was the strong correlation observed between the concentration of macronutrients within the food formulations and the bioaccessibility of curcuminoids. In fact, macronutrient content emerged as a very informative explanatory variable of bioaccessibility and was used, alongside other variables, as predictors in a Bayesian hierarchical model that predicted curcuminoid bioaccessibility accurately (optimisation performance of 0.97 R2) for the majority of cross-validated test formulations (LOOCV of 0.92 R2). These preliminary results open the door to further exploration, enabling researchers to investigate a broader spectrum of food matrix types and additional properties that may influence bioaccessibility. Conclusions: This research sheds light on the intricate interplay between food matrix composition and the bioaccessibility of curcuminoids. This study lays a foundation for future investigations, offering a promising avenue for advancing our understanding of bioactive compound bioaccessibility and its implications for the food industry and informed consumer choices.

Keywords: bioactive bioaccessibility, food formulation, food matrix, machine learning, probabilistic modelling

Procedia PDF Downloads 71

Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

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The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

Procedia PDF Downloads 151

Authors: Rafal Bryk, Holger Schmidt, Thomas Mull, Ingo Ganzmann, Oliver Herbst

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Prediction of the two-phase water mixture level during fast depressurization of the Reactor Pressure Vessel (RPV) resulting from an accident scenario is an important issue from the view point of the reactor safety. Since the level swell may influence the behavior of some passive safety systems, it has been recognized that an assumption which at the beginning may be considered as a conservative one, not necessary leads to a conservative result. This paper discusses outcomes obtained during simulations of the water dynamics and heat transfer during sudden depressurization of a vessel filled up to a certain level with liquid water under saturation conditions and with the rest of the vessel occupied by saturated steam. In case of the pressure decrease e.g. due to the main steam line break, the liquid water evaporates abruptly, being a reason thereby, of strong transients in the vessel. These transients and the sudden emergence of void in the region occupied at the beginning by liquid, cause elevation of the two-phase mixture. In this work, several models calculating the water collapse and swell levels are presented and validated against experimental data. Each of the models uses different approach to calculate void fraction. The object-oriented models were developed with the Modelica modelling language and the OpenModelica environment. The models represent the RPV of the Integral Test Facility Karlstein (INKA) – a dedicated test rig for simulation of KERENA – a new Boiling Water Reactor design of Framatome. The models are based on dynamic mass and energy equations. They are divided into several dynamic volumes in each of which, the fluid may be single-phase liquid, steam or a two-phase mixture. The heat transfer between the wall of the vessel and the fluid is taken into account. Additional heat flow rate may be applied to the first volume of the vessel in order to simulate the decay heat of the reactor core in a similar manner as it is simulated at INKA. The comparison of the simulations results against the reference data shows a good agreement.

Keywords: boiling water reactor, level swell, Modelica, RPV depressurization, thermal-hydraulics

Procedia PDF Downloads 216

Authors: Marzieh Moattari Mitra Abbasi, Masoud Mousavinasab, Poorahmad

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Background: Nurses in their daily practice need to communicate with patients and their families as well as health professional team members. Effective communication contributes to patients’ satisfaction which is a fundamental outcome of nursing practice. There are some evidences in support of patients' dissatisfaction with nurses’ performance in communication process. Therefore improving nurses’ communication skills is a necessity for nursing scholars and nursing administrators. Objective: The aim of the present study was to evaluate the effect of a 2-days workshop on nurses’ competencies and performances in communication in a central hospital located in the sought of Iran. Materials and Method: This is a randomized controlled trial which comprised of a convenient sample of 70 eligible nurses, working in a central hospital. They were randomly divided into 2 experimental and control groups. Nurses’ competencies was measured by an Objective Structured Clinical Examination (OSCE) and their performance was measured by asking eligible patients hospitalized in the nurses work setting during a one month period to evaluate nurses' communication skills before and 2 months after intervention. The experimental group participated in a 2 day workshop on communication skills. Content included in this workshop were: the importance of communication (verbal and non verbal), basic communication skills such as initiating the communication, active listening and questioning technique. Other subjects were patient teaching, problem solving, and decision making, cross cultural communication and breaking bad news. Appropriate teaching strategies such as brief didactic sessions, small group discussion and reflection were applied to enhance participants learning. The data was analyzed using SPSS 16. Result: A significant between group differences was found in nurses’ communication skills competencies and performances in the posttest. The mean scores of the experimental group was higher than that of the control group in the total score of OSCE as well as all stations of OSCE (p<0.003). Overall posttest mean scores of patient satisfaction with nurse's communication skills and all of its four dimensions significantly differed between the two groups of the study (p<0.001). Conclusion: This study shows that the education of nurses in communication skills, improves their competencies and performances. Measurement of Nurses’ communication skills as a central component of efficient nurse patient relationship by valid and reliable methods of evaluation is recommended. Also it is necessary to integrate teaching of communication skills in continuing nursing education programs. Trial Registration Number: IRCT201204042621N11

Keywords: communication skills, simulation, performance, competency, objective structure, clinical evaluation

Procedia PDF Downloads 220

Authors: Elidrissi Laila, El Rhaoussi Fatima-Zahra, Haddad Fouad, Tahiri Mohamed, Hliwa Wafaa, Bellabah Ahmed, Badre Wafaa

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Introduction: Metabolic Dysfunction Associated with Non-Alcoholic Fatty Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is the leading cause of chronic liver disease. The cardiometabolic risk factors associated with MASLD represent common health issues and significant public health challenges. Medical students, being active participants in the healthcare system and a young demographic, are particularly relevant for understanding this entity to prevent its occurrence on a personal and collective level. The objective of our study is to assess the level of knowledge among medical students regarding MASLD, its risk factors, and its long-term consequences. Materials and Methods: We conducted a descriptive cross-sectional study using an anonymous questionnaire distributed through social media over a period of 2 weeks. Medical students from various faculties in Morocco answered 22 questions about MASLD, its etiological factors, diagnosis, complications, and principles of treatment. All responses were analyzed using the Jamovi software. Results: A total of 124 students voluntarily provided complete responses. 59% of our participants were in their 3rd year, with a median age of 21 years. Among the respondents, 27% were overweight, obese, or diabetic. 83% correctly answered more than half of the questions, and 77% believed they knew about MASLD. However, 84% of students were unaware that MASLD is the leading cause of chronic liver disease, and 12% even considered it a rare condition. Regarding etiological factors, overweight and obesity were mentioned in 93% of responses, and type 2 diabetes in 84%. 62% of participants believed that type 1 diabetes could not be implicated in MASLD. For 83 students, MASLD was considered a diagnosis of exclusion, while 41 students believed that a biopsy was mandatory for diagnosis. 12% believed that MASLD did not lead to long-term complications, and 44% were unaware that MASLD could progress to hepatocellular carcinoma. Regarding treatment, 85% included weight loss, and 19% did not consider diabetes management as a therapeutic approach for MASLD. At the end of the questionnaire, 89% of the students expressed a desire to learn more about MASLD and were invited to access an informative sheet through a hyperlink. Conclusion: MASLD represents a significant public health concern due to the prevalence of its risk factors, notably the obesity pandemic, which is widespread among the young population. There is a need for awareness about the seriousness of this emerging and long-underestimated condition among young future physicians.

Keywords: MASLD, medical students, obesity, diabetes

Procedia PDF Downloads 79

Authors: Mbida Yem, Alessandra Ribodetti, Joseph Quentin Yéné Atangana, Fabrice Jouffray, Dieudonné Bisso

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Central Cameroon is a mosaic complex of Proterozoïc litho-tectonic units, with structural deformations mainly inherited from Panafrican orogeny. It consists of a para-derived series with epicontinental affinity, structured as successive nappe thrusting southward on the Ntem complex, considered as the Congo Craton northern margin. A well-developed prograde metamorphic gradient is described from SE (Dja and Yokadouma meta-detritic series) to NW (gneiss and migmatites of the Yaounde series) with ages estimated at 600-620 Ma. Syn- to late phase of the Panafrican deformations crosscut the nappes structured with large mylonitic shear zones (Sanaga fault, Adamawa fault, Tcholiré-Banyo fault) coeval with intrusive granitoids. The scientific and industrial communities interested in exploring the groundwater resources of these litho-tectonic units using geophysics and geohydrology methods have grown steadily since the 1970s. In this paper, we present shallow and deep geophysical cross-sections that describe the most productive groundwater targets of the Central Cameroon litho-tectonic units. This study also discusses geological factors that control groundwater occurrences. The data analyzed were gathered from public and private groundwater surveys conducted in recent years and included 18 well-controlled resistivity sections and hydrogeological parameters of 150 drilling points. The depth of well records extends from 40 to 180m. Also, one of the challenges of geophysics investigations was to image groundwater reservoirs located above 120m depth. Therefore, the resistivity data were acquired using a 1200 m long digital streamer, with a 10 m electrode spacing in the selected sites. The modelled sections derived from these data show that the most productive groundwater targets of the study area include lithological contacts and dyke fault-zones. The average width of dyke fault-zones ranges between 40 and 380 m. These structures display a significant lateral extent, and their spatial distribution is often in correlation with mountain terranes and regional fault zones trending from SW-NE to NNW-SSE. Following these observations, transboundaries aquifers associated with fractured magmatic rocks can be found in the study area.

Keywords: Proterozoic, resistivity sections, dyke fault-zones, groundwater target

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Authors: Sara Segura, Diego Nuñez, Miryam Villamil

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In this work, we studied the microscale interaction of foreign substances with blood inside an artificial transparent artery system that represents medium and small muscular arteries. This artery system had channels ranging from 75 μm to 930 μm and was fabricated using glass and transparent polymer blends like Phenylbis(2,4,6-trimethylbenzoyl) phosphine oxide, Poly(ethylene glycol) and PDMS in order to be monitored in real time. The setup was performed using a computer controlled precision micropump and a high resolution optical microscope capable of tracking fluids at fast capture. Observation and analysis were performed using a real time software that reconstructs the fluid dynamics determining the flux velocity, injection dependency, turbulence and rheology. All experiments were carried out with fully computer controlled equipment. Interactions between substances like water, serum (0.9% sodium chloride and electrolyte with a ratio of 4 ppm) and blood cells were studied at microscale as high as 400nm of resolution and the analysis was performed using a frame-by-frame observation and HD-video capture. These observations lead us to understand the fluid and mixing behavior of the interest substance in the blood stream and to shed a light on the use of implantable devices for drug delivery at arteries with different Endothelial dysfunction. Several substances were tested using the artificial artery system. Initially, Milli-Q water was used as a control substance for the study of the basic fluid dynamics of the artificial artery system. However, serum and other low viscous substances were pumped into the system with the presence of other liquids to study the mixing profiles and behaviors. Finally, mammal blood was used for the final test while serum was injected. Different flow conditions, pumping rates, and time rates were evaluated for the determination of the optimal mixing conditions. Our results suggested the use of a very fine controlled microinjection for better mixing profiles with and approximately rate of 135.000 μm3/s for the administration of drugs inside arteries.

Keywords: artificial artery, drug delivery, microfluidics dynamics, arteriosclerosis

Procedia PDF Downloads 301

Authors: I. Ling Tsai, Shu Fen Wu, Chen-Fuh Lam, Chia Yu Chen, Shu Jiuan Chen, Yen Lin Liu

Abstract:

Purpose: Following the conduction of the National Health Insurance (NHI) system in Taiwan since 1995, the demand for anesthesia services continues to increase in the operating rooms and other medical units. It has been well recognized that increased work stress not only affects the clinical performance of the medical staff, long-term work load may also result in occupational burnout. Our study aimed to determine the influence of working environment, work stress and job satisfaction on the occupational burnout in nurse anesthetists. The ultimate goal of this research project is to develop a strategy in establishing a friendly, less stressful workplace for the nurse anesthetists to enhance their job satisfaction, thereby reducing occupational burnout and increasing the career life for nurse anesthetists. Methods: This was a cross-sectional, descriptive study performed in a metropolitan teaching hospital in southern Taiwan between May 2017 to July 2017. A structured self-administered questionnaire, modified from the Practice Environment Scale of the Nursing Work Index (PES-NWI), Occupational Stress Indicator 2 (OSI-2) and Maslach Burnout Inventory (MBI) manual was collected from the nurse anesthetists. The relationships between two numeric datasets were analyzed by the Pearson correlation test (SPSS 20.0). Results: A total of 66 completed questionnaires were collected from 75 nurses (response rate 88%). The average scores for the working environment, job satisfaction, and work stress were 69.6%, 61.5%, and 63.9%, respectively. The three perspectives used to assess the occupational burnout, namely emotional exhaustion, depersonalization and sense of personal accomplishment were 26.3, 13.0 and 24.5, suggesting the presence of moderate to high degrees of burnout in our nurse anesthetists. The presence of occupational burnout was closely correlated with the unsatisfactory working environment (r=-0.385, P=0.001) and reduced job satisfaction (r=-0.430, P=0.000). Junior nurse anesthetists (<1-year clinical experience) reported having higher satisfaction in working environment than the seniors (5 to 10-year clinical experience) (P=0.02). Although the average scores for work stress, job satisfaction, and occupational burnout were lower in junior nurses, the differences were not statistically different. The linear regression model, the working environment was the independent factor that predicted occupational burnout in nurse anesthetists up to 19.8%. Conclusions: High occupational burnout is more likely to develop in senior nurse anesthetists who experienced the dissatisfied working environment, work stress and lower job satisfaction. In addition to the regulation of clinical duties, the increased workload in the supervision of the junior nurse anesthetists may result in emotional stress and burnout in senior nurse anesthetists. Therefore, appropriate adjustment of clinical and teaching loading in the senior nurse anesthetists could be helpful to improve the occupational burnout and enhance the retention rate.

Keywords: nurse anesthetists, working environment, work stress, job satisfaction, occupational burnout

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