Search results for: continous blood pressure measurement
710 Techno-Economic Analysis (TEA) of Circular Economy Approach in the Valorisation of Pig Meat Processing Wastes
Authors: Ribeiro A., Vilarinho C., Luisa A., Carvalho J
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The pig meat industry generates large volumes of by- and co-products like blood, bones, skin, trimmings, organs, viscera, and skulls, among others, during slaughtering and meat processing and must be treated and disposed of ecologically. The yield of these by-products has been reported to account for about 10% to 15% of the value of the live animal in developed countries, although animal by-products account for about two-thirds of the animal after slaughter. It was selected for further valorization of the principal wastes produced throughout the value chain of pig meat production: Pig Manure, Pig Bones, Fats, Skins, Pig Hair, Wastewater, Wastewater sludges, and other animal subproducts type III. According to the potential valorization options, these wastes will be converted into Biomethane, Fertilizers (phosphorus and digestate), Hydroxyapatite, and protein hydrolysates (Keratin and Collagen). This work includes comprehensive technical and economic analyses (TEA) for each valorization route or applied technology. Metrics such as Net Present Value (NPV), Internal Rate of Return (IRR), and payback periods were used to evaluate economic feasibility. From this analysis, it can be concluded that, for Biogas Production, the scenarios using pig manure, wastewater sludges and mixed grass and leguminous wastes presented a remarkably high economic feasibility. Scenarios showed high economic feasibility with a positive payback period, NPV, and IRR. The optimal scenario combining pig manure with mixed grass and leguminous wastes had a payback period of 1.2 years and produced 427,6269 m³ of biomethane annually. Regarding the Chemical Extraction of Phosphorous and Nitrogen, results proved that the process is economically unviable due to negative cash flows despite high recovery rates. The TEA of Hydrolysis and Extraction of Keratin Hydrolysates indicate that a unit processing and valorizing 10 tons of pig hair per year for the production of keratin hydrolysate has an NPV of 907,940 €, an IRR of 13.07%, and a Payback period of 5.41 years. All of these indicators suggest a highly potential project to explore in the future. On the opposite, the results of Hydrolysis and Extraction of Collagen Hydrolysates showed a process economically unviable with negative cash flows in all scenarios due to the high-fat content in raw materials. In fact, the results from the valorization of 10 tons of pig skin had a negative cash flow of 453 743,88 €. TEA results of Extraction and purification of Hydroxyapatite from Pig Bones with Pyrolysis indicate that unit processing and valorizing 10 tons of pig bones per year for the production of hydroxyapatite has an NPV of 1 274 819,00 €, an IRR of 65.43%, and a Payback period of 1,5 years over a timeline of 10 years with a discount rate of 10%. These valorization routes, circular economy and bio-refinery approach offer significant contributions to sustainable bio-based operations within the agri-food industry. This approach transforms waste into valuable resources, enhancing both environmental and economic outcomes and contributing to a more sustainable and circular bioeconomy.Keywords: techno-economic analysis (TEA), pig meat processing wastes, circular economy, bio-refinery
Procedia PDF Downloads 15709 Coastal Modelling Studies for Jumeirah First Beach Stabilization
Authors: Zongyan Yang, Gagan K. Jena, Sankar B. Karanam, Noora M. A. Hokal
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Jumeirah First beach, a segment of coastline of length 1.5 km, is one of the popular public beaches in Dubai, UAE. The stability of the beach has been affected by several coastal developmental projects, including The World, Island 2 and La Mer. A comprehensive stabilization scheme comprising of two composite groynes (of lengths 90 m and 125m), modification to the northern breakwater of Jumeirah Fishing Harbour and beach re-nourishment was implemented by Dubai Municipality in 2012. However, the performance of the implemented stabilization scheme has been compromised by La Mer project (built in 2016), which modified the wave climate at the Jumeirah First beach. The objective of the coastal modelling studies is to establish design basis for further beach stabilization scheme(s). Comprehensive coastal modelling studies had been conducted to establish the nearshore wave climate, equilibrium beach orientations and stable beach plan forms. Based on the outcomes of the modeling studies, recommendation had been made to extend the composite groynes to stabilize the Jumeirah First beach. Wave transformation was performed following an interpolation approach with wave transformation matrixes derived from simulations of a possible range of wave conditions in the region. The Dubai coastal wave model is developed with MIKE21 SW. The offshore wave conditions were determined from PERGOS wave data at 4 offshore locations with consideration of the spatial variation. The lateral boundary conditions corresponding to the offshore conditions, at Dubai/Abu Dhabi and Dubai Sharjah borders, were derived with application of LitDrift 1D wave transformation module. The Dubai coastal wave model was calibrated with wave records at monitoring stations operated by Dubai Municipality. The wave transformation matrix approach was validated with nearshore wave measurement at a Dubai Municipality monitoring station in the vicinity of the Jumeirah First beach. One typical year wave time series was transformed to 7 locations in front of the beach to count for the variation of wave conditions which are affected by adjacent and offshore developments. Equilibrium beach orientations were estimated with application of LitDrift by finding the beach orientations with null annual littoral transport at the 7 selected locations. The littoral transport calculation results were compared with beach erosion/accretion quantities estimated from the beach monitoring program (twice a year including bathymetric and topographical surveys). An innovative integral method was developed to outline the stable beach plan forms from the estimated equilibrium beach orientations, with predetermined minimum beach width. The optimal lengths for the composite groyne extensions were recommended based on the stable beach plan forms.Keywords: composite groyne, equilibrium beach orientation, stable beach plan form, wave transformation matrix
Procedia PDF Downloads 263708 Bionaut™: A Minimally Invasive Microsurgical Platform to Treat Non-Communicating Hydrocephalus in Dandy-Walker Malformation
Authors: Suehyun Cho, Darrell Harrington, Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Alex Kiselyov, Michael Shpigelmacher
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The Dandy-Walker malformation (DWM) represents a clinical syndrome manifesting as a combination of posterior fossa cyst, hypoplasia of the cerebellar vermis, and obstructive hydrocephalus. Anatomic hallmarks include hypoplasia of the cerebellar vermis, enlargement of the posterior fossa, and cystic dilatation of the fourth ventricle. Current treatments of DWM, including shunting of the cerebral spinal fluid ventricular system and endoscopic third ventriculostomy (ETV), are frequently clinically insufficient, require additional surgical interventions, and carry risks of infections and neurological deficits. Bionaut Labs develops an alternative way to treat Dandy-Walker Malformation (DWM) associated with non-communicating hydrocephalus. We utilize our discreet microsurgical Bionaut™ particles that are controlled externally and remotely to perform safe, accurate, effective fenestration of the Dandy-Walker cyst, specifically in the posterior fossa of the brain, to directly normalize intracranial pressure. Bionaut™ allows for complex non-linear trajectories not feasible by any conventional surgical techniques. The microsurgical particle safely reaches targets in the lower occipital section of the brain. Bionaut™ offers a minimally invasive surgical alternative to highly involved posterior craniotomy or shunts via direct fenestration of the fourth ventricular cyst at the locus defined by the individual anatomy. Our approach offers significant advantages over the current standards of care in patients exhibiting anatomical challenge(s) as a manifestation of DWM, and therefore, is intended to replace conventional therapeutic strategies. Current progress, including platform optimization, Bionaut™ control, and real-time imaging and in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of ovine models, will be discussed.Keywords: Bionaut™, cerebral spinal fluid, CSF, cyst, Dandy-Walker, fenestration, hydrocephalus, micro-robot
Procedia PDF Downloads 221707 Laminar Periodic Vortex Shedding over a Square Cylinder in Pseudoplastic Fluid Flow
Authors: Shubham Kumar, Chaitanya Goswami, Sudipto Sarkar
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Pseudoplastic (n < 1, n being the power index) fluid flow can be found in food, pharmaceutical and process industries and has very complex flow nature. To our knowledge, inadequate research work has been done in this kind of flow even at very low Reynolds numbers. Here, in the present computation, we have considered unsteady laminar flow over a square cylinder in pseudoplastic flow environment. For Newtonian fluid flow, this laminar vortex shedding range lies between Re = 47-180. In this problem, we consider Re = 100 (Re = U∞ a/ ν, U∞ is the free stream velocity of the flow, a is the side of the cylinder and ν is the kinematic viscosity of the fluid). The pseudoplastic fluid range has been chosen from close to the Newtonian fluid (n = 0.8) to very high pseudoplasticity (n = 0.1). The flow domain is constituted using Gambit 2.2.30 and this software is also used to generate mesh and to impose the boundary conditions. For all places, the domain size is considered as 36a × 16a with 280 ×192 grid point in the streamwise and flow normal directions respectively. The domain and the grid points are selected after a thorough grid independent study at n = 1.0. Fine and equal grid spacing is used close to the square cylinder to capture the upper and lower shear layers shed from the cylinder. Away from the cylinder the grid is unequal in size and stretched out in all direction. Velocity inlet (u = U∞), pressure outlet (Neumann condition), symmetry (free-slip boundary condition du/dy = 0, v = 0) at upper and lower domain boundary conditions are used for this simulation. Wall boundary (u = v = 0) is considered on the square cylinder surface. Fully conservative 2-D unsteady Navier-Stokes equations are discretized and then solved by Ansys Fluent 14.5 to understand the flow nature. SIMPLE algorithm written in finite volume method is selected for this purpose which is the default solver in scripted in Fluent. The result obtained for Newtonian fluid flow agrees well with previous work supporting Fluent’s usefulness in academic research. A minute analysis of instantaneous and time averaged flow field is obtained both for Newtonian and pseudoplastic fluid flow. It has been observed that drag coefficient increases continuously with the reduced value of n. Also, the vortex shedding phenomenon changes at n = 0.4 due to flow instability. These are some of the remarkable findings for laminar periodic vortex shedding regime in pseudoplastic flow environment.Keywords: Ansys Fluent, CFD, periodic vortex shedding, pseudoplastic fluid flow
Procedia PDF Downloads 205706 Is Brain Death Reversal Possible in Near Future: Intrathecal Sodium Nitroprusside (SNP) Superfusion in Brain Death Patients=The 10,000 Fold Effect
Authors: Vinod Kumar Tewari, Mazhar Husain, Hari Kishan Das Gupta
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Background: Primary or secondary brain death is also accompanied with vasospasm of the perforators other than tissue disruption & further exaggerates the anoxic damage, in the form of neuropraxia. In normal conditions the excitatory impulse propagates as anterograde neurotransmission (ANT) and at the level of synapse, glutamate activates NMDA receptors on postsynaptic membrane. Nitric oxide (NO) is produced by Nitric oxide Synthetase (NOS) in postsynaptic dendride or cell body and travels backwards across a chemical synapse to bind to the axon terminal of a presynaptic neuron for regulation of ANT this process is called as the retrograde neurotransmission (RNT). Thus the primary function of NO is RNT and the purpose of RNT is regulation of chemical neurotransmission at synapse. For this reason, RNT allows neural circuits to create feedback loops. The haem is the ligand binding site of NO receptor (sGC) at presynaptic membrane. The affinity of haem exhibits > 10,000-fold excess for NO than Oxygen (THE 10,000 FOLD EFFECT). In pathological conditions ANT, normal synaptic activity including RNT is absent. NO donors like sodium nitroprusside (SNP) releases NO by activating NOS at the level of postsynaptic area. NO now travels backwards across a chemical synapse to bind to the haem of NO receptor at axon terminal of a presynaptic neuron as in normal condition. NO now acts as impulse generator (at presynaptic membrane) thus bypasses the normal ANT. Also the arteriolar perforators are having Nitric Oxide Synthetase (NOS) at the adventitial side (outer border) on which sodium nitroprusside (SNP) acts; causing release of Nitric Oxide (NO) which vasodilates the perforators causing gush of blood in brain’s tissue and reversal of brain death. Objective: In brain death cases we only think for various transplantations but this study being a pilot study reverses some criteria of brain death by vasodilating the arteriolar perforators. To study the effect of intrathecal sodium nitroprusside (IT SNP) in cases of brain death in which: 1. Retrograde transmission = assessed by the hyperacute timings of reversal 2. The arteriolar perforator vasodilatation caused by NO and the maintenance of reversal of brain death reversal. Methods: 35 year old male, who became brain death after head injury and has not shown any signs of improvement after every maneuver for 6 hours, a single superfusion done by SNP via transoptic canal route for quadrigeminal cistern and cisternal puncture for IV ventricular with SNP done. Results: He showed spontaneous respiration (7 bouts) with TCD studies showing start of pulsations of various branches of common carotid arteries. Conclusions: In future we can give this SNP via transoptic canal route and in IV ventricle before declaring the body to be utilized for transplantations or dead or in broader way we can say that in near future it is possible to revert back from brain death or we have to modify our criterion.Keywords: brain death, intrathecal sodium nitroprusside, TCD studies, perforators, vasodilatations, retrograde transmission, 10, 000 fold effect
Procedia PDF Downloads 403705 Maturity Level of Knowledge Management in Whole Life Costing in the UK Construction Industry: An Empirical Study
Authors: Ndibarefinia Tobin
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The UK construction industry has been under pressure for many years to produce economical buildings which offer value for money, not only during the construction phase, but more importantly, during the full life of the building. Whole life costing is considered as an economic analysis tool that takes into account the total investment cost in and ownership, operation and subsequent disposal of a product or system to which the whole life costing method is being applied. In spite of its importance, the practice is still crippled by the lack of tangible evidence, ‘know-how’ skills and knowledge of the practice i.e. the lack of professionals with the knowledge and training on the use of the practice in construction project, this situation is compounded by the absence of available data on whole life costing from relevant projects, lack of data collection mechanisms and so on. The aforementioned problems has forced many construction organisations to adopt project enhancement initiatives to boost their performance on the use of whole life costing techniques so as to produce economical buildings which offer value for money during the construction stage also the whole life of the building/asset. The management of knowledge in whole life costing is considered as one of the many project enhancement initiative and it is becoming imperative in the performance and sustainability of an organisation. Procuring building projects using whole life costing technique is heavily reliant on the knowledge, experience, ideas and skills of workers, which comes from many sources including other individuals, electronic media and documents. Due to the diversity of knowledge, capabilities and skills of employees that vary across an organisation, it is significant that they are directed and coordinated efficiently so as to capture, retrieve and share knowledge in order to improve the performance of the organisation. The implementation of knowledge management concept has different levels in each organisation. Measuring the maturity level of knowledge management in whole life costing practice will paint a comprehensible picture of how knowledge is managed in construction organisations. Purpose: The purpose of this study is to identify knowledge management maturity in UK construction organisations adopting whole life costing in construction project. Design/methodology/approach: This study adopted a survey method and conducted by distributing questionnaires to large construction companies that implement knowledge management activities in whole life costing practice in construction project. Four level of knowledge management maturity was proposed on this study. Findings: From the results obtained in the study shows that 34 contractors at the practiced level, 26 contractors at managed level and 12 contractors at continuously improved level.Keywords: knowledge management, whole life costing, construction industry, knowledge
Procedia PDF Downloads 244704 Investigation of Deep Eutectic Solvents for Microwave Assisted Extraction and Headspace Gas Chromatographic Determination of Hexanal in Fat-Rich Food
Authors: Birute Bugelyte, Ingrida Jurkute, Vida Vickackaite
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The most complicated step of the determination of volatile compounds in complex matrices is the separation of analytes from the matrix. Traditional analyte separation methods (liquid extraction, Soxhlet extraction) require a lot of time and labour; moreover, there is a risk to lose the volatile analytes. In recent years, headspace gas chromatography has been used to determine volatile compounds. To date, traditional extraction solvents have been used in headspace gas chromatography. As a rule, such solvents are rather volatile; therefore, a large amount of solvent vapour enters into the headspace together with the analyte. Because of that, the determination sensitivity of the analyte is reduced, a huge solvent peak in the chromatogram can overlap with the peaks of the analyts. The sensitivity is also limited by the fact that the sample can’t be heated at a higher temperature than the solvent boiling point. In 2018 it was suggested to replace traditional headspace gas chromatographic solvents with non-volatile, eco-friendly, biodegradable, inexpensive, and easy to prepare deep eutectic solvents (DESs). Generally, deep eutectic solvents have low vapour pressure, a relatively wide liquid range, much lower melting point than that of any of their individual components. Those features make DESs very attractive as matrix media for application in headspace gas chromatography. Also, DESs are polar compounds, so they can be applied for microwave assisted extraction. The aim of this work was to investigate the possibility of applying deep eutectic solvents for microwave assisted extraction and headspace gas chromatographic determination of hexanal in fat-rich food. Hexanal is considered one of the most suitable indicators of lipid oxidation degree as it is the main secondary oxidation product of linoleic acid, which is one of the principal fatty acids of many edible oils. Eight hydrophilic and hydrophobic deep eutectic solvents have been synthesized, and the influence of the temperature and microwaves on their headspace gas chromatographic behaviour has been investigated. Using the most suitable DES, microwave assisted extraction conditions and headspace gas chromatographic conditions have been optimized for the determination of hexanal in potato chips. Under optimized conditions, the quality parameters of the prepared technique have been determined. The suggested technique was applied for the determination of hexanal in potato chips and other fat-rich food.Keywords: deep eutectic solvents, headspace gas chromatography, hexanal, microwave assisted extraction
Procedia PDF Downloads 195703 A Triad Pedagogy for Increased Digital Competence of Human Resource Management Students: Reflecting on Human Resource Information Systems at a South African University
Authors: Esther Pearl Palmer
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Driven by the increased pressure on Higher Education Institutions (HEIs) to produce work-ready graduates for the modern world of work, this study reflects on triad teaching and learning practices to increase student engagement and employability. In the South African higher education context, the employability of graduates is imperative in strengthening the country’s economy and in increasing competitiveness. Within this context, the field of Human Resource Management (HRM) calls for innovative methods and approaches to teaching and learning and assessing the skills and competencies of graduates to render them employable. Digital competency in Human Resource Information Systems (HRIS) is an important component and prerequisite for employment in HRM. The purpose of this research is to reflect on the subject HRIS developed by lecturers at the Central University of Technology, Free State (CUT), with the intention to actively engage students in real-world learning activities and increase their employability. The Enrichment Triad Model (ETM) was used as theoretical framework to develop the subject as it supports a triad teaching and learning approach to education. It is, furthermore, an inter-structured model that supports collaboration between industry, academics and students. The study follows a mixed-method approach to reflect on the learning experiences of the industry, academics and students in the subject field over the past three years. This paper is a work in progress and seeks to broaden the scope of extant studies about student engagement in work-related learning to increase employability. Based on the ETM as theoretical framework and pedagogical practice, this paper proposes that following a triad teaching and learning approach will increase work-related skills of students. Findings from the study show that students, academics and industry alike regard educational opportunities that incorporate active learning experiences with the world of work enhances student engagement in learning and renders them more employable.Keywords: digital competence, enriched triad model, human resource information systems, student engagement, triad pedagogy.
Procedia PDF Downloads 92702 Risk Mapping of Road Traffic Incidents in Greater Kampala Metropolitan Area for Planning of Emergency Medical Services
Authors: Joseph Kimuli Balikuddembe
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Road traffic incidents (RTIs) continue to be a serious public health and development burden around the globe. Compared to high-income countries (HICs), the low and middle-income countries (LMICs) bear the heaviest brunt of RTIs. Like other LMICs, Uganda, a country located in Eastern Africa, has been experiencing a worryingly high burden of RTIs and their associated impacts. Over the years, the highest number of all the total registered RTIs in Uganda has taken place in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected. In this regard, the overall objective of the study was to risk map RTIs in the GKMA so as to help in the better planning of EMS for the victims of RTIs. Other objectives included: (i) identifying the factors affecting the exposure, vulnerability and EMS capacity for the victims of RTIs; (ii) identifying the RTI prone-areas and estimating their associated risk factors; (iii) identifying the weaknesses and capacities which affect the EMS systems for RTIs; and (iv) determining the strategies and priority actions that can help to improve the EMS response for RTI victims in the GKMA. To achieve these objectives, a mixed methodological approach was used in four phrases for approximately 15 months. It employed a systematic review based on the preferred reporting items for systematic reviews and meta-data analysis guidelines; a Delphi panel technique; retrospective data analysis; and a cross-sectional method. With Uganda progressing forward as envisaged in its 'Vision 2040', the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth, urbanization, infrastructure development, rapid motorization and other factors. Unless appropriate actions are taken, these changes are likely to worsen the already alarming rate of RTIs in Uganda, and in turn also to put pressure on the few existing EMS and facilities to render care for those affected. Therefore, road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that contribute to RTIs, particularly in the GKMA and Uganda as a whole.Keywords: emergency medical services, Kampala, risk mapping, road traffic incidents
Procedia PDF Downloads 121701 Possibilities of Psychodiagnostics in the Context of Highly Challenging Situations in Military Leadership
Authors: Markéta Chmelíková, David Ullrich, Iva Burešová
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The paper maps the possibilities and limits of diagnosing selected personality and performance characteristics of military leadership and psychology students in the context of coping with challenging situations. Individuals vary greatly inter-individually in their ability to effectively manage extreme situations, yet existing diagnostic tools are often criticized mainly for their low predictive power. Nowadays, every modern army focuses primarily on the systematic minimization of potential risks, including the prediction of desirable forms of behavior and the performance of military commanders. The context of military leadership is well known for its life-threatening nature. Therefore, it is crucial to research stress load in the specific context of military leadership for the purpose of possible anticipation of human failure in managing extreme situations of military leadership. The aim of the submitted pilot study, using an experiment of 24 hours duration, is to verify the possibilities of a specific combination of psychodiagnostic to predict people who possess suitable equipment for coping with increased stress load. In our pilot study, we conducted an experiment of 24 hours duration with an experimental group (N=13) in the bomb shelter and a control group (N=11) in a classroom. Both groups were represented by military leadership students (N=11) and psychology students (N=13). Both groups were equalized in terms of study type and gender. Participants were administered the following test battery of personality characteristics: Big Five Inventory 2 (BFI-2), Short Dark Triad (SD-3), Emotion Regulation Questionnaire (ERQ), Fatigue Severity Scale (FSS), and Impulsive Behavior Scale (UPPS-P). This test battery was administered only once at the beginning of the experiment. Along with this, they were administered a test battery consisting of the Test of Attention (d2) and the Bourdon test four times overall with 6 hours ranges. To better simulate an extreme situation – we tried to induce sleep deprivation - participants were required to try not to fall asleep throughout the experiment. Despite the assumption that a stay in an underground bomb shelter will manifest in impaired cognitive performance, this expectation has been significantly confirmed in only one measurement, which can be interpreted as marginal in the context of multiple testing. This finding is a fundamental insight into the issue of stress management in extreme situations, which is crucial for effective military leadership. The results suggest that a 24-hour stay in a shelter, together with sleep deprivation, does not seem to simulate sufficient stress for an individual, which would be reflected in the level of cognitive performance. In the context of these findings, it would be interesting in future to extend the diagnostic battery with physiological indicators of stress, such as: heart rate, stress score, physical stress, mental stress ect.Keywords: bomb shelter, extreme situation, military leadership, psychodiagnostic
Procedia PDF Downloads 91700 A Comprehensive Key Performance Indicators Dashboard for Emergency Medical Services
Authors: Giada Feletti, Daniela Tedesco, Paolo Trucco
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The present study aims to develop a dashboard of Key Performance Indicators (KPI) to enhance information and predictive capabilities in Emergency Medical Services (EMS) systems, supporting both operational and strategic decisions of different actors. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning the indicators currently used for the performance measurement of EMS systems. From this literature analysis, it emerged that current studies focus on two distinct perspectives: the ambulance service, a fundamental component of pre-hospital health treatment, and the patient care in the Emergency Department (ED). The perspective proposed by this study is to consider an integrated view of the ambulance service process and the ED process, both essential to ensure high quality of care and patient safety. Thus, the proposal focuses on the entire healthcare service process and, as such, allows considering the interconnection between the two EMS processes, the pre-hospital and hospital ones, connected by the assignment of the patient to a specific ED. In this way, it is possible to optimize the entire patient management. Therefore, attention is paid to the dependency of decisions that in current EMS management models tend to be neglected or underestimated. In particular, the integration of the two processes enables the evaluation of the advantage of an ED selection decision having visibility on EDs’ saturation status and therefore considering the distance, the available resources and the expected waiting times. Starting from a critical review of the KPIs proposed in the extant literature, the design of the dashboard was carried out: the high number of analyzed KPIs was reduced by eliminating the ones firstly not in line with the aim of the study and then the ones supporting a similar functionality. The KPIs finally selected were tested on a realistic dataset, which draws us to exclude additional indicators due to the unavailability of data required for their computation. The final dashboard, which was discussed and validated by experts in the field, includes a variety of KPIs able to support operational and planning decisions, early warning, and citizens’ awareness of EDs accessibility in real-time. By associating each KPI to the EMS phase it refers to, it was also possible to design a well-balanced dashboard covering both efficiency and effective performance of the entire EMS process. Indeed, just the initial phases related to the interconnection between ambulance service and patient’s care are covered by traditional KPIs compared to the subsequent phases taking place in the hospital ED. This could be taken into consideration for the potential future development of the dashboard. Moreover, the research could proceed by building a multi-layer dashboard composed of the first level with a minimal set of KPIs to measure the basic performance of the EMS system at an aggregate level and further levels with KPIs that can bring additional and more detailed information.Keywords: dashboard, decision support, emergency medical services, key performance indicators
Procedia PDF Downloads 113699 Change Detection of Water Bodies in Dhaka City: An Analysis Using Geographic Information System and Remote Sensing
Authors: M. Humayun Kabir, Mahamuda Afroze, K. Maudood Elahi
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Since the late 1900s, unplanned and rapid urbanization processes have drastically altered the land, reduced water bodies, and decreased vegetation cover in the capital city of Bangladesh, Dhaka. The capitalist modes of urbanization results in the encroachment of the surface water bodies in this city. The main goal of this study is to investigate the change detection of water bodies in Dhaka city, analyzing spatial distribution of water bodies and calculating the changing rate of it. This effort aims to influence public policy for environmental justice initiatives around protecting water bodies for ensuring proper function of the urban ecosystem. This study accomplishes research goal by compiling satellite imageries into GIS software to understand the changes of water bodies in Dhaka city. The work focuses on the late 20th century to early 21st century to analyze this city before and after major infrastructural changes occurred in unplanned manner. The land use of the study area has been classified into four categories, and the areas of the different land use have been calculated using MS Excel and SPSS. The results reveal that the urbanization expanded from central to northern part and major encroachment occurred at the western and eastern part of the city. It has also been found that, in 1988, the total area of water bodies was 8935.38 hectares, and it gradually decreased, and in 1998, 2008, 2017, the total areas of water bodies reached 6065.73, 4853.32, 2077.56 hectares, respectively. Rapid population growth, unplanned urbanization, and industrialization have generated pressure to change the land use pattern in Dhaka city. These expansion processes are engulfing wetland, water bodies, and vegetation cover without considering environmental impact. In order to regain the wetland and surface water bodies, the concern authorities must implement laws and act as a legal instrument in this regard and take action against the violators of it. This research is the synthesis of time series data that provides a complete picture of the water body’s status of Dhaka city that might help to make plans and policies for water body conservation.Keywords: ecosystem, GIS, industrialization, land use, remote sensing, urbanization
Procedia PDF Downloads 152698 Conceptualization and Assessment of Key Competencies for Children in Preschools: A Case Study in Southwest China
Authors: Yumei Han, Naiqing Song, Xiaoping Yang, Yuping Han
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This study explores the conceptualization of key competencies that children are expected to develop in three year preschools (age 3-6) and the assessment practices of such key competencies in China. Assessment of children development has been put into the central place of early childhood education quality evaluation system in China. In the context of students key competencies development centered education reform in China, defining and selecting key competencies of children in preschools are of great significance in that they would lay a solid foundation for children’s lifelong learning path, and they would lead to curriculum and instruction reform, teacher development reform as well as quality evaluation reform in the early childhood education area. Based on sense making theory and framework, this study adopted multiple stakeholders’ (early childhood educators, parents, evaluation administrators, scholars in the early childhood education field) perspectives and grass root voices to conceptualize and operationalize key competencies for children in preschools in Southwest China. On the ground of children development theories, Chinese and international literature related to children development and key competencies, and key competencies frameworks by UNESCO, OECD and other nations, the authors designed a two-phase sequential mixed method study to address three main questions: (a) How is early childhood key competency defined or labeled from literature and from different stakeholders’ views? (b) Based on the definitions explicated in the literature and the surveys on different stakeholders, what domains and components are regarded to constitute the key competency framework of children in three-year preschools in China? (c) How have early childhood key competencies been assessed and measured, and how such assessment and measurement contribute to enhancing early childhood development quality? On the first phase, a series of focus group surveys were conducted among different types of stakeholders around the research questions. Moreover, on the second phase, based on the coding of the participants’ answers, together with literature synthesis findings, a questionnaire survey was designed and conducted to select most commonly expected components of preschool children’s key competencies. Semi-structured open questions were also included in the questionnaire for the participants to add on competencies beyond the checklist. Rudimentary findings show agreeable concerns on the significance and necessity of conceptualization and assessment of key competencies for children in preschools, and a key competencies framework composed of 7 domains and 25 indicators was constructed. Meanwhile, the findings also show issues in the current assessment practices of children’s competencies, such as lack of effective assessment tools, lack of teacher capacity in applying the tools to evaluating children and advancing children development accordingly. Finally, the authors put forth suggestions and implications for China and international communities in terms of restructuring early childhood key competencies framework, and promoting child development centered reform in early childhood education quality evaluation and development.Keywords: assessment, conceptualization, early childhood education quality in China, key competencies
Procedia PDF Downloads 249697 The Anesthesia Considerations in Robotic Mastectomies
Authors: Amrit Vasdev, Edwin Rho, Gurinder Vasdev
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Robotic surgery has enabled a new spectrum of minimally invasive breast reconstruction by improving visualization, surgeon posturing, and improved patient outcomes.1 The DaVinci robot system can be utilized in nipple sparing mastectomies and reconstructions. The process involves the insufflation of the subglandular space and a dissection of the mammary gland with a combination of cautery and blunt dissection. This case outlines a 35-year-old woman who has a long-standing family history of breast cancer and a diagnosis of a deleterious BRCA2 genetic mutation. She has decided to proceed with bilateral nipple sparing mastectomies with implants. Her perioperative mammogram and MRI were negative for masses, however, her left internal mammary lymph node was enlarged. She has taken oral contraceptive pills for 3-5 years and denies DES exposure, radiation therapy, human replacement therapy, or prior breast surgery. She does not smoke and rarely consumes alcohol. During the procedure, the patient received a standardized anesthetic for out-patient surgery of propofol infusion, succinylcholine, sevoflurane, and fentanyl. Aprepitant was given as an antiemetic and preoperative Tylenol and gabapentin for pain management. Concerns for the patient during the procedure included CO2 insufflation into the subcutaneous space. With CO2 insufflation, there is a potential for rapid uptake leading to severe acidosis, embolism, and subcutaneous emphysema.2To mitigate this, it is important to hyperventilate the patient and reduce both the insufflation pressure and the CO2 flow rate to the minimal acceptable by the surgeon. For intraoperative monitoring during this 6-9 hour long procedure, it has been suggested to utilize an Arterial-Line for end-tidal CO2 monitoring. However, in this case, it was not necessary as the patient had excellent cardiovascular reserve, and end-tidal CO2 was within normal limits for the duration of the procedure. A BIS monitor was also utilized to reduce anesthesia burden and to facilitate a prompt discharge from the PACU. Minimal Invasive Robotic Surgery will continue to evolve, and anesthesiologists need to be prepared for the new challenges ahead. Based on our limit number of patients, robotic mastectomy appears to be a safe alternative to open surgery with the promise of clearer tissue demarcation and better cosmetic results.Keywords: anesthesia, mastectomies, robotic, hypercarbia
Procedia PDF Downloads 112696 Compression and Air Storage Systems for Small Size CAES Plants: Design and Off-Design Analysis
Authors: Coriolano Salvini, Ambra Giovannelli
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The use of renewable energy sources for electric power production leads to reduced CO2 emissions and contributes to improving the domestic energy security. On the other hand, the intermittency and unpredictability of their availability poses relevant problems in fulfilling safely and in a cost efficient way the load demand along the time. Significant benefits in terms of “grid system applications”, “end-use applications” and “renewable applications” can be achieved by introducing energy storage systems. Among the currently available solutions, CAES (Compressed Air Energy Storage) shows favorable features. Small-medium size plants equipped with artificial air reservoirs can constitute an interesting option to get efficient and cost-effective distributed energy storage systems. The present paper is addressed to the design and off-design analysis of the compression system of small size CAES plants suited to absorb electric power in the range of hundreds of kilowatt. The system of interest is constituted by an intercooled (in case aftercooled) multi-stage reciprocating compressor and a man-made reservoir obtained by connecting large diameter steel pipe sections. A specific methodology for the system preliminary sizing and off-design modeling has been developed. Since during the charging phase the electric power absorbed along the time has to change according to the peculiar CAES requirements and the pressure ratio increases continuously during the filling of the reservoir, the compressor has to work at variable mass flow rate. In order to ensure an appropriately wide range of operations, particular attention has been paid to the selection of the most suitable compressor capacity control device. Given the capacity regulation margin of the compressor and the actual level of charge of the reservoir, the proposed approach allows the instant-by-instant evaluation of minimum and maximum electric power absorbable from the grid. The developed tool gives useful information to appropriately size the compression system and to manage it in the most effective way. Various cases characterized by different system requirements are analysed. Results are given and widely discussed.Keywords: artificial air storage reservoir, compressed air energy storage (CAES), compressor design, compression system management.
Procedia PDF Downloads 229695 Linking Information Systems Capabilities for Service Quality: The Role of Customer Connection and Environmental Dynamism
Authors: Teng Teng, Christos Tsinopoulos
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The purpose of this research is to explore the link between IS capabilities, customer connection, and quality performance in the service context, with investigation of the impact of firm’s stable and dynamic environments. The application of Information Systems (IS) has become a significant effect on contemporary service operations. Firms invest in IS with the presumption that they will facilitate operations processes so that their performance will improve. Yet, IS resources by themselves are not sufficiently 'unique' and thus, it would be more useful and theoretically relevant to focus on the processes they affect. One such organisational process, which has attracted a lot of research attention by supply chain management scholars, is the integration of customer connection, where IS-enabled customer connection enhances communication and contact processes, and with such customer resources integration comes greater success for the firm in its abilities to develop a good understanding of customer needs and set accurate customer. Nevertheless, prior studies on IS capabilities have focused on either one specific type of technology or operationalised it as a highly aggregated concept. Moreover, although conceptual frameworks have been identified to show customer integration is valuable in service provision, there is much to learn about the practices of integrating customer resources. In this research, IS capabilities have been broken down into three dimensions based on the framework of Wade and Hulland: IT for supply chain activities (ITSCA), flexible IT infrastructure (ITINF), and IT operations shared knowledge (ITOSK); and focus on their impact on operational performance of firms in services. With this background, this paper addresses the following questions: -How do IS capabilities affect the integration of customer connection and service quality? -What is the relationship between environmental dynamism and the relationship of customer connection and service quality? A survey of 156 service establishments was conducted, and the data analysed to determine the role of customer connection in mediating the effects of IS capabilities on firms’ service quality. Confirmatory factor analysis was used to check convergent validity. There is a good model fit for the structural model. Moderating effect of environmental dynamism on the relationship of customer connection and service quality is analysed. Results show that ITSCA, ITINF, and ITOSK have a positive influence on the degree of the integration of customer connection. In addition, customer connection positively related to service quality; this relationship is further emphasised when firms work in a dynamic environment. This research takes a step towards quelling concerns about the business value of IS, contributing to the development and validation of the measurement of IS capabilities in the service operations context. Additionally, it adds to the emerging body of literature linking customer connection to the operational performance of service firms. Managers of service firms should consider the strength of the mediating role of customer connection when investing in IT-related technologies and policies. Particularly, service firms developing IS capabilities should simultaneously implement processes that encourage supply chain integration.Keywords: customer connection, environmental dynamism, information systems capabilities, service quality, service supply chain
Procedia PDF Downloads 140694 Intracranial Hypotension: A Brief Review of the Pathophysiology and Diagnostic Algorithm
Authors: Ana Bermudez de Castro Muela, Xiomara Santos Salas, Silvia Cayon Somacarrera
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The aim of this review is to explain what is the intracranial hypotension and its main causes, and also to approach to the diagnostic management in the different clinical situations, understanding radiological findings, and physiopathological substrate. An approach to the diagnostic management is presented: what are the guidelines to follow, the different tests available, and the typical findings. We review the myelo-CT and myelo-RM studies in patients with suspected CSF fistula or hypotension of unknown cause during the last 10 years in three centers. Signs of intracranial hypotension (subdural hygromas/hematomas, pachymeningeal enhancement, venous sinus engorgement, pituitary hyperemia, and lowering of the brain) that are evident in baseline CT and MRI are also sought. The intracranial hypotension is defined as a lower opening pressure of 6 cmH₂O. It is a relatively rare disorder with an annual incidence of 5 per 100.000, with a female to male ratio 2:1. The clinical features it’s an orthostatic headache, which is defined as development or aggravation of headache when patients move from a supine to an upright position and disappear or typically relieve after lay down. The etiology is a decrease in the amount of cerebrospinal fluid (CSF), usually by loss of it, either spontaneous or secondary (post-traumatic, post-surgical, systemic disease, post-lumbar puncture etc.) and rhinorrhea and/or otorrhea may exist. The pathophysiological mechanisms of hypotension and CSF hypertension are interrelated, as a situation of hypertension may lead to hypotension secondary to spontaneous CSF leakage. The diagnostic management of intracranial hypotension in our center includes, in the case of being spontaneous and without rhinorrhea and/or otorrhea and according to necessity, a range of available tests, which will be performed from less to more complex: cerebral CT, cerebral MRI and spine without contrast and CT/MRI with intrathecal contrast. If we are in a situation of intracranial hypotension with the presence of rhinorrhea/otorrhea, a sample can be obtained for the detection of b2-transferrin, which is found in the CSF physiologically, as well as sinus CT and cerebral MRI including constructive interference steady state (CISS) sequences. If necessary, cisternography studies are performed to locate the exact point of leakage. It is important to emphasize the significance of myelo-CT / MRI to establish the diagnosis and location of CSF leak, which is indispensable for therapeutic planning (whether surgical or not) in patients with more than one lesion or doubts in the baseline tests.Keywords: cerebrospinal fluid, neuroradiology brain, magnetic resonance imaging, fistula
Procedia PDF Downloads 127693 Insufficiency of Cardioprotection at Adaptation to Chronic Hypoxia and at Remote Postconditioning in Young and Aged Rats with Metabolic Syndrome, the Role of Metabolic Disorders or Opioid Signaling
Authors: Natalia V. Naryzhnaya, Alexandr V. Mukhomedzyanov, Ivan A. Derkachev, Boris K. Kurbatov, Leonid N. Maslov
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Background: Techniques of adaptation to hypoxia and remote postconditioning (RPost) have great prospects for use in the clinic. However, recent studies have shown low efficacy of remote postconditioning in patients with AMI. We hypothesize that the reasons for this inefficiency may be metabolic disorders, which are very common, especially in patients with cardiovascular disease, and age of patients. The purpose of the study was to reveal the effectiveness of adaptation to chronic hypoxia and RPost. To determine the possible relationship between the decrease in the effectiveness of projective impacts and disorders of carbohydrate and lipid metabolism. Design: The study was carried out on Wistar rats 60 day old. MetS was induced by high-carbohydrate, high-fat diet (HСHFD). Modeling MS led to the formation of obesity, hypertension, impaired lipid and carbohydrate metabolism, hyperleptinemia, and moderate stress. Groups with adaptation to chronic hypoxia were subjected to hypoxia for 21 days at 12% O2 and 0.3% CO2 after complete of HСHFD. All animals were subjected to 45 min coronary occlusion and 120 min reperfusion. Groups with RPost, immediately after the end of ischemia, tourniquets were applied to the hind limbs in the area of the hip joint (3 times in the mode of 5 min ischemia, 5 min reperfusion). Results: RPost led to a twofold reduction of infarct size in rats with intact metabolism (р < 0.0001), while in rats with MetS, a decrease in infarct size during RPost was 25 % (p = 0.00003). A direct correlation was found between of infarct size during RPost and the serum leptin level of rats with MetC (r = 0.85). The presented data suggested that a decrease in the efficiency of remote postconditioning in rats with diet-induced metabolic syndrome depends on serum leptin. Chronic hypoxia resulted in a 38% reduced in infarct size in metabolically intact rats. The decrease of cardioprotection was observed in rats with chronic hypoxia and MetS. Infarct size showed a direct correlation with impaired glucose tolerance (AUC, glucose tolerance test, r = 0.034) and serum triglyceride levels (r = 0.39). Our study showed the dependence of cardioprotection in rats with metabolic syndrome during chronic hypoxia and DPost on opioids in the blood serum and myocardium, protein kinase C and NO synthase activity. Conclusion: The results obtained showed that the infarct-limiting efficiency of adaptation to hypoxia and remote postconditioning is reduced or completely absent in animals with metabolic syndrome. The increase in the infarction, in this case, directly depends on the disturbances in carbohydrate. lipid metabolism and opioids signaling. Funding: Investigation of effectiveness of chronic hypoxia at the metabolic syndrome was carried out within the support of Russian Science Foundation Grant 22-15-00048. Studies of the mechanisms of arterial hypertension in induced metabolic syndrome were carried out within the framework of the state assignment (122020300042-4). The work was performed using the Center for Collective Use "Medical Genomics".Keywords: chronic hypoxia, opioids, remote postconditioning, metabolic syndrome
Procedia PDF Downloads 79692 Experimental Measurement of Equatorial Ring Current Generated by Magnetoplasma Sail in Three-Dimensional Spatial Coordinate
Authors: Masato Koizumi, Yuya Oshio, Ikkoh Funaki
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Magnetoplasma Sail (MPS) is a future spacecraft propulsion that generates high levels of thrust by inducing an artificial magnetosphere to capture and deflect solar wind charged particles in order to transfer momentum to the spacecraft. By injecting plasma in the spacecraft’s magnetic field region, the ring current azimuthally drifts on the equatorial plane about the dipole magnetic field generated by the current flowing through the solenoid attached on board the spacecraft. This ring current results in magnetosphere inflation which improves the thrust performance of MPS spacecraft. In this present study, the ring current was experimentally measured using three Rogowski Current Probes positioned in a circular array about the laboratory model of MPS spacecraft. This investigation aims to determine the detailed structure of ring current through physical experimentation performed under two different magnetic field strengths engendered by varying the applied voltage on the solenoid with 300 V and 600 V. The expected outcome was that the three current probes would detect the same current since all three probes were positioned at equal radial distance of 63 mm from the center of the solenoid. Although experimental results were numerically implausible due to probable procedural error, the trends of the results revealed three pieces of perceptive evidence of the ring current behavior. The first aspect is that the drift direction of the ring current depended on the strength of the applied magnetic field. The second aspect is that the diamagnetic current developed at a radial distance not occupied by the three current probes under the presence of solar wind. The third aspect is that the ring current distribution varied along the circumferential path about the spacecraft’s magnetic field. Although this study yielded experimental evidence that differed from the original hypothesis, the three key findings of this study have informed two critical MPS design solutions that will potentially improve thrust performance. The first design solution is the positioning of the plasma injection point. Based on the implication of the first of the three aspects of ring current behavior, the plasma injection point must be located at a distance instead of at close proximity from the MPS Solenoid for the ring current to drift in the direction that will result in magnetosphere inflation. The second design solution, predicated by the third aspect of ring current behavior, is the symmetrical configuration of plasma injection points. In this study, an asymmetrical configuration of plasma injection points using one plasma source resulted in a non-uniform distribution of ring current along the azimuthal path. This distorts the geometry of the inflated magnetosphere which minimizes the deflection area for the solar wind. Therefore, to realize a ring current that best provides the maximum possible inflated magnetosphere, multiple plasma sources must be spaced evenly apart for the plasma to be injected evenly along its azimuthal path.Keywords: Magnetoplasma Sail, magnetosphere inflation, ring current, spacecraft propulsion
Procedia PDF Downloads 310691 A Study on the Effect of Design Factors of Slim Keyboard’s Tactile Feedback
Authors: Kai-Chieh Lin, Chih-Fu Wu, Hsiang Ling Hsu, Yung-Hsiang Tu, Chia-Chen Wu
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With the rapid development of computer technology, the design of computers and keyboards moves towards a trend of slimness. The change of mobile input devices directly influences users’ behavior. Although multi-touch applications allow entering texts through a virtual keyboard, the performance, feedback, and comfortableness of the technology is inferior to traditional keyboard, and while manufacturers launch mobile touch keyboards and projection keyboards, the performance has not been satisfying. Therefore, this study discussed the design factors of slim pressure-sensitive keyboards. The factors were evaluated with an objective (accuracy and speed) and a subjective evaluation (operability, recognition, feedback, and difficulty) depending on the shape (circle, rectangle, and L-shaped), thickness (flat, 3mm, and 6mm), and force (35±10g, 60±10g, and 85±10g) of the keyboard. Moreover, MANOVA and Taguchi methods (regarding signal-to-noise ratios) were conducted to find the optimal level of each design factor. The research participants, by their typing speed (30 words/ minute), were divided in two groups. Considering the multitude of variables and levels, the experiments were implemented using the fractional factorial design. A representative model of the research samples were established for input task testing. The findings of this study showed that participants with low typing speed primarily relied on vision to recognize the keys, and those with high typing speed relied on tactile feedback that was affected by the thickness and force of the keys. In the objective and subjective evaluation, a combination of keyboard design factors that might result in higher performance and satisfaction was identified (L-shaped, 3mm, and 60±10g) as the optimal combination. The learning curve was analyzed to make a comparison with a traditional standard keyboard to investigate the influence of user experience on keyboard operation. The research results indicated the optimal combination provided input performance to inferior to a standard keyboard. The results could serve as a reference for the development of related products in industry and for applying comprehensively to touch devices and input interfaces which are interacted with people.Keywords: input performance, mobile device, slim keyboard, tactile feedback
Procedia PDF Downloads 299690 Direct Current Electric Field Stimulation against PC12 Cells in 3D Bio-Reactor to Enhance Axonal Extension
Authors: E. Nakamachi, S. Tanaka, K. Yamamoto, Y. Morita
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In this study, we developed a three-dimensional (3D) direct current electric field (DCEF) stimulation bio-reactor for axonal outgrowth enhancement to generate the neural network of the central nervous system (CNS). By using our newly developed 3D DCEF stimulation bio-reactor, we cultured the rat pheochromocytoma cells (PC12) and investigated the effects on the axonal extension enhancement and network generation. Firstly, we designed and fabricated a 3D bio-reactor, which can load DCEF stimulation on PC12 cells embedded in the collagen gel as extracellular environment. The connection between the electrolyte and the medium using salt bridges for DCEF stimulation was introduced to avoid the cell death by the toxicity of metal ion. The distance between the salt bridges was adopted as the design variable to optimize a structure for uniform DCEF stimulation, where the finite element (FE) analyses results were used. Uniform DCEF strength and electric flux vector direction in the PC12 cells embedded in collagen gel were examined through measurements of the fabricated 3D bio-reactor chamber. Measurement results of DCEF strength in the bio-reactor showed a good agreement with FE results. In addition, the perfusion system was attached to maintain pH 7.2 ~ 7.6 of the medium because pH change was caused by DCEF stimulation loading. Secondly, we disseminated PC12 cells in collagen gel and carried out 3D culture. Finally, we measured the morphology of PC12 cell bodies and neurites by the multiphoton excitation fluorescence microscope (MPM). The effectiveness of DCEF stimulation to enhance the axonal outgrowth and the neural network generation was investigated. We confirmed that both an increase of mean axonal length and axogenesis rate of PC12, which have been exposed 5 mV/mm for 6 hours a day for 4 days in the bioreactor. We found following conclusions in our study. 1) Design and fabrication of DCEF stimulation bio-reactor capable of 3D culture nerve cell were completed. A uniform electric field strength of average value of 17 mV/mm within the 1.2% error range was confirmed by using FE analyses, after the structure determination through the optimization process. In addition, we attached a perfusion system capable of suppressing the pH change of the culture solution due to DCEF stimulation loading. 2) Evaluation of DCEF stimulation effects on PC12 cell activity was executed. The 3D culture of PC 12 was carried out adopting the embedding culture method using collagen gel as a scaffold for four days under the condition of 5.0 mV/mm and 10mV/mm. There was a significant effect on the enhancement of axonal extension, as 11.3% increase in an average length, and the increase of axogenesis rate. On the other hand, no effects on the orientation of axon against the DCEF flux direction was observed. Further, the network generation was enhanced to connect longer distance between the target neighbor cells by DCEF stimulation.Keywords: PC12, DCEF stimulation, 3D bio-reactor, axonal extension, neural network generation
Procedia PDF Downloads 184689 The Role of Uterine Artery Embolization in the Management of Postpartum Hemorrhage
Authors: Chee Wai Ku, Pui See Chin
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As an emerging alternative to hysterectomy, uterine artery embolization (UAE) has been widely used in the management of fibroids and in controlling postpartum hemorrhage (PPH) unresponsive to other therapies. Research has shown UAE to be a safe, minimally invasive procedure with few complications and minimal effects on future fertility. We present two cases highlighting the use of UAE in preventing PPH in a patient with a large fibroid at the time of cesarean section and in the treatment of secondary PPH refractory to other therapies in another patient. We present a 36-year primiparous woman who booked at 18+6 weeks gestation with a 13.7 cm subserosal fibroid at the lower anterior wall of the uterus near the cervix and a 10.8 cm subserosal fibroid in the left wall. Prophylactic internal iliac artery occlusion balloons were placed prior to the planned classical midline cesarean section. The balloons were inflated once the baby was delivered. Bilateral uterine arteries were embolized subsequently. The estimated blood loss (EBL) was 400 mls and hemoglobin (Hb) remained stable at 10 g/DL. Ultrasound scan 2 years postnatally showed stable uterine fibroids 10.4 and 7.1 cm, which was significantly smaller than before. We present the second case of a 40-year-old G2P1 with a previous cesarean section for failure to progress. There were no antenatal problems, and the placenta was not previa. She presented with term labour and underwent an emergency cesarean section for failed vaginal birth after cesarean. Intraoperatively extensive adhesions were noted with bladder drawn high, and EBL was 300 mls. Postpartum recovery was uneventful. She presented with secondary PPH 3 weeks later complicated by hypovolemic shock. She underwent an emergency examination under anesthesia and evacuation of the uterus, with EBL 2500mls. Histology showed decidua with chronic inflammation. She was discharged well with no further PPH. She subsequently returned one week later for secondary PPH. Bedside ultrasound showed that the endometrium was thin with no evidence of retained products of conception. Uterotonics were administered, and examination under anesthesia was performed, with uterine Bakri balloon and vaginal pack insertion after. EBL was 1000 mls. There was no definite cause of PPH with no uterine atony or products of conception. To evaluate a potential cause, pelvic angiogram and super selective left uterine arteriogram was performed which showed profuse contrast extravasation and acute bleeding from the left uterine artery. Superselective embolization of the left uterine artery was performed. No gross contrast extravasation from the right uterine artery was seen. These two cases demonstrated the superior efficacy of UAE. Firstly, the prophylactic use of intra-arterial balloon catheters in pregnant patients with large fibroids, and secondly, in the diagnosis and management of secondary PPH refractory to uterotonics and uterine tamponade. In both cases, the need for laparotomy hysterectomy was avoided, resulting in the preservation of future fertility. UAE should be a consideration for hemodynamically stable patients in centres with access to interventional radiology.Keywords: fertility preservation, secondary postpartum hemorrhage, uterine embolization, uterine fibroids
Procedia PDF Downloads 187688 Biosurfactants Produced by Antarctic Bacteria with Hydrocarbon Cleaning Activity
Authors: Claudio Lamilla, Misael Riquelme, Victoria Saez, Fernanda Sepulveda, Monica Pavez, Leticia Barrientos
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Biosurfactants are compounds synthesized by microorganisms that show various chemical structures, including glycolipids, lipopeptides, polysaccharide-protein complex, phospholipids, and fatty acids. These molecules have attracted attention in recent years due to the amphipathic nature of these compounds, which allows their application in various activities related to emulsification, foaming, detergency, wetting, dispersion and solubilization of hydrophobic compounds. Microorganisms that produce biosurfactants are ubiquitous, not only present in water, soil, and sediments but in extreme conditions of pH, salinity or temperature such as those present in Antarctic ecosystems. Due to this, it is of interest to study biosurfactants producing bacterial strains isolated from Antarctic environments, with the potential to be used in various biotechnological processes. The objective of this research was to characterize biosurfactants produced by bacterial strains isolated from Antarctic environments, with potential use in biotechnological processes for the cleaning of sites contaminated with hydrocarbons. The samples were collected from soils and sediments in the South Shetland Islands and the Antarctic Peninsula, during the Antarctic Research Expedition INACH 2016, from both pristine and human occupied areas (influenced). The bacteria isolation was performed from solid R2A, M1 and LB media. The selection of strains producing biosurfactants was done by hemolysis test on blood agar plates (5%) and blue agar (CTAB). From 280 isolates, it was determined that 10 bacterial strains produced biosurfactants after stimulation with different carbon sources. 16S rDNA taxonomic markers, using the universal primers 27F-1492R, were used to identify these bacterias. Biosurfactants production was carried out in 250 ml flasks using Bushnell Hass liquid culture medium enriched with different carbon sources (olive oil, glucose, glycerol, and hexadecane) during seven days under constant stirring at 20°C. Each cell-free supernatant was characterized by physicochemical parameters including drop collapse, emulsification and oil displacement, as well as stability at different temperatures, salinity, and pH. In addition, the surface tension of each supernatant was quantified using a tensiometer. The strains with the highest activity were selected, and the production of biosurfactants was stimulated in six liters of culture medium. Biosurfactants were extracted from the supernatants with chloroform methanol (2:1). These biosurfactants were tested against crude oil and motor oil, to evaluate their displacement activity (detergency). The characterization by physicochemical properties of 10 supernatants showed that 80% of them produced the drop collapse, 60% had stability at different temperatures, and 90% had detergency activity in motor and olive oil. The biosurfactants obtained from two bacterial strains showed a high activity of dispersion of crude oil and motor oil with halos superior to 10 cm. We can conclude that bacteria isolated from Antarctic soils and sediments provide biological material of high quality for the production of biosurfactants, with potential applications in the biotechnological industry, especially in hydrocarbons -contaminated areas such as petroleum.Keywords: antarctic, bacteria, biosurfactants, hydrocarbons
Procedia PDF Downloads 279687 BLS-2/BSL-3 Laboratory for Diagnosis of Pathogens on the Colombia-Ecuador Border Region: A Post-COVID Commitment to Public Health
Authors: Anderson Rocha-Buelvas, Jaqueline Mena Huertas, Edith Burbano Rosero, Arsenio Hidalgo Troya, Mauricio Casas Cruz
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COVID-19 is a disruptive pandemic for the public health and economic system of whole countries, including Colombia. Nariño Department is the southwest of the country and draws attention to being on the border with Ecuador, constantly facing demographic transition affecting infections between countries. In Nariño, the early routine diagnosis of SARS-CoV-2, which can be handled at BSL-2, has affected the transmission dynamics of COVID-19. However, new emerging and re-emerging viruses with biological flexibility classified as a Risk Group 3 agent can take advantage of epidemiological opportunities, generating the need to increase clinical diagnosis, mainly in border regions between countries. The overall objective of this project was to assure the quality of the analytical process in the diagnosis of high biological risk pathogens in Nariño by building a laboratory that includes biosafety level (BSL)-2 and (BSL)-3 containment zones. The delimitation of zones was carried out according to the Verification Tool of the National Health Institute of Colombia and following the standard requirements for the competence of testing and calibration laboratories of the International Organization for Standardization. This is achieved by harmonization of methods and equipment for effective and durable diagnostics of the large-scale spread of highly pathogenic microorganisms, employing negative-pressure containment systems and UV Systems in accordance with a finely controlled electrical system and PCR systems as new diagnostic tools. That increases laboratory capacity. Protection in BSL-3 zones will separate the handling of potentially infectious aerosols within the laboratory from the community and the environment. It will also allow the handling and inactivation of samples with suspected pathogens and the extraction of molecular material from them, allowing research with pathogens with high risks, such as SARS-CoV-2, Influenza, and syncytial virus, and malaria, among others. The diagnosis of these pathogens will be articulated across the spectrum of basic, applied, and translational research that could receive about 60 daily samples. It is expected that this project will be articulated with the health policies of neighboring countries to increase research capacity.Keywords: medical laboratory science, SARS-CoV-2, public health surveillance, Colombia
Procedia PDF Downloads 91686 Effect of Cutting Tools and Working Conditions on the Machinability of Ti-6Al-4V Using Vegetable Oil-Based Cutting Fluids
Authors: S. Gariani, I. Shyha
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Cutting titanium alloys are usually accompanied with low productivity, poor surface quality, short tool life and high machining costs. This is due to the excessive generation of heat at the cutting zone and difficulties in heat dissipation due to relatively low heat conductivity of this metal. The cooling applications in machining processes are crucial as many operations cannot be performed efficiently without cooling. Improving machinability, increasing productivity, enhancing surface integrity and part accuracy are the main advantages of cutting fluids. Conventional fluids such as mineral oil-based, synthetic and semi-synthetic are the most common cutting fluids in the machining industry. Although, these cutting fluids are beneficial in the industries, they pose a great threat to human health and ecosystem. Vegetable oils (VOs) are being investigated as a potential source of environmentally favourable lubricants, due to a combination of biodegradability, good lubricous properties, low toxicity, high flash points, low volatility, high viscosity indices and thermal stability. Fatty acids of vegetable oils are known to provide thick, strong, and durable lubricant films. These strong lubricating films give the vegetable oil base stock a greater capability to absorb pressure and high load carrying capacity. This paper details preliminary experimental results when turning Ti-6Al-4V. The impact of various VO-based cutting fluids, cutting tool materials, working conditions was investigated. The full factorial experimental design was employed involving 24 tests to evaluate the influence of process variables on average surface roughness (Ra), tool wear and chip formation. In general, Ra varied between 0.5 and 1.56 µm and Vasco1000 cutting fluid presented comparable performance with other fluids in terms of surface roughness while uncoated coarse grain WC carbide tool achieved lower flank wear at all cutting speeds. On the other hand, all tools tips were subjected to uniform flank wear during whole cutting trails. Additionally, formed chip thickness ranged between 0.1 and 0.14 mm with a noticeable decrease in chip size when higher cutting speed was used.Keywords: cutting fluids, turning, Ti-6Al-4V, vegetable oils, working conditions
Procedia PDF Downloads 279685 Rohingya Refugees and Bangladesh: Balance of Human Rights and Rationalization
Authors: Kudrat-E-Khuda Babu
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Rohingya refugees are the most marginalized and persecuted section of people in the world. The heinous brutality of Myanmar has forced the Muslim minority community to flee themselves to their neighboring country, Bangladesh for quite a few times now. The recent atrocity of the Buddhist country has added insult to injury on the existing crisis. In lieu of protection, the rights of the Rohingya community in Myanmar are being violated through exclusion from citizenship and steamroller of persecution. The mass influx of Rohingya refugees to Bangladesh basically took place in 1978, 1992, 2012, and 2017. At present, there are around one million Rohingyas staying at Teknaf, Ukhiya of Cox’s Bazar, the southern part of Bangladesh. The country, despite being a poverty-stricken one, has shown unprecedented generosity in sheltering the Rohingya people. For sheltering half of the total refugees in 2017, the Prime Minister of Bangladesh, Sheikh Hasina is now being regarded as the lighthouse of humanity or the mother of humanity. Though Bangladesh is not a ratifying state of the UN Refugee Convention, 1951 and its Additional Protocol, 1967, the country cannot escape its obligation under international human rights jurisprudence. Bangladesh is a party to eight human rights instruments out of nine core instruments, and thus, the country has an indirect obligation to protect and promote the rights of the refugees. Pressure from international bodies has also made Bangladesh bound to provide refuge to Rohingya people. Even though the demographic vulnerability and socio-economic condition of the country do not suggest taking over extra responsibility, the principle of non-refoulment as a part of customary international law reminds us to stay beside those persecuted or believed to have well-founded fear of persecution. In the case of HM Ershad v. Bangladesh and Others, 7 BLC (AD) 67, it was held that any international treaty or document after signing or ratification is not directly enforceable unless and until the parliament enacts a similar statute howsoever sweet the document is. As per Article 33(2) of the 1951 Refugee Convention, there are even exceptions for a state party in case of serious consequences like threat to national security, apprehension of serious crime and danger to safeguard state population. Bangladesh is now at a cross-road of human rights and national interest. The world community should come forward to resolve the crisis of the persecuted Rohingya people through repatriation, resettlement, and reintegration.Keywords: Rohingya refugees, human rights, Bangladesh, Myanmar
Procedia PDF Downloads 188684 Characterization of Volatiles Botrytis cinerea in Blueberry Using Solid Phase Micro Extraction, Gas Chromatography Mass Spectrometry
Authors: Ahmed Auda, Manjree Agarwala, Giles Hardya, Yonglin Rena
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Botrytis cinerea is a major pest for many plants. It can attack a wide range of plant parts. It can attack buds, flowers, and leaves, stems, and fruit. However, B. cinerea can be mixed with other diseases that cause the same damage. There are many species of botrytis and more than one different strains of each. Botrytis might infect the foliage of nursery stock stored through winter in damp conditions. There are no known resistant plants. Botrytis must have nutrients or food source before it infests the plant. Nutrients leaking from wounded plant parts or dying tissue like old flower petals give the required nutrients. From this food, the fungus becomes more attackers and invades healthy tissue. Dark to light brown rot forms in the ill tissue. High humidity conditions support the growth of this fungus. However, we suppose that selection pressure can act on the morphological and neurophysiologic filter properties of the receiver and on both the biochemical and the physiological regulation of the signal. Communication is implied when signal and receiver evolves toward more and more specific matching, culminating. In other hand, receivers respond to portions of a body odor bouquet which is released to the environment not as an (intentional) signal but as an unavoidable consequence of metabolic activity or tissue damage. Each year Botrytis species can cause considerable economic losses to plant crops. Even with the application of strict quarantine and control measures, these fungi can still find their way into crops and cause the imposition of onerous restrictions on exports. Blueberry fruit mould caused by a fungal infection usually results in major losses during post-harvest storage. Therefore, the management of infection in early stages of disease development is necessary to minimize losses. The overall purpose of this study will develop sensitive, cheap, quick and robust diagnostic techniques for the detection of B. cinerea in blueberry. The specific aim was designed to investigate the performance of volatile organic compounds (VOCs) in the detection and discrimination of blueberry fruits infected by fungal pathogens with an emphasis on Botrytis in the early storage stage of post-harvest.Keywords: botrytis cinerea, blueberry, GC/MS, VOCs
Procedia PDF Downloads 241683 Isolation and Characterization of Chromium Tolerant Staphylococcus aureus from Industrial Wastewater and Their Potential Use to Bioremediate Environmental Chromium
Authors: Muhammad Tariq, Muhammad Waseem, Muhammad Hidayat Rasool
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Isolation and characterization of chromium tolerant Staphylococcus aureus from industrial wastewater and their potential use to bioremediate environmental chromium. Objectives: Chromium with its great economic importance in industrial use is major metal pollutant of the environment. Chromium are used in different industries for various applications such as textile, dyeing and pigmentation, wood preservation, manufacturing pulp and paper, chrome plating, steel and tanning. The release of untreated chromium in industrial effluents causes serious threat to environment and human health, therefore, the current study designed to isolate chromium tolerant Staphylococcus aureus for removal of chromium prior to their final discharge into the environment due to its cost effective and beneficial advantage over physical and chemical methods. Methods: Wastewater samples were collected from discharge point of different industries. Heavy metal analysis by atomic absorption spectrophotometer and microbiological analysis such as total viable count, total coliform, fecal coliform and Escherichia coli were conducted. Staphylococcus aureus was identified through gram’s staining, biomeriux vitek 2 microbial identification system and 16S rRNA gene amplification by polymerase chain reaction. Optimum growth conditions with respect to temperature, pH, salt concentrations and effect of chromium on the growth of bacteria, resistance to other heavy metal ions, minimum inhibitory concentration and chromium uptake ability of Staphylococcus aureus strain K1 was determined by spectrophotometer. Antibiotic sensitivity pattern was also determined by disc diffusion method. Furthermore, chromium uptake ability was confirmed by Fourier transform infrared spectroscopy (FTIR) and scanning electron microscope equipped with Oxford Energy Dipersive X-ray (EDX) micro analysis system. Results: The results presented that optimum temperature was 35ᵒC, pH was 8.0 and salt concentration was 0.5% for growth of Staphylococcus aureus K1. The maximum uptake ability of chromium by bacteria was 20mM than other heavy metal ions. The antibiotic sensitivity pattern revealed that Staphylococcus aureus was vancomycin and methicillin sensitive. Non hemolytic activity on blood agar and negative coagulase reaction showed that it was non-pathogenic. Furthermore, the growth of bacteria decreases in the presence of chromium and maximum chromium uptake by bacteria observed at optimum growth conditions. Fourier transform infrared spectroscopy (FTIR), scanning electron microscope (SEM) and Energy dispersive X-ray (EDX) analysis confirmed the presence of chromium uptake by Staphylococcus aureus K1. Conclusion: The study revealed that Staphylococcus aureus K1 have the potential to bio-remediate chromium toxicity from wastewater. Gradually, this biological treatment becomes more important due to its advantage over physical and chemical methods to protect environment and human health.Keywords: wastewater, staphylococcus, chromium, bioremediation
Procedia PDF Downloads 169682 Testing Depression in Awareness Space: A Proposal to Evaluate Whether a Psychotherapeutic Method Based on Spatial Cognition and Imagination Therapy Cures Moderate Depression
Authors: Lucas Derks, Christine Beenhakker, Michiel Brandt, Gert Arts, Ruud van Langeveld
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Background: The method Depression in Awareness Space (DAS) is a psychotherapeutic intervention technique based on the principles of spatial cognition and imagination therapy with spatial components. The basic assumptions are: mental space is the primary organizing principle in the mind, and all psychological issues can be treated by first locating and by next relocating the conceptualizations involved. The most clinical experience was gathered over the last 20 years in the area of social issues (with the social panorama model). The latter work led to the conclusion that a mental object (image) gains emotional impact when it is placed more central, closer and higher in the visual field – and vice versa. Changing the locations of mental objects in space thus alters the (socio-) emotional meaning of the relationships. The experience of depression seems always associated with darkness. Psychologists tend to see the link between depression and darkness as a metaphor. However, clinical practice hints to the existence of more literal forms of darkness. Aims: The aim of the method Depression in Awareness Space is to reduce the distress of clients with depression in the clinical counseling practice, as a reliable alternative method of psychological therapy for the treatment of depression. The method Depression in Awareness Space aims at making dark areas smaller, lighter and more transparent in order to identify the problem or the cause of the depression which lies behind the darkness. It was hypothesized that the darkness is a subjective side-effect of the neurological process of repression. After reducing the dark clouds the real problem behind the depression becomes more visible, allowing the client to work on it and in that way reduce their feelings of depression. This makes repression of the issue obsolete. Results: Clients could easily get into their 'sadness' when asked to do so and finding the location of the dark zones proved pretty easy as well. In a recent pilot study with five participants with mild depressive symptoms (measured on two different scales and tested against an untreated control group with similar symptoms), the first results were also very promising. If the mental spatial approach to depression can be proven to be really effective, this would be very good news. The Society of Mental Space Psychology is now looking for sponsoring of an up scaled experiment. Conclusions: For spatial cognition and the research into spatial psychological phenomena, the discovery of dark areas can be a step forward. Beside out of pure scientific interest, it is great to know that this discovery has a clinical implication: when darkness can be connected to depression. Also, darkness seems to be more than metaphorical expression. Progress can be monitored over measurement tools that quantify the level of depressive symptoms and by reviewing the areas of darkness.Keywords: depression, spatial cognition, spatial imagery, social panorama
Procedia PDF Downloads 169681 Analyzing Concrete Structures by Using Laser Induced Breakdown Spectroscopy
Authors: Nina Sankat, Gerd Wilsch, Cassian Gottlieb, Steven Millar, Tobias Guenther
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Laser-Induced Breakdown Spectroscopy (LIBS) is a combination of laser ablation and optical emission spectroscopy, which in principle can simultaneously analyze all elements on the periodic table. Materials can be analyzed in terms of chemical composition in a two-dimensional, time efficient and minor destructive manner. These advantages predestine LIBS as a monitoring technique in the field of civil engineering. The decreasing service life of concrete infrastructures is a continuously growing problematic. A variety of intruding, harmful substances can damage the reinforcement or the concrete itself. To insure a sufficient service life a regular monitoring of the structure is necessary. LIBS offers many applications to accomplish a successful examination of the conditions of concrete structures. A selection of those applications are the 2D-evaluation of chlorine-, sodium- and sulfur-concentration, the identification of carbonation depths and the representation of the heterogeneity of concrete. LIBS obtains this information by using a pulsed laser with a short pulse length (some mJ), which is focused on the surfaces of the analyzed specimen, for this only an optical access is needed. Because of the high power density (some GW/cm²) a minimal amount of material is vaporized and transformed into a plasma. This plasma emits light depending on the chemical composition of the vaporized material. By analyzing the emitted light, information for every measurement point is gained. The chemical composition of the scanned area is visualized in a 2D-map with spatial resolutions up to 0.1 mm x 0.1 mm. Those 2D-maps can be converted into classic depth profiles, as typically seen for the results of chloride concentration provided by chemical analysis like potentiometric titration. However, the 2D-visualization offers many advantages like illustrating chlorine carrying cracks, direct imaging of the carbonation depth and in general allowing the separation of the aggregates from the cement paste. By calibrating the LIBS-System, not only qualitative but quantitative results can be obtained. Those quantitative results can also be based on the cement paste, while excluding the aggregates. An additional advantage of LIBS is its mobility. By using the mobile system, located at BAM, onsite measurements are feasible. The mobile LIBS-system was already used to obtain chloride, sodium and sulfur concentrations onsite of parking decks, bridges and sewage treatment plants even under hard conditions like ongoing construction work or rough weather. All those prospects make LIBS a promising method to secure the integrity of infrastructures in a sustainable manner.Keywords: concrete, damage assessment, harmful substances, LIBS
Procedia PDF Downloads 176