Search results for: the attenuation coefficient
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2410

Search results for: the attenuation coefficient

1660 [Keynote Talk]: Three Dimensional Finite Element Analysis of Functionally Graded Radiation Shielding Nanoengineered Sandwich Composites

Authors: Nasim Abuali Galehdari, Thomas J. Ryan, Ajit D. Kelkar

Abstract:

In recent years, nanotechnology has played an important role in the design of an efficient radiation shielding polymeric composites. It is well known that, high loading of nanomaterials with radiation absorption properties can enhance the radiation attenuation efficiency of shielding structures. However, due to difficulties in dispersion of nanomaterials into polymer matrices, there has been a limitation in higher loading percentages of nanoparticles in the polymer matrix. Therefore, the objective of the present work is to provide a methodology to fabricate and then to characterize the functionally graded radiation shielding structures, which can provide an efficient radiation absorption property along with good structural integrity. Sandwich structures composed of Ultra High Molecular Weight Polyethylene (UHMWPE) fabric as face sheets and functionally graded epoxy nanocomposite as core material were fabricated. A method to fabricate a functionally graded core panel with controllable gradient dispersion of nanoparticles is discussed. In order to optimize the design of functionally graded sandwich composites and to analyze the stress distribution throughout the sandwich composite thickness, a finite element method was used. The sandwich panels were discretized using 3-Dimensional 8 nodded brick elements. Classical laminate analysis in conjunction with simplified micromechanics equations were used to obtain the properties of the face sheets. The presented finite element model would provide insight into deformation and damage mechanics of the functionally graded sandwich composites from the structural point of view.

Keywords: nanotechnology, functionally graded material, radiation shielding, sandwich composites, finite element method

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1659 Analysis of Elastic-Plastic Deformation of Reinforced Concrete Shear-Wall Structures under Earthquake Excitations

Authors: Oleg Kabantsev, Karomatullo Umarov

Abstract:

The engineering analysis of earthquake consequences demonstrates a significantly different level of damage to load-bearing systems of different types. Buildings with reinforced concrete columns and separate shear-walls receive the highest level of damage. Traditional methods for predicting damage under earthquake excitations do not provide an answer to the question about the reasons for the increased vulnerability of reinforced concrete frames with shear-walls bearing systems. Thus, the study of the problem of formation and accumulation of damages in the structures reinforced concrete frame with shear-walls requires the use of new methods of assessment of the stress-strain state, as well as new approaches to the calculation of the distribution of forces and stresses in the load-bearing system based on account of various mechanisms of elastic-plastic deformation of reinforced concrete columns and walls. The results of research into the processes of non-linear deformation of structures with a transition to destruction (collapse) will allow to substantiate the characteristics of limit states of various structures forming an earthquake-resistant load-bearing system. The research of elastic-plastic deformation processes of reinforced concrete structures of frames with shear-walls is carried out on the basis of experimentally established parameters of limit deformations of concrete and reinforcement under dynamic excitations. Limit values of deformations are defined for conditions under which local damages of the maximum permissible level are formed in constructions. The research is performed by numerical methods using ETABS software. The research results indicate that under earthquake excitations, plastic deformations of various levels are formed in various groups of elements of the frame with the shear-wall load-bearing system. During the main period of seismic effects in the shear-wall elements of the load-bearing system, there are insignificant volumes of plastic deformations, which are significantly lower than the permissible level. At the same time, plastic deformations are formed in the columns and do not exceed the permissible value. At the final stage of seismic excitations in shear-walls, the level of plastic deformations reaches values corresponding to the plasticity coefficient of concrete , which is less than the maximum permissible value. Such volume of plastic deformations leads to an increase in general deformations of the bearing system. With the specified parameters of the deformation of the shear-walls in concrete columns, plastic deformations exceeding the limiting values develop, which leads to the collapse of such columns. Based on the results presented in this study, it can be concluded that the application seismic-force-reduction factor, common for the all load-bearing system, does not correspond to the real conditions of formation and accumulation of damages in elements of the load-bearing system. Using a single coefficient of seismic-force-reduction factor leads to errors in predicting the seismic resistance of reinforced concrete load-bearing systems. In order to provide the required level of seismic resistance buildings with reinforced concrete columns and separate shear-walls, it is necessary to use values of the coefficient of seismic-force-reduction factor differentiated by types of structural groups.1

Keywords: reinforced concrete structures, earthquake excitation, plasticity coefficients, seismic-force-reduction factor, nonlinear dynamic analysis

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1658 The K-Distance Neighborhood Polynomial of a Graph

Authors: Soner Nandappa D., Ahmed Mohammed Naji

Abstract:

In a graph G = (V, E), the distance from a vertex v to a vertex u is the length of shortest v to u path. The eccentricity e(v) of v is the distance to a farthest vertex from v. The diameter diam(G) is the maximum eccentricity. The k-distance neighborhood of v, for 0 ≤ k ≤ e(v), is Nk(v) = {u ϵ V (G) : d(v, u) = k}. In this paper, we introduce a new distance degree based topological polynomial of a graph G is called a k- distance neighborhood polynomial, denoted Nk(G, x). It is a polynomial with the coefficient of the term k, for 0 ≤ k ≤ e(v), is the sum of the cardinalities of Nk(v) for every v ϵ V (G). Some properties of k- distance neighborhood polynomials are obtained. Exact formulas of the k- distance neighborhood polynomial for some well-known graphs, Cartesian product and join of graphs are presented.

Keywords: vertex degrees, distance in graphs, graph operation, Nk-polynomials

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1657 Rainwater Harvesting and Management of Ground Water (Case Study Weather Modification Project in Iran)

Authors: Samaneh Poormohammadi, Farid Golkar, Vahideh Khatibi Sarabi

Abstract:

Climate change and consecutive droughts have increased the importance of using rainwater harvesting methods. One of the methods of rainwater harvesting and, in other words, the management of atmospheric water resources is the use of weather modification technologies. Weather modification (also known as weather control) is the act of intentionally manipulating or altering the weather. The most common form of weather modification is cloud seeding, which increases rain or snow, usually for the purpose of increasing the local water supply. Cloud seeding operations in Iran have been married since 1999 in central Iran with the aim of harvesting rainwater and reducing the effects of drought. In this research, we analyze the results of cloud seeding operations in the Simindashtplain in northern Iran. Rainwater harvesting with the help of cloud seeding technology has been evaluated through its effects on surface water and underground water. For this purpose, two different methods have been used to estimate runoff. The first method is the US Soil Conservation Service (SCS) curve number method. Another method, known as the reasoning method, has also been used. In order to determine the infiltration rate of underground water, the balance reports of the comprehensive water plan of the country have been used. In this regard, the study areas located in the target area of each province have been extracted by drawing maps of the influence coefficients of each area in the GIS software. It should be mentioned that the infiltration coefficients were taken from the balance sheet reports of the country's comprehensive water plan. Then, based on the area of each study area, the weighted average of the infiltration coefficient of the study areas located in the target area of each province is considered as the infiltration coefficient of that province. Results show that the amount of water extracted from the rain with the help of cloud seeding projects in Simindasht is as follows: an increase in runoff 63.9 million cubic meters (with SCS equation) or 51.2 million cubic meters (with logical equation) and an increase in ground water resources: 40.5 million cubic meters.

Keywords: rainwater harvesting, ground water, atmospheric water resources, weather modification, cloud seeding

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1656 Assessment of Hepatosteatosis Among Diabetic and Nondiabetic Patients Using Biochemical Parameters and Noninvasive Imaging Techniques

Authors: Tugba Sevinc Gamsiz, Emine Koroglu, Ozcan Keskin

Abstract:

Aim: Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the general population. The higher mortality and morbidity among NAFLD patients and lack of symptoms makes early detection and management important. In our study, we aimed to evaluate the relationship between noninvasive imaging and biochemical markers in diabetic and nondiabetic patients diagnosed with NAFLD. Materials and Methods: The study was conducted from (September 2017) to (December 2017) on adults admitted to Internal Medicine and Gastroenterology outpatient clinics with hepatic steatosis reported on ultrasound or transient elastography within the last six months that exclude patients with other liver diseases or alcohol abuse. The data were collected and analyzed retrospectively. Number cruncher statistical system (NCSS) 2007 program was used for statistical analysis. Results: 116 patients were included in this study. Diabetic patients compared to nondiabetics had significantly higher Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM) and fibrosis values. Also, hypertension, hepatomegaly, high BMI, hypertriglyceridemia, hyperglycemia, high A1c, and hyperuricemia were found to be risk factors for NAFLD progression to fibrosis. Advanced fibrosis (F3, F4) was present in 18,6 % of all our patients; 35,8 % of diabetic and 5,7 % of nondiabetic patients diagnosed with hepatic steatosis. Conclusion: Transient elastography is now used in daily clinical practice as an accurate noninvasive tool during follow-up of patients with fatty liver. Early diagnosis of the stage of liver fibrosis improves the monitoring and management of patients, especially in those with metabolic syndrome criteria.

Keywords: diabetes, elastography, fatty liver, fibrosis, metabolic syndrome

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1655 The Effect of Using Augmented Reality Technique in a Computer Course Unit on the Academic Achievement and Attitudes of High School Female Students

Authors: Maha A. Al-Hsayni

Abstract:

Title of the Study: The Effect of Using Augmented Reality Technique in a Computer Course Unit on the Academic Achievement and Attitudes of High School Female Students. This study aimed at identifying the effect of using the Augmented Reality technique on the academic achievement of computer course at the cognitive domains (Knowledge, comprehension and analysis) with third high school female students in Holy Makkah. The researcher used: The quasi-experimental approach. The sample of the study was comprised of (55) female students in the third high school level in Holy Makkah in the second semester of the academic year 1434/1435 H. These students were assigned to two groups: The experimental group of (28) students who were taught by using the Augmented Reality technology, and the control group of (27) students, who were taught by using the traditional method. The researcher prepared a set of tools and materials, which are represented in achievement test consisted of (30) clauses, direction instrument consisted of (25) clauses and the design of augmented reality for computer study unit. The study used the following statistical methods for data analysis: Cronbach's alpha coefficient, Pearson correlation coefficient, means, standard deviations, t-test and analysis of covariance test ANCOVA. The study reached the following results: 1- There are statistically significance difference at ( 0.05) among the adjusted means of the experimental and control groups in the posttest at the domains of (Knowledge, comprehension and analysis) of third high school graders after adjusting the pretest 2- There are statistically significance difference at ( 0.05) among the means of pre and post-test for female students of the experimental group in the scale of attitude towards using Augmented Reality Technique. In the light of the study results, the researcher recommends the followings: The necessity of using Augmented Reality Technique in teaching computer courses for high school students. Furthermore, emphasizing the need to provide schools with educational halls equipped with instruments and screens that enable teachers to use the Augmented Reality in teaching the other courses. Also, the researcher suggested conducting more studies in order to improve the process of teaching and learning.

Keywords: augmented reality technique, computer course unit, academic achievement, attitudes, high school female students

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1654 Effects of Subsidy Reform on Consumption and Income Inequalities in Iran

Authors: Pouneh Soleimaninejadian, Chengyu Yang

Abstract:

In this paper, we use data on Household Income and Expenditure survey of Statistics Centre of Iran, conducted from 2005-2014, to calculate several inequality measures and to estimate the effects of Iran’s targeted subsidy reform act on consumption and income inequality. We first calculate Gini coefficients for income and consumption in order to study the relation between the two and also the effects of subsidy reform. Results show that consumption inequality has not been always mirroring changes in income inequality. However, both Gini coefficients indicate that subsidy reform caused improvement in inequality. Then we calculate Generalized Entropy Index based on consumption and income for years before and after the Subsidy Reform Act of 2010 in order to have a closer look into the changes in internal structure of inequality after subsidy reforms. We find that the improvement in income inequality is mostly caused by the decrease in inequality of lower income individuals. At the same time consumption inequality has been decreased as a result of more equal consumption in both lower and higher income groups. Moreover, the increase in Engle coefficient after the subsidy reform shows that a bigger portion of income is allocated to consumption on food which is a sign of lower living standard in general. This increase in Engle coefficient is due to rise in inflation rate and relative increase in price of food which partially is another consequence of subsidy reform. We have conducted some experiments on effect of subsidy payments and possible effects of change on distribution pattern and amount of cash subsidy payments on income inequality. Result of the effect of cash payments on income inequality shows that it leads to a definite decrease in income inequality and had a bigger share in improvement of rural areas compared to those of urban households. We also examine the possible effect of constant payments on the increasing income inequality for years after 2011. We conclude that reduction in value of payments as a result of inflation plays an important role regardless of the fact that there may be other reasons. We finally experiment with alternative allocations of transfers while keeping the total amount of cash transfers constant or make it smaller through eliminating three higher deciles from the cash payment program, the result shows that income equality would be improved significantly.

Keywords: consumption inequality, generalized entropy index, income inequality, Irans subsidy reform

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1653 Algorithms Inspired from Human Behavior Applied to Optimization of a Complex Process

Authors: S. Curteanu, F. Leon, M. Gavrilescu, S. A. Floria

Abstract:

Optimization algorithms inspired from human behavior were applied in this approach, associated with neural networks models. The algorithms belong to human behaviors of learning and cooperation and human competitive behavior classes. For the first class, the main strategies include: random learning, individual learning, and social learning, and the selected algorithms are: simplified human learning optimization (SHLO), social learning optimization (SLO), and teaching-learning based optimization (TLBO). For the second class, the concept of learning is associated with competitiveness, and the selected algorithms are sports-inspired algorithms (with Football Game Algorithm, FGA and Volleyball Premier League, VPL) and Imperialist Competitive Algorithm (ICA). A real process, the synthesis of polyacrylamide-based multicomponent hydrogels, where some parameters are difficult to obtain experimentally, is considered as a case study. Reaction yield and swelling degree are predicted as a function of reaction conditions (acrylamide concentration, initiator concentration, crosslinking agent concentration, temperature, reaction time, and amount of inclusion polymer, which could be starch, poly(vinyl alcohol) or gelatin). The experimental results contain 175 data. Artificial neural networks are obtained in optimal form with biologically inspired algorithm; the optimization being perform at two level: structural and parametric. Feedforward neural networks with one or two hidden layers and no more than 25 neurons in intermediate layers were obtained with values of correlation coefficient in the validation phase over 0.90. The best results were obtained with TLBO algorithm, correlation coefficient being 0.94 for an MLP(6:9:20:2) – a feedforward neural network with two hidden layers and 9 and 20, respectively, intermediate neurons. Good results obtained prove the efficiency of the optimization algorithms. More than the good results, what is important in this approach is the simulation methodology, including neural networks and optimization biologically inspired algorithms, which provide satisfactory results. In addition, the methodology developed in this approach is general and has flexibility so that it can be easily adapted to other processes in association with different types of models.

Keywords: artificial neural networks, human behaviors of learning and cooperation, human competitive behavior, optimization algorithms

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1652 Computational Feasibility Study of a Torsional Wave Transducer for Tissue Stiffness Monitoring

Authors: Rafael Muñoz, Juan Melchor, Alicia Valera, Laura Peralta, Guillermo Rus

Abstract:

A torsional piezoelectric ultrasonic transducer design is proposed to measure shear moduli in soft tissue with direct access availability, using shear wave elastography technique. The measurement of shear moduli of tissues is a challenging problem, mainly derived from a) the difficulty of isolating a pure shear wave, given the interference of multiple waves of different types (P, S, even guided) emitted by the transducers and reflected in geometric boundaries, and b) the highly attenuating nature of soft tissular materials. An immediate application, overcoming these drawbacks, is the measurement of changes in cervix stiffness to estimate the gestational age at delivery. The design has been optimized using a finite element model (FEM) and a semi-analytical estimator of the probability of detection (POD) to determine a suitable geometry, materials and generated waves. The technique is based on the time of flight measurement between emitter and receiver, to infer shear wave velocity. Current research is centered in prototype testing and validation. The geometric optimization of the transducer was able to annihilate the compressional wave emission, generating a quite pure shear torsional wave. Currently, mechanical and electromagnetic coupling between emitter and receiver signals are being the research focus. Conclusions: the design overcomes the main described problems. The almost pure shear torsional wave along with the short time of flight avoids the possibility of multiple wave interference. This short propagation distance reduce the effect of attenuation, and allow the emission of very low energies assuring a good biological security for human use.

Keywords: cervix ripening, preterm birth, shear modulus, shear wave elastography, soft tissue, torsional wave

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1651 Comparison of On-Site Stormwater Detention Real Performance and Theoretical Simulations

Authors: Pedro P. Drumond, Priscilla M. Moura, Marcia M. L. P. Coelho

Abstract:

The purpose of On-site Stormwater Detention (OSD) system is to promote the detention of addition stormwater runoff caused by impervious areas, in order to maintain the peak flow the same as the pre-urbanization condition. In recent decades, these systems have been built in many cities around the world. However, its real efficiency continues to be unknown due to the lack of research, especially with regard to monitoring its real performance. Thus, this study aims to compare the water level monitoring data of an OSD built in Belo Horizonte/Brazil with the results of theoretical methods simulations, usually adopted in OSD design. There were made two theoretical simulations, one using the Rational Method and Modified Puls method and another using the Soil Conservation Service (SCS) method and Modified Puls method. The monitoring data were obtained with a water level sensor, installed inside the reservoir and connected to a data logger. The comparison of OSD performance was made for 48 rainfall events recorded from April/2015 to March/2017. The comparison of maximum water levels in the OSD showed that the results of the simulations with Rational/Puls and SCS/Puls methods were, on average 33% and 73%, respectively, lower than those monitored. The Rational/Puls results were significantly higher than the SCS/Puls results, only in the events with greater frequency. In the events with average recurrence interval of 5, 10 and 200 years, the maximum water heights were similar in both simulations. Also, the results showed that the duration of rainfall events was close to the duration of monitored hydrograph. The rising time and recession time of the hydrographs calculated with the Rational Method represented better the monitored hydrograph than SCS Method. The comparison indicates that the real discharge coefficient value could be higher than 0.61, adopted in Puls simulations. New researches evaluating OSD real performance should be developed. In order to verify the peak flow damping efficiency and the value of the discharge coefficient is necessary to monitor the inflow and outflow of an OSD, in addition to monitor the water level inside it.

Keywords: best management practices, on-site stormwater detention, source control, urban drainage

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1650 Spirituality and Happiness among Youth: A Correlative Study

Authors: Harsh Shah

Abstract:

Spirituality and happiness are two very important aspects of human life. After defining happiness, an attempt has been made in this paper to review research on the relationship between happiness and spirituality, and then to experimentally study their correlation among students aged between 18-24 years. The relation was assessed in 200 students from IIT Kharagpur, who rated their own spirituality, and happiness using the Daily Spiritual Experience Scale (DSES) developed by Underwood, and the Subjective Happiness Scale (SHS) developed by Lyubomirsky and Lepper, respectively. Students who were more spiritual in general, were happier as well, and the Pearson Correlation Coefficient method gave a high positive correlation between happiness and spirituality.

Keywords: happiness, spirituality, youth, correlation, depression, religion

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1649 An Intelligent Text Independent Speaker Identification Using VQ-GMM Model Based Multiple Classifier System

Authors: Ben Soltane Cheima, Ittansa Yonas Kelbesa

Abstract:

Speaker Identification (SI) is the task of establishing identity of an individual based on his/her voice characteristics. The SI task is typically achieved by two-stage signal processing: training and testing. The training process calculates speaker specific feature parameters from the speech and generates speaker models accordingly. In the testing phase, speech samples from unknown speakers are compared with the models and classified. Even though performance of speaker identification systems has improved due to recent advances in speech processing techniques, there is still need of improvement. In this paper, a Closed-Set Tex-Independent Speaker Identification System (CISI) based on a Multiple Classifier System (MCS) is proposed, using Mel Frequency Cepstrum Coefficient (MFCC) as feature extraction and suitable combination of vector quantization (VQ) and Gaussian Mixture Model (GMM) together with Expectation Maximization algorithm (EM) for speaker modeling. The use of Voice Activity Detector (VAD) with a hybrid approach based on Short Time Energy (STE) and Statistical Modeling of Background Noise in the pre-processing step of the feature extraction yields a better and more robust automatic speaker identification system. Also investigation of Linde-Buzo-Gray (LBG) clustering algorithm for initialization of GMM, for estimating the underlying parameters, in the EM step improved the convergence rate and systems performance. It also uses relative index as confidence measures in case of contradiction in identification process by GMM and VQ as well. Simulation results carried out on voxforge.org speech database using MATLAB highlight the efficacy of the proposed method compared to earlier work.

Keywords: feature extraction, speaker modeling, feature matching, Mel frequency cepstrum coefficient (MFCC), Gaussian mixture model (GMM), vector quantization (VQ), Linde-Buzo-Gray (LBG), expectation maximization (EM), pre-processing, voice activity detection (VAD), short time energy (STE), background noise statistical modeling, closed-set tex-independent speaker identification system (CISI)

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1648 Yield Level, Variability and Yield Gap of Maize (Zea Mays L.) Under Variable Climate Condition of the Semi-arid Central Rift Valley of Ethiopia

Authors: Fitih Ademe, Kibebew Kibret, Sheleme Beyene, Mezgebu Getnet, Gashaw Meteke

Abstract:

Soil moisture and nutrient availability are the two key edaphic factors that affect crop yields and are directly or indirectly affected by climate variability and change. The study examined climate-induced yield level, yield variability and gap of maize during 1981-2010 main growing season in the Central Rift Valley (CRV) of Ethiopia. Pearson correlation test was employed to see the relationship between climate variables and yield. The coefficient of variation (CV) was used to analyze annual yield variability. Decision Support System for Agro-technology Transfer cropping system model (DSSAT-CSM) was used to simulate the growth and yield of maize for the study period. The result indicated that maize grain yield was strongly (P<0.01) and positively correlated with seasonal rainfall (r=0.67 at Melkassa and r = 0.69 at Ziway) in the CRV while day temperature affected grain yield negatively (r= -0.44) at Ziway (P<0.05) during the simulation period. Variations in total seasonal rainfall at Melkassa and Ziway explained 44.9 and 48.5% of the variation in yield, respectively, under optimum nutrition. Following variation in rainfall, high yield variability (CV=23.5%, Melkassa and CV=25.3%, Ziway) was observed for optimum nutrient simulation than the corresponding nutrient limited simulation (CV=16%, Melkassa and 24.1%, Ziway) in the study period. The observed farmers’ yield was 72, 52 and 43% of the researcher-managed, water-limited and potential yield of the crop, respectively, indicating a wide maize yield gap in the region. The study revealed rainfed crop production in the CRV is prone to yield variabilities due to its high dependence on seasonal rainfall and nutrient level. Moreover, the high coefficient of variation in the yield gap for the 30-year period also foretells the need for dependable water supply at both locations. Given the wide yield gap especially during lower rainfall years across the simulation periods, it signifies the requirement for a more dependable application of irrigation water and a potential shift to irrigated agriculture; hence, adopting options that can improve water availability and nutrient use efficiency would be crucial for crop production in the area.

Keywords: climate variability, crop model, water availability, yield gap, yield variability

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1647 Foot Self-Monitoring Knowledge, Attitude, Practice, and Related Factors among Diabetic Patients: A Descriptive and Correlational Study in a Taiwan Teaching Hospital

Authors: Li-Ching Lin, Yu-Tzu Dai

Abstract:

Recurrent foot ulcers or foot amputation have a major impact on patients with diabetes mellitus (DM), medical professionals, and society. A critical procedure for foot care is foot self-monitoring. Medical professionals’ understanding of patients’ foot self-monitoring knowledge, attitude, and practice is beneficial for raising patients’ disease awareness. This study investigated these and related factors among patients with DM through a descriptive study of the correlations. A scale for measuring the foot self-monitoring knowledge, attitude, and practice of patients with DM was used. Purposive sampling was adopted, and 100 samples were collected from the respondents’ self-reports or from interviews. The statistical methods employed were an independent-sample t-test, one-way analysis of variance, Pearson correlation coefficient, and multivariate regression analysis. The findings were as follows: the respondents scored an average of 12.97 on foot self-monitoring knowledge, and the correct answer rate was 68.26%. The respondents performed relatively lower in foot health screenings and recording, and awareness of neuropathy in the foot. The respondents held a positive attitude toward self-monitoring their feet and a negative attitude toward having others check the soles of their feet. The respondents scored an average of 12.64 on foot self-monitoring practice. Their scores were lower in their frequency of self-monitoring their feet, recording their self-monitoring results, checking their pedal pulse, and examining if their soles were red immediately after taking off their shoes. Significant positive correlations were observed among foot self-monitoring knowledge, attitude, and practice. The correlation coefficient between self-monitoring knowledge and self-monitoring practice was 0.20, and that between self-monitoring attitude and self-monitoring practice was 0.44. Stepwise regression analysis revealed that the main predictive factors of the foot self-monitoring practice in patients with DM were foot self-monitoring attitude, prior experience in foot care, and an educational attainment of college or higher. These factors predicted 33% of the variance. This study concludes that patients with DM lacked foot self-monitoring practice and advises that the patients’ self-monitoring abilities be evaluated first, including whether patients have poor eyesight, difficulties in bending forward due to obesity, and people who can assist them in self-monitoring. In addition, patient education should emphasize self-monitoring knowledge and practice, such as perceptions regarding the symptoms of foot neurovascular lesions, pulse monitoring methods, and new foot self-monitoring equipment. By doing so, new or recurring ulcers may be discovered in their early stages.

Keywords: diabetic foot, foot self-monitoring attitude, foot self-monitoring knowledge, foot self-monitoring practice

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1646 Nitrate-Induced Biochemical and Histopathological Changes in the Kidney of Rats: Attenuation by Hyparrhenia hirta

Authors: Hanen Bouaziz, Moez Rafrafi, Ghada Ben Salah, Kamel Jamoussi, Tahia Boudawara, Najiba Zeghal

Abstract:

The present study investigated the protective role of Hyparrhenia hirta against sodium nitrate (NaNO3)-induced nephrotoxicity. A high-performance liquid chromatography coupled with a mass spectrometer (HPLC-MS) method was developed to separate and identify flavonoids in Hyparrhenia hirta. Seven flavonoids were identified as 3-O-methylquercetin, luteolin-7-O-glucoside, luteolin, apigenin-7-O-glucoside, apigenin-8-C-glucoside, luteolin-8-C-glucoside and luteolin-6-C-glucoside. Wistar rats were randomly divided into three groups: a control group and two treated groups during 50 days with NaNO3 administered either alone in drinking water or co-administered with Hyparrhenia hirta. NaNO3 treatment induced a significant increase in plasma levels of creatinine, urea and uric while urinary level decreased significantly. Nephrotoxicity induced by NaNO3 was characterized by significant increase in creatinine clearance. In parallel, a significant increase in malondialdehyde level along with a concomitant decrease in total glutathione content and superoxide dismutase, catalase and glutathione peroxidase activities were observed in the kidney after NaNO3 treatment. The histopathological changes in kidney after NaNO3 administration were shrunken. There were renal tubule cell degeneration and infiltration of mononuclear cells. Most glomeruli revealed shrinkage, a wide capsular space and a peri-glomerular mononuclear cells infiltration. Hyparrhenia hirta supplementation showed a remarkable amelioration of the abnormalities cited above. The results concluded that the treatment with Hyparrhenia hirta had a significant role in protecting the animals from nitrate-induced kidney dysfunction.

Keywords: flavonoids, hyparrhenia hirta, kidney, nitrate toxicity, oxidative stress, rat

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1645 Selected Technological Factors Influencing the Modulus of Elasticity of Concrete

Authors: Klara Krizova, Rudolf Hela

Abstract:

The topic of the article focuses on the evaluation of selected technological factors and their influence on resulting elasticity modulus of concrete. A series of various factors enter into the manufacturing process which, more or less, influences the elasticity modulus. This paper presents the results of concrete in which the influence of water coefficient and the size of maximum fraction of the aggregate on the static elasticity modulus were monitored. Part of selected results of the long-term programme was discussed in which a wide scope of various variants of proposals for the composition of concretes was evaluated.

Keywords: mix design, water-cement ratio, aggregate, modulus of elasticity

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1644 Pretherapy Initial Dosimetry Results in Prostat Cancer Radionuclide Therapy with Lu-177-PSMA-DOTA-617

Authors: M. Abuqebitah, H. Tanyildizi, N. Yeyin, I. Cavdar, M. Demir, L. Kabasakal

Abstract:

Aim: Targeted radionuclide therapy (TRT) is an increasingly used treatment modality for wide range of cancers. Presently dosimetry is highly required either to plan treatment or to ascertain the absorbed dose delivered to critical organs during treatment. Methods and Materials: The study comprised 7 patients suffered from prostate cancer with progressive disease and candidate to undergo Lu-177-DOTA-617 therapy following to PSMA- PET/CT imaging for all patients. (5.2±0.3 mCi) was intravenously injected. To evaluate bone marrow absorbed dose 2 cc blood samples were withdrawn in short variable times (3, 15, 30, 60, 180 minutes) after injection. Furthermore, whole body scans were performed using scintillation gama camera in 4, 24, 48, and 120 hours after injection and in order to quantify the activity taken up in the body, kidneys , liver, right parotid, and left parotid the geometric mean of anterior and posterior counts were determined through ROI analysis, after that background subtraction and attenuation correction were applied using patients PSMA- PET/CT images taking in a consideration: organ thickness, body thickness, and Hounsfield unites from CT scan. OLINDA/EXM dosimetry program was used for curve fitting, residence time calculation, and absorbed dose calculations. Findings: Absorbed doses of bone marrow, left kidney, right kidney, liver, left parotid, right parotid, total body were 1.28±0.52, 32.36±16.36, 32.7±13.68, 10.35±3.45, 38.67±21.29, 37.55±19.77, 2.25±0.95 (mGy/mCi), respectively. Conclusion: Our first results clarify that Lu-177-DOTA-617 is safe and reliable therapy as there were no complications seen. In the other hand, the observable variation in the absorbed dose of the critical organs among the patients necessitate patient-specific dosimetry approach to save body organs and particularly highly exposed kidneys and parotid gland.

Keywords: Lu-177-PSMA, prostate cancer, radionuclide therapy

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1643 Capability of Intelligent Techniques for Friction Factor Simulation in Water Channels

Authors: Kiyoumars Roushangar, Shabnam Mirheidarian

Abstract:

This study proposes metamodel approaches as a new intelligent technique for the explicit formulation of friction factors of water conveyance structures. For this purpose, experimental data of a movable bed flume with dune bed form were used. Analyzing the result clears the high capability of metamodel approaches (MNE= 0.05, R= 0.92) as a powerful tool for optimizing and explicit simulation of Manning's roughness coefficients of water conveyance structures compared to other nonlinear approaches.

Keywords: intelligent techniques, explicit simulation, roughness coefficient, water conveyance structure

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1642 Synthesis, Characterization, and Application of Some Acid Dyes Derived from 1-Amino-4 Bromo-Anthraquine-2-Sulphonic Acid

Authors: Nuradeen Abdullahi Nadabo, Kasali Adewale Bello, Istifanus Chindo, Nurudeen Ayeni

Abstract:

Ten acid dyes were synthesized from 1-amino-4-bromo anthraghinone-2 sulphuric acid by condensation with different substituted amilines. These dyes were characterized by IR Spectroscopy and the results revealed an incorporation of various substituents. Application of these dyes were carried out on Nylon and wool fabrics using standard procedure melting point, percentage yield, molar extinction coefficient, wash, light and staining of adjacent fibre, of these dyes were also evaluated and the results obtained are within a reasonable range acceptable for commercial dyes.

Keywords: acid dyes, dyeing, exhaustion, extinction co-efficient

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1641 The Effects of Damping Devices on Displacements, Velocities and Accelerations of Structures

Authors: Radhwane Boudjelthia

Abstract:

The most recent earthquakes occurred in the world have killed thousands of people and severe damage. For all the actors involved in the building process, the earthquake is the litmus test for construction. The goal we set ourselves is to contribute to the implementation of a thoughtful approach to the seismic protection of structures. For many engineers, the most conventional approach to protection works (buildings and bridges) the effects of earthquakes is to increase rigidity. This approach is not always effective, especially when there is a context that favors the phenomenon of resonance and amplification of seismic forces. Therefore, the field of earthquake engineering has made significant inroads, among others catalyzed by the development of computational techniques in computer form and the use of powerful test facilities. This has led to the emergence of several innovative technologies, such as the introduction of special devices insulation between infrastructure and superstructure. This approach, commonly known as "seismic isolation," to absorb the significant efforts without the structure is damaged and thus ensuring the protection of lives and property. In addition, the restraints to the construction by the ground shaking are located mainly at the supports. With these moves, the natural period of construction is increasing, and seismic loads are reduced. Thus, there is an attenuation of the seismic movement. Likewise, the insulation of the base mechanism may be used in combination with earthquake dampers in order to control the deformation of the insulation system and the absolute displacement of the superstructure located above the isolation interface. On the other hand, only can use these earthquake dampers to reduce the oscillation amplitudes and thus reduce seismic loads. The use of damping devices represents an effective solution for the rehabilitation of existing structures. Given all these acceleration reducing means considered passive, much research has been conducted for several years to develop an active control system of the response of buildings to earthquakes.

Keywords: earthquake, building, seismic forces, displacement, resonance, response.

Procedia PDF Downloads 69
1640 A Regression Model for Predicting Sugar Crystal Size in a Fed-Batch Vacuum Evaporative Crystallizer

Authors: Sunday B. Alabi, Edikan P. Felix, Aniediong M. Umo

Abstract:

Crystal size distribution is of great importance in the sugar factories. It determines the market value of granulated sugar and also influences the cost of production of sugar crystals. Typically, sugar is produced using fed-batch vacuum evaporative crystallizer. The crystallization quality is examined by crystal size distribution at the end of the process which is quantified by two parameters: the average crystal size of the distribution in the mean aperture (MA) and the width of the distribution of the coefficient of variation (CV). Lack of real-time measurement of the sugar crystal size hinders its feedback control and eventual optimisation of the crystallization process. An attractive alternative is to use a soft sensor (model-based method) for online estimation of the sugar crystal size. Unfortunately, the available models for sugar crystallization process are not suitable as they do not contain variables that can be measured easily online. The main contribution of this paper is the development of a regression model for estimating the sugar crystal size as a function of input variables which are easy to measure online. This has the potential to provide real-time estimates of crystal size for its effective feedback control. Using 7 input variables namely: initial crystal size (Lo), temperature (T), vacuum pressure (P), feed flowrate (Ff), steam flowrate (Fs), initial super-saturation (S0) and crystallization time (t), preliminary studies were carried out using Minitab 14 statistical software. Based on the existing sugar crystallizer models, and the typical ranges of these 7 input variables, 128 datasets were obtained from a 2-level factorial experimental design. These datasets were used to obtain a simple but online-implementable 6-input crystal size model. It seems the initial crystal size (Lₒ) does not play a significant role. The goodness of the resulting regression model was evaluated. The coefficient of determination, R² was obtained as 0.994, and the maximum absolute relative error (MARE) was obtained as 4.6%. The high R² (~1.0) and the reasonably low MARE values are an indication that the model is able to predict sugar crystal size accurately as a function of the 6 easy-to-measure online variables. Thus, the model can be used as a soft sensor to provide real-time estimates of sugar crystal size during sugar crystallization process in a fed-batch vacuum evaporative crystallizer.

Keywords: crystal size, regression model, soft sensor, sugar, vacuum evaporative crystallizer

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1639 Performance Evaluation of Lithium Bromide Absorption Chiller

Authors: Z. Neffah, L. Merabti, N. Hatraf

Abstract:

Absorption refrigeration technology has been used for cooling purposes over a hundred years. Today, the technology developments have made of the absorption refrigeration an economic and effective alternative to the vapour compression cooling cycle. A parametric study was conducted over the entire admissible ranges of the generator and absorber temperatures. On the other hand, simultaneously raising absorber temperatures was seen to result in deterioration of coefficient of performance. The influence of generator, absorber temperatures, as well as solution concentration on the different performance indicators was also calculated and examined.

Keywords: absorption system, Aqueous solution, chiller, water-lithium bromide

Procedia PDF Downloads 302
1638 Model Organic Ranikin Cycle Power Plant for Waste Heat Recovery in Olkaria-I Geothermal Power Plant

Authors: Haile Araya Nigusse, Hiram M. Ndiritu, Robert Kiplimo

Abstract:

Energy consumption is an indispensable component for the continued development of the human population. The global energy demand increases with development and population rise. The increase in energy demand, high cost of fossil fuels and the link between energy utilization and environmental impacts have resulted in the need for a sustainable approach to the utilization of the low grade energy resources. The Organic Rankine Cycle (ORC) power plant is an advantageous technology that can be applied in generation of power from low temperature brine of geothermal reservoirs. The power plant utilizes a low boiling organic working fluid such as a refrigerant or a hydrocarbon. Researches indicated that the performance of ORC power plant is highly dependent upon factors such as proper organic working fluid selection, types of heat exchangers (condenser and evaporator) and turbine used. Despite a high pressure drop, shell-tube heat exchangers have satisfactory performance for ORC power plants. This study involved the design, fabrication and performance assessment of the components of a model Organic Rankine Cycle power plant to utilize the low grade geothermal brine. Two shell and tube heat exchangers (evaporator and condenser) and a single stage impulse turbine have been designed, fabricated and the performance assessment of each component has been conducted. Pentane was used as a working fluid and hot water simulating the geothermal brine. The results of the experiment indicated that the increase in mass flow rate of hot water by 0.08 kg/s caused a rise in overall heat transfer coefficient of the evaporator by 17.33% and the heat transferred was increased by 6.74%. In the condenser, the increase of cooling water flow rate from 0.15 kg/s to 0.35 kg/s increased the overall heat transfer coefficient by 1.21% and heat transferred was increased by 4.26%. The shaft speed varied from 1585 to 4590 rpm as inlet pressure was varied from 0.5 to 5.0 bar and power generated was varying from 4.34 to 14.46W. The results of the experiments indicated that the performance of each component of the model Organic Rankine Cycle power plant operating at low temperature heat resources was satisfactory.

Keywords: brine, heat exchanger, ORC, turbine

Procedia PDF Downloads 649
1637 Numerical Response of Coaxial HPGe Detector for Skull and Knee Measurement

Authors: Pabitra Sahu, M. Manohari, S. Priyadharshini, R. Santhanam, S. Chandrasekaran, B. Venkatraman

Abstract:

Radiation workers of reprocessing plants have a potential for internal exposure due to actinides and fission products. Radionuclides like Americium, lead, Polonium and Europium are bone seekers and get accumulated in the skeletal part. As the major skeletal content is in the skull (13%) and knee (22%), measurements of old intake have to be carried out in the skull and knee. At the Indira Gandhi Centre for Atomic Research, a twin HPGe-based actinide monitor is used for the measurement of actinides present in bone. Efficiency estimation, which is one of the prerequisites for the quantification of radionuclides, requires anthropomorphic phantoms. Such phantoms are very limited. Hence, in this study, efficiency curves for a Twin HPGe-based actinide monitoring system are established theoretically using the FLUKA Monte Carlo method and ICRP adult male voxel phantom. In the case of skull measurement, the detector is placed over the forehead, and for knee measurement, one detector is placed over each knee. The efficiency values of radionuclides present in the knee and skull vary from 3.72E-04 to 4.19E-04 CPS/photon and 5.22E-04 to 7.07E-04 CPS/photon, respectively, for the energy range 17 to 3000keV. The efficiency curves for the measurement are established, and it is found that initially, the efficiency value increases up to 100 keV and then starts decreasing. It is found that the skull efficiency values are 4% to 63% higher than that of the knee, depending on the energy for all the energies except 17.74 keV. The reason is the closeness of the detector to the skull compared to the knee. But for 17.74 keV the efficiency of the knee is more than the skull due to the higher attenuation caused in the skull bones because of its greater thickness. The Minimum Detectable Activity (MDA) for 241Am present in the skull and knee is 9 Bq. 239Pu has a MDA of 950 Bq and 1270 Bq for knee and skull, respectively, for a counting time of 1800 sec. This paper discusses the simulation method and the results obtained in the study.

Keywords: FLUKA Monte Carlo Method, ICRP adult male voxel phantom, knee, Skull.

Procedia PDF Downloads 51
1636 An Experimental Study of Diffuser-Enhanced Propeller Hydrokinetic Turbines

Authors: Matheus Nunes, Rafael Mendes, Taygoara Felamingo Oliveira, Antonio Brasil Junior

Abstract:

Wind tunnel experiments of horizontal axis propeller hydrokinetic turbines model were carried out, in order to determine the performance behavior for different configurations and operational range. The present experiments introduce the use of two different geometries of rear diffusers to enhance the performance of the free flow machine. The present paper reports an increase of the power coefficient about 50%-80%. It represents an important feature that has to be taken into account in the design of this kind of machine.

Keywords: diffuser-enhanced turbines, hydrokinetic turbine, wind tunnel experiments, micro hydro

Procedia PDF Downloads 278
1635 Wear Resistance in Dry and Lubricated Conditions of Hard-anodized EN AW-4006 Aluminum Alloy

Authors: C. Soffritti, A. Fortini, E. Baroni, M. Merlin, G. L. Garagnani

Abstract:

Aluminum alloys are widely used in many engineering applications due to their advantages such ashigh electrical and thermal conductivities, low density, high strength to weight ratio, and good corrosion resistance. However, their low hardness and poor tribological properties still limit their use in industrial fields requiring sliding contacts. Hard anodizing is one of the most common solution for overcoming issues concerning the insufficient friction resistance of aluminum alloys. In this work, the tribological behavior ofhard-anodized AW-4006 aluminum alloys in dry and lubricated conditions was evaluated. Three different hard-anodizing treatments were selected: a conventional one (HA) and two innovative golden hard-anodizing treatments (named G and GP, respectively), which involve the sealing of the porosity of anodic aluminum oxides (AAO) with silver ions at different temperatures. Before wear tests, all AAO layers were characterized by scanning electron microscopy (VPSEM/EDS), X-ray diffractometry, roughness (Ra and Rz), microhardness (HV0.01), nanoindentation, and scratch tests. Wear tests were carried out according to the ASTM G99-17 standard using a ball-on-disc tribometer. The tests were performed in triplicate under a 2 Hz constant frequency oscillatory motion, a maximum linear speed of 0.1 m/s, normal loads of 5, 10, and 15 N, and a sliding distance of 200 m. A 100Cr6 steel ball10 mm in diameter was used as counterpart material. All tests were conducted at room temperature, in dry and lubricated conditions. Considering the more recent regulations about the environmental hazard, four bio-lubricants were considered after assessing their chemical composition (in terms of Unsaturation Number, UN) and viscosity: olive, peanut, sunflower, and soybean oils. The friction coefficient was provided by the equipment. The wear rate of anodized surfaces was evaluated by measuring the cross-section area of the wear track with a non-contact 3D profilometer. Each area value, obtained as an average of four measurements of cross-section areas along the track, was used to determine the wear volume. The worn surfaces were analyzed by VPSEM/EDS. Finally, in agreement with DoE methodology, a statistical analysis was carried out to identify the most influencing factors on the friction coefficients and wear rates. In all conditions, results show that the friction coefficient increased with raising the normal load. Considering the wear tests in dry sliding conditions, irrespective of the type of anodizing treatments, metal transfer between the mating materials was observed over the anodic aluminum oxides. During sliding at higher loads, the detachment of the metallic film also caused the delamination of some regions of the wear track. For the wear tests in lubricated conditions, the natural oils with high percentages of oleic acid (i.e., olive and peanut oils) maintained high friction coefficients and low wear rates. Irrespective of the type of oil, smallmicrocraks were visible over the AAO layers. Based on the statistical analysis, the type of anodizing treatment and magnitude of applied load were the main factors of influence on the friction coefficient and wear rate values. Nevertheless, an interaction between bio-lubricants and load magnitude could occur during the tests.

Keywords: hard anodizing treatment, silver ions, bio-lubricants, sliding wear, statistical analysis

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1634 Dielectric Properties of La2MoO6 Ceramics at Microwave Frequency

Authors: Yih-Chien Chen, Yu-Cheng You

Abstract:

The microwave dielectric properties of La2MoO6 ceramics were investigated with a view to their application in mobile communication. La2MoO6 ceramics were prepared by the conventional solid-state method with various sintering conditions. The X-ray diffraction peaks of La2MoO6 ceramic did not vary significantly with sintering conditions. The average grain size of La2MoO6 ceramics increased as the temperature and time of sintering increased. A maximum density of 5.67 g/cm3, a dielectric constants (εr) of 14.1, a quality factor (Q×f) of 68,000 GHz, and a temperature coefficient of resonant frequency (τf) of -56 ppm/℃ were obtained when La2MoO6 ceramics that were sintered at 1300 ℃ for 4h.

Keywords: ceramics, sintering, microwave dielectric properties, La2MoO6

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1633 Influence of UV Aging on the Mechanical Properties of Polycarbonate

Authors: S. Redjala, N. Ait Hocine, M. Gratton, N. Poirot, R. Ferhoum, S. Azem

Abstract:

Polycarbonate (PC) is a promising polymer with high transparency in the range of the visible spectrum and is used in various fields, for example medical, electronic, automotive. Its low weight, chemical inertia, high impact resistance and relatively low cost are of major importance. In recent decades, some materials such as metals and ceramics have been replaced by polymers because of their superior advantages. However, some characteristics of the polymers are highly modified under the effect of ultraviolet (UV) radiation and temperature. The changes induced in the material by such aging depend on the exposure time, the wavelength of the UV radiation and the temperature level. The UV energy is sufficient to break the chemical bonds leading to a cleavage of the molecular chains. This causes changes in the mechanical, thermal, optical and morphological properties of the material. The present work is focused on the study of the effects of aging under ultraviolet (UV) radiation and under different temperature values on the physical-chemical and mechanical properties of a PC. Thus, various investigations, such as FTIR and XRD analyses, SEM and optical microscopy observations, micro-hardness measurements and monotonic and cyclic tensile tests, were carried out on the PC in the initial state and after aging. Results have shown the impact of aging on the properties of the PC studied. In fact, the MEB highlighted changes in the superficial morphology of the material by the presence of cracks and material de-bonding in the form of debris. The FTIR spectra reveal an attenuation of the peaks like the hydroxyl (OH) groups located at 3520 cm-1. The XRD lines shift towards a larger angle, reaching a maximum of 3°. In addition, Vickers micro-hardness measurements show that aging affects the surface and the core of the material, which results in different mechanical behaviours under monotonic and cyclic tensile tests. This study pointed out effects of aging on the macroscopic properties of the PC studied, in relationship with its microstructural changes.

Keywords: mechanical properties, physical-chemical properties, polycarbonate, UV aging, temperature aging

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1632 Determinants of Stone Free Status After a Single Session of Flexible Ureteroscopy with Laser Lithotripsy for Renal Calculi

Authors: Mohamed Elkoushy, Sameer Munshi, Waseem Tayeb

Abstract:

Background: Flexible ureteroscopy (fURS) has dramatically improved the minimally invasive management of complex nephrolithiasis. fUR is increasingly being used as the first-line treatment for patients with renal stones. Stone-free status (SFS) is the primary goal in the management of patients with urolithiasis. However, substantial variations exist in the reported SFS following fURS. Objectives: This study determines the predictors of SFS after a single session of fURS with holmium laser lithotripsy (HLL) for renal calculi. Methods: A retrospective review of prospectively collected data was performed for all consecutive patients undergoing fURS and HLL for renal calculi at a tertiary care center. Patients with previous ipsilateral URS for the same stones were excluded. All patients underwent JJ ureteral stent insertion at the end of the procedure. SFS was defined as the presence of no residuals or ≤4-mm non-obstructing stone and was assessed by CT/KUB imaging after 3-4 weeks post-operatively. Multivariate logistic regression was used to detect possible predictors of SFS. Results: A total of 212 patients were included with a mean age of 52.3±8.3 years and a stone burden <20 mm (49.1%), 20-30 mm (41.0%) and >30 mm (9.9%). Overall SFS after a single session of fURS was 71.7%, 92% and 52% for stones less and larger than 20 mm, respectively. Patients with stones> 20 mm need retreatment with a mean number of 1.8 (1.3-2.7) fURS. SFS was significantly associated with male gender, stone bulk <20 mm (95.7% vs. 56.2%), non-lower pole stones, hydronephrotic kidney, low stone intensity, ureteral access sheath, and preoperative stenting. SFS was associated with a lower readmission rate (5.9% vs. 38.9%) and urinary tract infections (3.8% vs. 25.9%). In multivariate regression analysis, SFS maintains its significant association with low stone burden of <20 mm (OR: 5.21), stone intensity <600 HFU (OR: 2.87), and non-lower caliceal stones (OR: 3.84). Conclusion: Best results after a single-session fURS for renal stone were obtained for the stone burden of less than 20 mm and low stone attenuation. Lower calyceal stones may influence stone clearance and need a different approach than fURS, especially for higher stone burden.

Keywords: ureteroscopy, kidney stone, lithotripsy, stone-free, predictors

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1631 Competence of the Health Workers in Diagnosing and Managing Complicated Pregnancies: A Clinical Vignette Based Assessment in District and Sub-District Hospitals in Bangladesh

Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

Abstract:

Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

Procedia PDF Downloads 191