Search results for: cross flow
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8551

Search results for: cross flow

571 Starting the Hospitalization Procedure with a Medicine Combination in the Cardiovascular Department of the Imam Reza (AS) Mashhad Hospital

Authors: Maryamsadat Habibi

Abstract:

Objective: pharmaceutical errors are avoidable occurrences that can result in inappropriate pharmaceutical use, patient harm, treatment failure, increased hospital costs and length of stay, and other outcomes that affect both the individual receiving treatment and the healthcare provider. This study aimed to perform a reconciliation of medications in the cardiovascular ward of Imam Reza Hospital in Mashhad, Iran, and evaluate the prevalence of medication discrepancies between the best medication list created for the patient by the pharmacist and the medication order of the treating physician there. Materials & Methods: The 97 patients in the cardiovascular ward of the Imam Reza Hospital in Mashhad were the subject of a cross-sectional study from June to September of 2021. After giving their informed consent and being admitted to the ward, all patients with at least one underlying condition and at least two medications being taken at home were included in the study. A medical reconciliation form was used to record patient demographics and medical histories during the first 24 hours of admission, and the information was contrasted with the doctors' orders. The doctor then discovered medication inconsistencies between the two lists and double-checked them to separate the intentional from the accidental anomalies. Finally, using SPSS software version 22, it was determined how common medical discrepancies are and how different sorts of discrepancies relate to various variables. Results: The average age of the participants in this study was 57.6915.84 years, with 57.7% of men and 42.3% of women. 95.9% of the patients among these people encountered at least one medication discrepancy, and 58.9% of them suffered at least one unintentional drug cessation. Out of the 659 medications registered in the study, 399 cases (60.54%) had inconsistencies, of which 161 cases (40.35%) involved the intentional stopping of a medication, 123 cases (30.82%) involved the stopping of a medication unintentionally, and 115 cases (28.82%) involved the continued use of a medication by adjusting the dose. Additionally, the category of cardiovascular pharmaceuticals and the category of gastrointestinal medications were found to have the highest medical inconsistencies in the current study. Furthermore, there was no correlation between the frequency of medical discrepancies and the following variables: age, ward, date of visit, type, and number of underlying diseases (P=0.13), P=0.61, P=0.72, P=0.82, P=0.44, and so forth. On the other hand, there was a statistically significant correlation between the number of medications taken at home (P=0.037) and the prevalence of medical discrepancies with gender (P=0.029). The results of this study revealed that 96% of patients admitted to the cardiovascular unit at Imam Reza Hospital had at least one medication error, which was typically an intentional drug discontinuance. According to the study's findings, patients admitted to Imam Reza Hospital's cardiovascular ward have a great potential for identifying and correcting various medication discrepancies as well as for avoiding prescription errors when the medication reconciliation method is used. As a result, it is essential to carry out a precise assessment to achieve the best treatment outcomes and avoid unintended medication discontinuation, unwanted drug-related events, and drug interactions between the patient's home medications and those prescribed in the hospital.

Keywords: drug combination, drug side effects, drug incompatibility, cardiovascular department

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570 Optimization and Evaluation of Different Pathways to Produce Biofuel from Biomass

Authors: Xiang Zheng, Zhaoping Zhong

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In this study, Aspen Plus was used to simulate the whole process of biomass conversion to liquid fuel in different ways, and the main results of material and energy flow were obtained. The process optimization and evaluation were carried out on the four routes of cellulosic biomass pyrolysis gasification low-carbon olefin synthesis olefin oligomerization, biomass water pyrolysis and polymerization to jet fuel, biomass fermentation to ethanol, and biomass pyrolysis to liquid fuel. The environmental impacts of three biomass species (poplar wood, corn stover, and rice husk) were compared by the gasification synthesis pathway. The global warming potential, acidification potential, and eutrophication potential of the three biomasses were the same as those of rice husk > poplar wood > corn stover. In terms of human health hazard potential and solid waste potential, the results were poplar > rice husk > corn stover. In the popular pathway, 100 kg of poplar biomass was input to obtain 11.9 kg of aviation coal fraction and 6.3 kg of gasoline fraction. The energy conversion rate of the system was 31.6% when the output product energy included only the aviation coal product. In the basic process of hydrothermal depolymerization process, 14.41 kg aviation kerosene was produced per 100 kg biomass. The energy conversion rate of the basic process was 33.09%, which can be increased to 38.47% after the optimal utilization of lignin gasification and steam reforming for hydrogen production. The total exergy efficiency of the system increased from 30.48% to 34.43% after optimization, and the exergy loss mainly came from the concentration of precursor dilute solution. Global warming potential in environmental impact is mostly affected by the production process. Poplar wood was used as raw material in the process of ethanol production from cellulosic biomass. The simulation results showed that 827.4 kg of pretreatment mixture, 450.6 kg of fermentation broth, and 24.8 kg of ethanol were produced per 100 kg of biomass. The power output of boiler combustion reached 94.1 MJ, the unit power consumption in the process was 174.9 MJ, and the energy conversion rate was 33.5%. The environmental impact was mainly concentrated in the production process and agricultural processes. On the basis of the original biomass pyrolysis to liquid fuel, the enzymatic hydrolysis lignin residue produced by cellulose fermentation to produce ethanol was used as the pyrolysis raw material, and the fermentation and pyrolysis processes were coupled. In the coupled process, 24.8 kg ethanol and 4.78 kg upgraded liquid fuel were produced per 100 kg biomass with an energy conversion rate of 35.13%.

Keywords: biomass conversion, biofuel, process optimization, life cycle assessment

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569 Mitigation of Indoor Human Exposure to Traffic-Related Fine Particulate Matter (PM₂.₅)

Authors: Ruchi Sharma, Rajasekhar Balasubramanian

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Motor vehicles emit a number of air pollutants, among which fine particulate matter (PM₂.₅) is of major concern in cities with high population density due to its negative impacts on air quality and human health. Typically, people spend more than 80% of their time indoors. Consequently, human exposure to traffic-related PM₂.₅ in indoor environments has received considerable attention. Most of the public residential buildings in tropical countries are designed for natural ventilation where indoor air quality tends to be strongly affected by the migration of air pollutants of outdoor origin. However, most of the previously reported traffic-related PM₂.₅ exposure assessment studies relied on ambient PM₂.₅ concentrations and thus, the health impact of traffic-related PM₂.₅ on occupants in naturally ventilated buildings remains largely unknown. Therefore, a systematic field study was conducted to assess indoor human exposure to traffic-related PM₂.₅ with and without mitigation measures in a typical naturally ventilated residential apartment situated near a road carrying a large volume of traffic. Three PM₂.₅ exposure scenarios were simulated in this study, i.e., Case 1: keeping all windows open with a ceiling fan on as per the usual practice, Case 2: keeping all windows fully closed as a mitigation measure, and Case 3: keeping all windows fully closed with the operation of a portable indoor air cleaner as an additional mitigation measure. The indoor to outdoor (I/O) ratios for PM₂.₅ mass concentrations were assessed and the effectiveness of using the indoor air cleaner was quantified. Additionally, potential human health risk based on the bioavailable fraction of toxic trace elements was also estimated for the three cases in order to identify a suitable mitigation measure for reducing PM₂.₅ exposure indoors. Traffic-related PM₂.₅ levels indoors exceeded the air quality guidelines (12 µg/m³) in Case 1, i.e., under natural ventilation conditions due to advective flow of outdoor air into the indoor environment. However, while using the indoor air cleaner, a significant reduction (p < 0.05) in the PM₂.₅ exposure levels was noticed indoors. Specifically, the effectiveness of the air cleaner in terms of reducing indoor PM₂.₅ exposure was estimated to be about 74%. Moreover, potential human health risk assessment also indicated a substantial reduction in potential health risk while using the air cleaner. This is the first study of its kind that evaluated the indoor human exposure to traffic-related PM₂.₅ and identified a suitable exposure mitigation measure that can be implemented in densely populated cities to realize health benefits.

Keywords: fine particulate matter, indoor air cleaner, potential human health risk, vehicular emissions

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568 Applying Big Data Analysis to Efficiently Exploit the Vast Unconventional Tight Oil Reserves

Authors: Shengnan Chen, Shuhua Wang

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Successful production of hydrocarbon from unconventional tight oil reserves has changed the energy landscape in North America. The oil contained within these reservoirs typically will not flow to the wellbore at economic rates without assistance from advanced horizontal well and multi-stage hydraulic fracturing. Efficient and economic development of these reserves is a priority of society, government, and industry, especially under the current low oil prices. Meanwhile, society needs technological and process innovations to enhance oil recovery while concurrently reducing environmental impacts. Recently, big data analysis and artificial intelligence become very popular, developing data-driven insights for better designs and decisions in various engineering disciplines. However, the application of data mining in petroleum engineering is still in its infancy. The objective of this research aims to apply intelligent data analysis and data-driven models to exploit unconventional oil reserves both efficiently and economically. More specifically, a comprehensive database including the reservoir geological data, reservoir geophysical data, well completion data and production data for thousands of wells is firstly established to discover the valuable insights and knowledge related to tight oil reserves development. Several data analysis methods are introduced to analysis such a huge dataset. For example, K-means clustering is used to partition all observations into clusters; principle component analysis is applied to emphasize the variation and bring out strong patterns in the dataset, making the big data easy to explore and visualize; exploratory factor analysis (EFA) is used to identify the complex interrelationships between well completion data and well production data. Different data mining techniques, such as artificial neural network, fuzzy logic, and machine learning technique are then summarized, and appropriate ones are selected to analyze the database based on the prediction accuracy, model robustness, and reproducibility. Advanced knowledge and patterned are finally recognized and integrated into a modified self-adaptive differential evolution optimization workflow to enhance the oil recovery and maximize the net present value (NPV) of the unconventional oil resources. This research will advance the knowledge in the development of unconventional oil reserves and bridge the gap between the big data and performance optimizations in these formations. The newly developed data-driven optimization workflow is a powerful approach to guide field operation, which leads to better designs, higher oil recovery and economic return of future wells in the unconventional oil reserves.

Keywords: big data, artificial intelligence, enhance oil recovery, unconventional oil reserves

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567 Japanese and Europe Legal Frameworks on Data Protection and Cybersecurity: Asymmetries from a Comparative Perspective

Authors: S. Fantin

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This study is the result of the legal research on cybersecurity and data protection within the EUNITY (Cybersecurity and Privacy Dialogue between Europe and Japan) project, aimed at fostering the dialogue between the European Union and Japan. Based on the research undertaken therein, the author offers an outline of the main asymmetries in the laws governing such fields in the two regions. The research is a comparative analysis of the two legal frameworks, taking into account specific provisions, ratio legis and policy initiatives. Recent doctrine was taken into account, too, as well as empirical interviews with EU and Japanese stakeholders and project partners. With respect to the protection of personal data, the European Union has recently reformed its legal framework with a package which includes a regulation (General Data Protection Regulation), and a directive (Directive 680 on personal data processing in the law enforcement domain). In turn, the Japanese law under scrutiny for this study has been the Act on Protection of Personal Information. Based on a comparative analysis, some asymmetries arise. The main ones refer to the definition of personal information and the scope of the two frameworks. Furthermore, the rights of the data subjects are differently articulated in the two regions, while the nature of sanctions take two opposite approaches. Regarding the cybersecurity framework, the situation looks similarly misaligned. Japan’s main text of reference is the Basic Cybersecurity Act, while the European Union has a more fragmented legal structure (to name a few, Network and Information Security Directive, Critical Infrastructure Directive and Directive on the Attacks at Information Systems). On an relevant note, unlike a more industry-oriented European approach, the concept of cyber hygiene seems to be neatly embedded in the Japanese legal framework, with a number of provisions that alleviate operators’ liability by turning such a burden into a set of recommendations to be primarily observed by citizens. With respect to the reasons to fill such normative gaps, these are mostly grounded on three basis. Firstly, the cross-border nature of cybercrime brings to consider both magnitude of the issue and its regulatory stance globally. Secondly, empirical findings from the EUNITY project showed how recent data breaches and cyber-attacks had shared implications between Europe and Japan. Thirdly, the geopolitical context is currently going through the direction of bringing the two regions to significant agreements from a trade standpoint, but also from a data protection perspective (with an imminent signature by both parts of a so-called ‘Adequacy Decision’). The research conducted in this study reveals two asymmetric legal frameworks on cyber security and data protection. With a view to the future challenges presented by the strengthening of the collaboration between the two regions and the trans-national fashion of cybercrime, it is urged that solutions are found to fill in such gaps, in order to allow European Union and Japan to wisely increment their partnership.

Keywords: cybersecurity, data protection, European Union, Japan

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566 Fine-Scale Modeling the Influencing Factors of Multi-Time Dimensions of Transit Ridership at Station Level: The Study of Guangzhou City

Authors: Dijiang Lyu, Shaoying Li, Zhangzhi Tan, Zhifeng Wu, Feng Gao

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Nowadays, China is experiencing rapidly urban rail transit expansions in the world. The purpose of this study is to finely model factors influencing transit ridership at multi-time dimensions within transit stations’ pedestrian catchment area (PCA) in Guangzhou, China. This study was based on multi-sources spatial data, including smart card data, high spatial resolution images, points of interest (POIs), real-estate online data and building height data. Eight multiple linear regression models using backward stepwise method and Geographic Information System (GIS) were created at station-level. According to Chinese code for classification of urban land use and planning standards of development land, residential land-use were divided into three categories: first-level (e.g. villa), second-level (e.g. community) and third-level (e.g. urban villages). Finally, it concluded that: (1) four factors (CBD dummy, number of feeder bus route, number of entrance or exit and the years of station operation) were proved to be positively correlated with transit ridership, but the area of green land-use and water land-use negative correlated instead. (2) The area of education land-use, the second-level and third-level residential land-use were found to be highly connected to the average value of morning peak boarding and evening peak alighting ridership. But the area of commercial land-use and the average height of buildings, were significantly positive associated with the average value of morning peak alighting and evening peak boarding ridership. (3) The area of the second-level residential land-use was rarely correlated with ridership in other regression models. Because private car ownership is still large in Guangzhou now, and some residents living in the community around the stations go to work by transit at peak time, but others are much more willing to drive their own car at non-peak time. The area of the third-level residential land-use, like urban villages, was highly positive correlated with ridership in all models, indicating that residents who live in the third-level residential land-use are the main passenger source of the Guangzhou Metro. (4) The diversity of land-use was found to have a significant impact on the passenger flow on the weekend, but was non-related to weekday. The findings can be useful for station planning, management and policymaking.

Keywords: fine-scale modeling, Guangzhou city, multi-time dimensions, multi-sources spatial data, transit ridership

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565 Prosodic Transfer in Foreign Language Learning: A Phonetic Crosscheck of Intonation and F₀ Range between Italian and German Native and Non-Native Speakers

Authors: Violetta Cataldo, Renata Savy, Simona Sbranna

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Background: Foreign Language Learning (FLL) is characterised by prosodic transfer phenomena regarding pitch accents placement, intonation patterns, and pitch range excursion from the learners’ mother tongue to their Foreign Language (FL) which suggests that the gradual development of general linguistic competence in FL does not imply an equally correspondent improvement of the prosodic competence. Topic: The present study aims to monitor the development of prosodic competence of learners of Italian and German throughout the FLL process. The primary object of this study is to investigate the intonational features and the f₀ range excursion of Italian and German from a cross-linguistic perspective; analyses of native speakers’ productions point out the differences between this pair of languages and provide models for the Target Language (TL). A following crosscheck compares the L2 productions in Italian and German by non-native speakers to the Target Language models, in order to verify the occurrence of prosodic interference phenomena, i.e., type, degree, and modalities. Methodology: The subjects of the research are university students belonging to two groups: Italian native speakers learning German as FL and German native speakers learning Italian as FL. Both of them have been divided into three subgroups according to the FL proficiency level (beginners, intermediate, advanced). The dataset consists of wh-questions placed in situational contexts uttered in both speakers’ L1 and FL. Using a phonetic approach, analyses have considered three domains of intonational contours (Initial Profile, Nuclear Accent, and Terminal Contour) and two dimensions of the f₀ range parameter (span and level), which provide a basis for comparison between L1 and L2 productions. Findings: Results highlight a strong presence of prosodic transfer phenomena affecting L2 productions in the majority of both Italian and German learners, irrespective of their FL proficiency level; the transfer concerns all the three domains of the contour taken into account, although with different modalities and characteristics. Currently, L2 productions of German learners show a pitch span compression on the domain of the Terminal Contour compared to their L1 towards the TL; furthermore, German learners tend to use lower pitch range values in deviation from their L1 when improving their general linguistic competence in Italian FL proficiency level. Results regarding pitch range span and level in L2 productions by Italian learners are still in progress. At present, they show a similar tendency to expand the pitch span and to raise the pitch level, which also reveals a deviation from the L1 possibly in the direction of German TL. Conclusion: Intonational features seem to be 'resistant' parameters to which learners appear not to be particularly sensitive. By contrast, they show a certain sensitiveness to FL pitch range dimensions. Making clear which the most resistant and the most sensitive parameters are when learning FL prosody could lay groundwork for the development of prosodic trainings thanks to which learners could finally acquire a clear and natural pronunciation and intonation.

Keywords: foreign language learning, German, Italian, L2 prosody, pitch range, transfer

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564 Employing Remotely Sensed Soil and Vegetation Indices and Predicting ‎by Long ‎Short-Term Memory to Irrigation Scheduling Analysis

Authors: Elham Koohikerade, Silvio Jose Gumiere

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In this research, irrigation is highlighted as crucial for improving both the yield and quality of ‎potatoes due to their high sensitivity to soil moisture changes. The study presents a hybrid Long ‎Short-Term Memory (LSTM) model aimed at optimizing irrigation scheduling in potato fields in ‎Quebec City, Canada. This model integrates model-based and satellite-derived datasets to simulate ‎soil moisture content, addressing the limitations of field data. Developed under the guidance of the ‎Food and Agriculture Organization (FAO), the simulation approach compensates for the lack of direct ‎soil sensor data, enhancing the LSTM model's predictions. The model was calibrated using indices ‎like Surface Soil Moisture (SSM), Normalized Vegetation Difference Index (NDVI), Enhanced ‎Vegetation Index (EVI), and Normalized Multi-band Drought Index (NMDI) to effectively forecast ‎soil moisture reductions. Understanding soil moisture and plant development is crucial for assessing ‎drought conditions and determining irrigation needs. This study validated the spectral characteristics ‎of vegetation and soil using ECMWF Reanalysis v5 (ERA5) and Moderate Resolution Imaging ‎Spectrometer (MODIS) data from 2019 to 2023, collected from agricultural areas in Dolbeau and ‎Peribonka, Quebec. Parameters such as surface volumetric soil moisture (0-7 cm), NDVI, EVI, and ‎NMDI were extracted from these images. A regional four-year dataset of soil and vegetation moisture ‎was developed using a machine learning approach combining model-based and satellite-based ‎datasets. The LSTM model predicts soil moisture dynamics hourly across different locations and ‎times, with its accuracy verified through cross-validation and comparison with existing soil moisture ‎datasets. The model effectively captures temporal dynamics, making it valuable for applications ‎requiring soil moisture monitoring over time, such as anomaly detection and memory analysis. By ‎identifying typical peak soil moisture values and observing distribution shapes, irrigation can be ‎scheduled to maintain soil moisture within Volumetric Soil Moisture (VSM) values of 0.25 to 0.30 ‎m²/m², avoiding under and over-watering. The strong correlations between parcels suggest that a ‎uniform irrigation strategy might be effective across multiple parcels, with adjustments based on ‎specific parcel characteristics and historical data trends. The application of the LSTM model to ‎predict soil moisture and vegetation indices yielded mixed results. While the model effectively ‎captures the central tendency and temporal dynamics of soil moisture, it struggles with accurately ‎predicting EVI, NDVI, and NMDI.‎

Keywords: irrigation scheduling, LSTM neural network, remotely sensed indices, soil and vegetation ‎monitoring

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563 Mature Field Rejuvenation Using Hydraulic Fracturing: A Case Study of Tight Mature Oilfield with Reveal Simulator

Authors: Amir Gharavi, Mohamed Hassan, Amjad Shah

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The main characteristics of unconventional reservoirs include low-to ultra low permeability and low-to-moderate porosity. As a result, hydrocarbon production from these reservoirs requires different extraction technologies than from conventional resources. An unconventional reservoir must be stimulated to produce hydrocarbons at an acceptable flow rate to recover commercial quantities of hydrocarbons. Permeability for unconventional reservoirs is mostly below 0.1 mD, and reservoirs with permeability above 0.1 mD are generally considered to be conventional. The hydrocarbon held in these formations naturally will not move towards producing wells at economic rates without aid from hydraulic fracturing which is the only technique to assess these tight reservoir productions. Horizontal well with multi-stage fracking is the key technique to maximize stimulated reservoir volume and achieve commercial production. The main objective of this research paper is to investigate development options for a tight mature oilfield. This includes multistage hydraulic fracturing and spacing by building of reservoir models in the Reveal simulator to model potential development options based on sidetracking the existing vertical well. To simulate potential options, reservoir models have been built in the Reveal. An existing Petrel geological model was used to build the static parts of these models. A FBHP limit of 40bars was assumed to take into account pump operating limits and to maintain the reservoir pressure above the bubble point. 300m, 600m and 900m lateral length wells were modelled, in conjunction with 4, 6 and 8 stages of fracs. Simulation results indicate that higher initial recoveries and peak oil rates are obtained with longer well lengths and also with more fracs and spacing. For a 25year forecast, the ultimate recovery ranging from 0.4% to 2.56% for 300m and 1000m laterals respectively. The 900m lateral with 8 fracs 100m spacing gave the highest peak rate of 120m3/day, with the 600m and 300m cases giving initial peak rates of 110m3/day. Similarly, recovery factor for the 900m lateral with 8 fracs and 100m spacing was the highest at 2.65% after 25 years. The corresponding values for the 300m and 600m laterals were 2.37% and 2.42%. Therefore, the study suggests that longer laterals with 8 fracs and 100m spacing provided the optimal recovery, and this design is recommended as the basis for further study.

Keywords: unconventional, resource, hydraulic, fracturing

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562 Alkali Activation of Fly Ash, Metakaolin and Slag Blends: Fresh and Hardened Properties

Authors: Weiliang Gong, Lissa Gomes, Lucile Raymond, Hui Xu, Werner Lutze, Ian L. Pegg

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Alkali-activated materials, particularly geopolymers, have attracted much interest in academia. Commercial applications are on the rise, as well. Geopolymers are produced typically by a reaction of one or two aluminosilicates with an alkaline solution at room temperature. Fly ash is an important aluminosilicate source. However, using low-Ca fly ash, the byproduct of burning hard or black coal reacts and sets slowly at room temperature. The development of mechanical durability, e.g., compressive strength, is slow as well. The use of fly ashes with relatively high contents ( > 6%) of unburned carbon, i.e., high loss on ignition (LOI), is particularly disadvantageous as well. This paper will show to what extent these impediments can be mitigated by mixing the fly ash with one or two more aluminosilicate sources. The fly ash used here is generated at the Orlando power plant (Florida, USA). It is low in Ca ( < 1.5% CaO) and has a high LOI of > 6%. The additional aluminosilicate sources are metakaolin and blast furnace slag. Binary fly ash-metakaolin and ternary fly ash-metakaolin-slag geopolymers were prepared. Properties of geopolymer pastes before and after setting have been measured. Fresh mixtures of aluminosilicates with an alkaline solution were studied by Vicat needle penetration, rheology, and isothermal calorimetry up to initial setting and beyond. The hardened geopolymers were investigated by SEM/EDS and the compressive strength was measured. Initial setting (fluid to solid transition) was indicated by a rapid increase in yield stress and plastic viscosity. The rheological times of setting were always smaller than the Vicat times of setting. Both times of setting decreased with increasing replacement of fly ash with blast furnace slag in a ternary fly ash-metakaolin-slag geopolymer system. As expected, setting with only Orlando fly ash was the slowest. Replacing 20% fly ash with metakaolin shortened the set time. Replacing increasing fractions of fly ash in the binary system by blast furnace slag (up to 30%) shortened the time of setting even further. The 28-day compressive strength increased drastically from < 20 MPa to 90 MPa. The most interesting finding relates to the calorimetric measurements. The use of two or three aluminosilicates generated significantly more heat (20 to 65%) than the calculated from the weighted sum of the individual aluminosilicates. This synergetic heat contributes or may be responsible for most of the increase of compressive strength of our binary and ternary geopolymers. The synergetic heat effect may be also related to increased incorporation of calcium in sodium aluminosilicate hydrate to form a hybrid (N,C)A-S-H) gel. The time of setting will be correlated with heat release and maximum heat flow.

Keywords: alkali-activated materials, binary and ternary geopolymers, blends of fly ash, metakaolin and blast furnace slag, rheology, synergetic heats

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561 Association between Obstetric Factors with Affected Areas of Health-Related Quality of Life of Pregnant Women

Authors: Cinthia G. P. Calou, Franz J. Antezana, Ana I. O. Nicolau, Eveliny S. Martins, Paula R. A. L. Soares, Glauberto S. Quirino, Dayanne R. Oliveira, Priscila S. Aquino, Régia C. M. B. Castro, Ana K. B. Pinheiro

Abstract:

Introduction: As an integral part of the health-disease process, gestation is a period in which the social insertion of women can influence, in a positive or negative way, the course of the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices in the quest to make them more effective and real for the promotion of a more humanized care. This study explores the associations between the obstetric factors with affected areas of health-related quality of life of pregnant women with habitual risk. Methods: This is a cross-sectional, quantitative study conducted in three public facilities and a private service that provides prenatal care in the city of Fortaleza, Ceara, Brazil. The sample consisted of 261 pregnant women who underwent low-risk prenatal care and were interviewed from September to November 2014. The collection instruments were a questionnaire containing socio-demographic and obstetric variables, in addition to the Brazilian version of the Mother scale Generated Index (MGI) characterized by being a specific and objective instrument, consisting of a single sheet and subdivided into three stages. It allows identifying the areas of life of the pregnant woman that are most affected, which could go unnoticed by the pre-formulated measurement instruments. The obstetric data, as well as the data concerning the application of the MGI scale, were compiled and analyzed through the statistical program Statistical Package for the Social Sciences (SPSS), version 20.0. After the compilation, a descriptive analysis was carried out. Then, associations were made between some variables. The tests applied were the Pearson Chi-Square and the Fisher's exact test. The odds ratio was also calculated. These associations were considered statistically significant when the p (probability) value was less than or equal to a level of 5% (α = 0.05) in the tests performed. Results: The variables that negatively reflected the quality of life of the pregnant women and presented a significant association with the polaciuria were: gestational age (p = 0.022) and parity (p = 0.048). Episodes of nausea and vomiting also showed significant with gestational age correlation (p = 0.0001). Evaluating the crossing of stress, we observed a significant association with parity (p = 0.0001). In turn, emotional lability revealed dependence on the variable type of delivery (p = 0.009). Conclusion: The health professionals involved in the assistance to the pregnant woman can understand how the process of gestation is experienced, considering all its peculiar transformations; to meet their individual needs, stimulating their autonomy and their power of choice, envisaging the achievement of a better quality of life related to health in the perspective of health promotion.

Keywords: health-related quality of life, obstetric nursing, pregnant women, prenatal care

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560 Examination of Indoor Air Quality of Naturally Ventilated Dwellings During Winters in Mega-City Kolkata

Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya

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The US Environmental Protection Agency defines indoor air quality as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. The built environment can affect health directly and indirectly through immediate or long-term exposure to indoor air pollutants. Health effects associated with indoor air pollutants include eye/nose/throat irritation, respiratory diseases, heart disease, and even cancer. This study attempts to demonstrate the causal relationship between the indoor air quality and its determining aspects. Detailed indoor air quality audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavorable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses indoor air quality based on factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.

Keywords: indoor air quality, occupant health, urban housing, air pollution, natural ventilation, architecture, urban issues

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559 A Novel Nanocomposite Membrane Designed for the Treatment of Oil/Gas Produced Water

Authors: Zhaoyang Liu, Detao Qin, Darren Delai Sun

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The onshore production of oil and gas (for example, shale gas) generates large quantities of wastewater, referred to be ‘produced water’, which contains high contents of oils and salts. The direct discharge of produced water, if not appropriately treated, can be toxic to the environment and human health. Membrane filtration has been deemed as an environmental-friendly and cost-effective technology for treating oily wastewater. However, conventional polymeric membranes have their drawbacks of either low salt rejection rate or high membrane fouling tendency when treating oily wastewater. Recent years, forward osmosis (FO) membrane filtration has emerged as a promising technology with its unique advantages of low operation pressure and less membrane fouling tendency. However, until now there is still no report about FO membranes specially designed and fabricated for treating the oily and salty produced water. In this study, a novel nanocomposite FO membrane was developed specially for treating oil- and salt-polluted produced water. By leveraging the recent advance of nanomaterials and nanotechnology, this nanocomposite FO membrane was designed to be made of double layers: an underwater oleophobic selective layer on top of a nanomaterial infused polymeric support layer. Wherein, graphene oxide (GO) nanosheets were selected to add into the polymeric support layer because adding GO nanosheets can optimize the pore structures of the support layer, thus potentially leading to high water flux for FO membranes. In addition, polyvinyl alcohol (PVA) hydrogel was selected as the selective layer because hydrated and chemically-crosslinked PVA hydrogel is capable of simultaneously rejecting oil and salt. After nanocomposite FO membranes were fabricated, the membrane structures were systematically characterized with the instruments of TEM, FESEM, XRD, ATR-FTIR, surface zeta-potential and Contact angles (CA). The membrane performances for treating produced waters were tested with the instruments of TOC, COD and Ion chromatography. The working mechanism of this new membrane was also analyzed. Very promising experimental results have been obtained. The incorporation of GO nanosheets can reduce internal concentration polarization (ICP) effect in the polymeric support layer. The structural parameter (S value) of the new FO membrane is reduced by 23% from 265 ± 31 μm to 205 ± 23 μm. The membrane tortuosity (τ value) is decreased by 20% from 2.55 ± 0.19 to 2.02 ± 0.13 μm, which contributes to the decrease of S value. Moreover, the highly-hydrophilic and chemically-cross-linked hydrogel selective layer present high antifouling property under saline oil/water emulsions. Compared with commercial FO membrane, this new FO membrane possesses three times higher water flux, higher removal efficiencies for oil (>99.9%) and salts (>99.7% for multivalent ions), and significantly lower membrane fouling tendency (<10%). To our knowledge, this is the first report of a nanocomposite FO membrane with the combined merits of high salt rejection, high oil repellency and high water flux for treating onshore oil/gas produced waters. Due to its outstanding performance and ease of fabrication, this novel nanocomposite FO membrane possesses great application potential in wastewater treatment industry.

Keywords: nanocomposite, membrane, polymer, graphene oxide

Procedia PDF Downloads 253
558 Relationship between Gully Development and Characteristics of Drainage Area in Semi-Arid Region, NW Iran

Authors: Ali Reza Vaezi, Ouldouz Bakhshi Rad

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Gully erosion is a widespread and often dramatic form of soil erosion caused by water during and immediately after heavy rainfall. It occurs when flowing surface water is channelled across unprotected land and washes away the soil along the drainage lines. The formation of gully is influenced by various factors, including climate, drainage surface area, slope gradient, vegetation cover, land use, and soil properties. It is a very important problem in semi-arid regions, where soils have lower organic matter and are weakly aggregated. Intensive agriculture and tillage along the slope can accelerate soil erosion by water in the region. There is little information on the development of gully erosion in agricultural rainfed areas. Therefore, this study was carried out to investigate the relationship between gully erosion and morphometric characteristics of the drainage area and the effects of soil properties and soil management factors (land use and tillage method) on gully development. A field study was done in a 900 km2 agricultural area in Hshtroud township located in the south of East Azarbijan province, NW Iran. Toward this, two hundred twenty-two gullies created in rainfed lands were found in the area. Some properties of gullies, consisting of length, width, depth, height difference, cross section area, and volume, were determined. Drainage areas for each or some gullies were determined, and their boundaries were drawn. Additionally, the surface area of each drainage, land use, tillage direction, and soil properties that may affect gully formation were determined. The soil erodibility factor (K) defined in the Universal Soil Loss Equation (USLE) was estimated based on five soil properties (silt and very fine sand, coarse sand, organic matter, soil structure code, and soil permeability). Gully development in each drainage area was quantified using its volume and soil loss. The dependency of gully development on drainage area characteristics (surface area, land use, tillage direction, and soil properties) was determined using correlation matrix analysis. Based on the results, gully length was the most important morphometric characteristic indicating the development of gully erosion in the lands. Gully development in the area was related to slope gradient (r= -0.26), surface area (r= 0.71), the area of rainfed lands (r= 0.23), and the area of rainfed tilled along the slope (r= 0.24). Nevertheless, its correlation with the area of pasture and soil erodibility factor (K) was not significant. Among the characteristics of drainage area, surface area is the major factor controlling gully volume in the agricultural land. No significant correlation was found between gully erosion and soil erodibility factor (K) estimated by the Universal Soil Loss Equation (USLE). It seems the estimated soil erodibility can’t describe the susceptibility of the study soils to the gully erosion process. In these soils, aggregate stability and soil permeability are the two soil physical properties that affect the actual soil erodibility and in consequence, these soil properties can control gully erosion in the rainfed lands.

Keywords: agricultural area, gully properties, soil structure, USLE

Procedia PDF Downloads 81
557 Analysis of Reduced Mechanisms for Premixed Combustion of Methane/Hydrogen/Propane/Air Flames in Geometrically Modified Combustor and Its Effects on Flame Properties

Authors: E. Salem

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Combustion has been used for a long time as a means of energy extraction. However, in recent years, there has been a further increase in air pollution, through pollutants such as nitrogen oxides, acid etc. In order to solve this problem, there is a need to reduce carbon and nitrogen oxides through learn burning modifying combustors and fuel dilution. A numerical investigation has been done to investigate the effectiveness of several reduced mechanisms in terms of computational time and accuracy, for the combustion of the hydrocarbons/air or diluted with hydrogen in a micro combustor. The simulations were carried out using the ANSYS Fluent 19.1. To validate the results “PREMIX and CHEMKIN” codes were used to calculate 1D premixed flame based on the temperature, composition of burned and unburned gas mixtures. Numerical calculations were carried for several hydrocarbons by changing the equivalence ratios and adding small amounts of hydrogen into the fuel blends then analyzing the flammable limit, the reduction in NOx and CO emissions, then comparing it to experimental data. By solving the conservations equations, several global reduced mechanisms (2-9-12) were obtained. These reduced mechanisms were simulated on a 2D cylindrical tube with dimensions of 40 cm in length and 2.5 cm diameter. The mesh of the model included a proper fine quad mesh, within the first 7 cm of the tube and around the walls. By developing a proper boundary layer, several simulations were performed on hydrocarbon/air blends to visualize the flame characteristics than were compared with experimental data. Once the results were within acceptable range, the geometry of the combustor was modified through changing the length, diameter, adding hydrogen by volume, and changing the equivalence ratios from lean to rich in the fuel blends, the results on flame temperature, shape, velocity and concentrations of radicals and emissions were observed. It was determined that the reduced mechanisms provided results within an acceptable range. The variation of the inlet velocity and geometry of the tube lead to an increase of the temperature and CO2 emissions, highest temperatures were obtained in lean conditions (0.5-0.9) equivalence ratio. Addition of hydrogen blends into combustor fuel blends resulted in; reduction in CO and NOx emissions, expansion of the flammable limit, under the condition of having same laminar flow, and varying equivalence ratio with hydrogen additions. The production of NO is reduced because the combustion happens in a leaner state and helps in solving environmental problems.

Keywords: combustor, equivalence-ratio, hydrogenation, premixed flames

Procedia PDF Downloads 118
556 Tracking Patient Pathway for Assessing Public Health and Financial Burden to Community for Pulmonary Tuberculosis: Pointer from Central India

Authors: Ashish Sinha, Pushpend Agrawal

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Background: Patients with undiagnosed pulmonary TB predominantly act as reservoirs for its transmission through 10-15 secondary infections in the next 1-5 Yrs. Delays in the diagnosis and treatment may worsen the disease with increase the risk of death. Factors responsible for such delays by tracking patient pathways to treatment may help in planning better interventions. The provision of ‘free diagnosis and treatment’ forms the cornerstone of the National Tuberculosis Elimination Programme (NTEP). OOPE is defined as the money spent by the patient during TB care other than public health facilities. Free TB care at all health facilities could reduce out-of-pocket expenses to the minimum possible levels. Material and Methods: This cross-sectional study was conducted among randomly selected 252 TB patients from Nov – Oct 2022 by taking in-depth interviews following informed verbal consent. We documented their journey from initial symptoms until they reached the public health facility, along with their ‘out-of-pocket expenditure’ (OOPE) pertaining to TB care. Results: Total treatment delay was 91±72 days on average (median: 77days, IQR: 45-104 days), while the isolated patient delay was 31±45 days (median: 15 days, IQR: 0 days to 43 days); diagnostic delay; 57±60 days (median: 42days, IQR 14-78 days), treatment delay 19 ± 18 days (median: 15days, IQR: 11-19 days). A patient delay (> 30 days) was significantly associated with ignorance about classic symptoms of pulmonary TB, adoption of self-medication, illiteracy, and middle and lower social class. Diagnostic delay was significantly higher among those who contacted private health facilities, were unaware of signs and symptoms, had >2 consultations, and not getting an appropriate referral for TB care. Most (97%) of the study participants interviewed claimed to have incurred some expenditure.Median total expenses were 6155(IQR: 2625-15175) rupees. More than half 141 (56%) of the study participants had expenses >5000 rupees. Median transport expenses were 525(IQR: 200-1012) rupees; Median consultation expenses were 700(IQR: 200-1600) rupees; Median investigation expenses were 1000(IQR: 0-3025) rupees and the Median medicine expenses were 3350(IQR: 1300-7525).OOPE for consultation, investigation, and medicine was observed to be significantly higher among patients who ignored classical signs& symptoms of TB, repeated visits to private health facilities, and due to self-medication practices. Transport expenses and delays in seeking care at facilities were observed to have an upward trend with OOP Expenses (r =1). Conclusion: Delay in TB care due to low awareness about signs and symptoms of TB and poor seeking care, lack of proper consultation, and appropriate referrals reported by the study subjects indicate the areas which need proper attention by the program managers. Despite a centrally sponsored programme, the financial burden on TB patients is still in the unacceptable range. OOPE could be reduced as low as possible by addressing the responsible factors linked to it.

Keywords: patient pathway, delay, pulmonary tuberculosis, out of pocket expenses

Procedia PDF Downloads 68
555 Translation and Validation of the Thai Version of the Japanese Sleep Questionnaire for Preschoolers

Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul

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Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.

Keywords: preschooler, questionnaire, validation, Thai version

Procedia PDF Downloads 110
554 Noninvasive Technique for Measurement of Heartbeat in Zebrafish Embryos Exposed to Electromagnetic Fields at 27 GHz

Authors: Sara Ignoto, Elena M. Scalisi, Carmen Sica, Martina Contino, Greta Ferruggia, Antonio Salvaggio, Santi C. Pavone, Gino Sorbello, Loreto Di Donato, Roberta Pecoraro, Maria V. Brundo

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The new fifth generation technology (5G), which should favor high data-rate connections (1Gbps) and latency times lower than the current ones (<1ms), has the characteristic of working on different frequency bands of the radio wave spectrum (700 MHz, 3.6-3.8 GHz and 26.5-27.5 GHz), thus also exploiting higher frequencies than previous mobile radio generations (1G-4G). The higher frequency waves, however, have a lower capacity to propagate in free space and therefore, in order to guarantee the capillary coverage of the territory for high reliability applications, it will be necessary to install a large number of repeaters. Following the introduction of this new technology, there has been growing concern in recent years about the possible harmful effects on human health and several studies were published using several animal models. This study aimed to observe the possible short-term effects induced by 5G-millimeter waves on heartbeat of early life stages of Danio rerio using DanioScope software (Noldus). DanioScope is the complete toolbox for measurements on zebrafish embryos and larvae. The effect of substances can be measured on the developing zebrafish embryo by a range of parameters: earliest activity of the embryo’s tail, activity of the developing heart, speed of blood flowing through the vein, length and diameters of body parts. Activity measurements, cardiovascular data, blood flow data and morphometric parameters can be combined in one single tool. Obtained data are elaborate and provided by the software both numerical as well as graphical. The experiments were performed at 27 GHz by a no commercial high gain pyramidal horn antenna. According to OECD guidelines, exposure to 5G-millimeter waves was tested by fish embryo toxicity test within 96 hours post fertilization, Observations were recorded every 24h, until the end of the short-term test (96h). The results have showed an increase of heartbeat rate on exposed embryos at 48h hpf than control group, but this increase has not been shown at 72-96 h hpf. Nowadays, there is a scant of literature data about this topic, so these results could be useful to approach new studies and also to evaluate potential cardiotoxic effects of mobile radiofrequency.

Keywords: Danio rerio, DanioScope, cardiotoxicity, millimeter waves.

Procedia PDF Downloads 192
553 An Australian Tertiary Centre Experience of Complex Endovascular Aortic Repairs

Authors: Hansraj Bookun, Rachel Xuan, Angela Tan, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos, Jim Iliopoulos

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Introduction: Complex endovascular aortic aneursymal repairs with fenestrated and branched endografts require customised devices to exclude the pathology while reducing morbidity and mortality, which was historically associated with open repair of complex aneurysms. Such endovascular procedures have predominantly been performed in a large volume dedicated tertiary centres. We present here our nine year multidisciplinary experience with this technology in an Australian tertiary centre. Method: This was a cross-sectional, single-centre observational study of 670 patients who had undergone complex endovascular aortic aneurysmal repairs with conventional endografts, fenestrated endografts, and iliac-branched devices from January 2010 to July 2019. Descriptive statistics were used to characterise our sample with regards to demographic and perioperative variables. Homogeneity of the sample was tested using multivariant regression, which did not identify any statistically significant confounding variables. Results: 670 patients of mean age 74, were included (592 males) and the comorbid burden was as follows: ischemic heart disease (55%), diabetes (18%), hypertension (90%), stage four or greater kidney impairment (8%) and current or ex-smoking (78%). The main indications for surgery were elective aneurysms (86%), symptomatic aneurysms (5%), and rupture aneurysms (5%). 106 patients (16%) underwent fenestrated or branched endograft repairs. The mean length of stay was 7.6 days. 2 patients experienced reactionary bleeds, 11 patients had access wound complications (6 lymph fistulae, 5 haematoms), 11 patients had cardiac complications (5 arrhythmias, 3 acute myocadial infarctions, 3 exacerbation of congestive cardiac failure), 10 patients had respiratory complications, 8 patients had renal impairment, 4 patients had gastrointestinal complications, 2 patients suffered from paraplegia, 1 major stroke, 1 minor stroke, and 1 acute brain syndrome. There were 4 vascular occlusions requiring further arterial surgery, 4 type I endoleaks, 4 type II endoleaks, 3 episodes of thromboembolism, and 2 patients who required further arterial operations in the setting of patient vessels. There were 9 unplanned returns to the theatre. Discussion: Our numbers of 10 years suggest that we are not a dedicated high volume centre focusing on aortic repairs. However, we have achieved significantly low complication rates. This can be attributed to our multidisciplinary approach with the intraoperative involvement of skilled interventional radiologists and vascular surgeons as well as postoperative protocols with particular attention to spinal cord protection. Additionally, we have a ratified perioperative pathway that involves multidisciplinary team discussions of patient-related factors and lesion-centered characteristics, which allows for holistic, patient-centered care.

Keywords: aneurysm, aortic, endovascular, fenestrated

Procedia PDF Downloads 124
552 Solutions of Thickening the Sludge from the Wastewater Treatment by a Rotor with Bars

Authors: Victorita Radulescu

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Introduction: The sewage treatment plants, in the second stage, are formed by tanks having as main purpose the formation of the suspensions with high possible solid concentration values. The paper presents a solution to produce a rapid concentration of the slurry and sludge, having as main purpose the minimization as much as possible the size of the tanks. The solution is based on a rotor with bars, tested into two different areas of industrial activity: the remediation of the wastewater from the oil industry and, in the last year, into the mining industry. Basic Methods: It was designed, realized and tested a thickening system with vertical bars that manages to reduce sludge moisture content from 94% to 87%. The design was based on the hypothesis that the streamlines of the vortices detached from the rotor with vertical bars accelerate, under certain conditions, the sludge thickening. It is moved at the lateral sides, and in time, it became sediment. The formed vortices with the vertical axis in the viscous fluid, under the action of the lift, drag, weight, and inertia forces participate at a rapid aggregation of the particles thus accelerating the sludge concentration. Appears an interdependence between the Re number attached to the flow with vortex induced by the vertical bars and the size of the hydraulic compaction phenomenon, resulting from an accelerated process of sedimentation, therefore, a sludge thickening depending on the physic-chemical characteristics of the resulting sludge is projected the rotor's dimensions. Major findings/ Results: Based on the experimental measurements was performed the numerical simulation of the hydraulic rotor, as to assure the necessary vortices. The experimental measurements were performed to determine the optimal height and the density of the bars for the sludge thickening system, to assure the tanks dimensions as small as possible. The time thickening/settling was reduced by 24% compared to the conventional used systems. In the present, the thickeners intend to decrease the intermediate stage of water treatment, using primary and secondary settling; but they assume a quite long time, the order of 10-15 hours. By using this system, there are no intermediary steps; the thickening is done automatically when are created the vortices. Conclusions: The experimental tests were carried out in the wastewater treatment plant of the Refinery of oil from Brazi, near the city Ploiesti. The results prove its efficiency in reducing the time for compacting the sludge and the smaller humidity of the evacuated sediments. The utilization of this equipment is now extended and it is tested the mining industry, with significant results, in Lupeni mine, from the Jiu Valley.

Keywords: experimental tests, hydrodynamic modeling, rotor efficiency, wastewater treatment

Procedia PDF Downloads 119
551 The Digital Desert in Global Business: Digital Analytics as an Oasis of Hope for Sub-Saharan Africa

Authors: David Amoah Oduro

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In the ever-evolving terrain of international business, a profound revolution is underway, guided by the swift integration and advancement of disruptive technologies like digital analytics. In today's international business landscape, where competition is fierce, and decisions are data-driven, the essence of this paper lies in offering a tangible roadmap for practitioners. It is a guide that bridges the chasm between theory and actionable insights, helping businesses, investors, and entrepreneurs navigate the complexities of international expansion into sub-Saharan Africa. This practitioner paper distils essential insights, methodologies, and actionable recommendations for businesses seeking to leverage digital analytics in their pursuit of market entry and expansion across the African continent. What sets this paper apart is its unwavering focus on a region ripe with potential: sub-Saharan Africa. The adoption and adaptation of digital analytics are not mere luxuries but essential strategic tools for evaluating countries and entering markets within this dynamic region. With the spotlight firmly fixed on sub-Saharan Africa, the aim is to provide a compelling resource to guide practitioners in their quest to unearth the vast opportunities hidden within sub-Saharan Africa's digital desert. The paper illuminates the pivotal role of digital analytics in providing a data-driven foundation for market entry decisions. It highlights the ability to uncover market trends, consumer behavior, and competitive landscapes. By understanding Africa's incredible diversity, the paper underscores the importance of tailoring market entry strategies to account for unique cultural, economic, and regulatory factors. For practitioners, this paper offers a set of actionable recommendations, including the creation of cross-functional teams, the integration of local expertise, and the cultivation of long-term partnerships to ensure sustainable market entry success. It advocates for a commitment to continuous learning and flexibility in adapting strategies as the African market evolves. This paper represents an invaluable resource for businesses, investors, and entrepreneurs who are keen on unlocking the potential of digital analytics for informed market entry in Africa. It serves as a guiding light, equipping practitioners with the essential tools and insights needed to thrive in this dynamic and diverse continent. With these key insights, methodologies, and recommendations, this paper is a roadmap to prosperous and sustainable market entry in Africa. It is vital for anyone looking to harness the transformational potential of digital analytics to create prosperous and sustainable ventures in a region brimming with promise. In the ever-advancing digital age, this practitioner paper becomes a lodestar, guiding businesses and visionaries toward success amidst the unique challenges and rewards of sub-Saharan Africa's international business landscape.

Keywords: global analytics, digital analytics, sub-Saharan Africa, data analytics

Procedia PDF Downloads 76
550 Particle Separation Using Individually-Controlled Magnetic Soft Artificial Cilia

Authors: Yau-Luen Ng, Nathan Banka, Santosh Devasia

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In this paper, a method based on soft artificial cilia is introduced to separate particles based on size and mass. In nature, cilia are used for fluid propulsion in the mammalian circulatory system, as well as for swimming and size-selective particle entrainment for feeding in microorganisms. Inspired by biological cilia, an array of artificial cilia was fabricated using Polydimethylsiloxane (PDMS) to simulate the actual motion. A row of four individually-controlled magnetic artificial cilia in a semi-circular channel are actuated by the magnetic fields from four permanent magnets. Each cilium is a slender rectangular cantilever approximately 13mm long made from a composite of PDMS and carbonyl iron particles. A time-varying magnetic force is achieved by periodically varying the out-of-plane distance from the permanent magnets to the cilia, resulting in large-amplitude deflections of the cilia that can be used to drive fluid motion. Previous results have shown that this system of individually-controlled magnetic cilia can generate effective mixing flows; the purpose of the present work is to apply the individual cilia control to a particle separation task. Based on the observed beating patterns of cilia arrays in nature, the experimental beating patterns were selected as a metachronal wave, in which a fixed phase lead or lag is imposed between adjacent cilia. Additionally, the beating frequency was varied. For each set of experimental parameters, the channel was filled with water and polyethylene microspheres introduced at the center of the cilia array. Two types of particles were used: large red microspheres with density 0.9971 g/cm³ and 850-1000 μm avg. diameter, and small blue microspheres with density 1.06 g/cm³ and diameter 30 μm. At low beating frequencies, all particles were propelled in the mean flow direction. However, the large particles were observed to reverse directions above about 4.8 Hz, whereas reversal of the small particle transport direction did not occur until 6 Hz. Between these two transition frequencies, the large and small particles can be separated as they move in opposite directions. The experimental results show that selecting an appropriate cilia beating pattern can lead to selective transport of neutrally-buoyant particles based on their size. Importantly, the separation threshold can be chosen dynamically by adjusting the actuation frequency. However, further study is required to determine the range of particle sizes that can be effectively separated for a given system geometry.

Keywords: magnetic cilia, particle separation, tunable separation, soft actutors

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549 A Study on the Shear-Induced Crystallization of Aliphatic-Aromatic Copolyester

Authors: Ramin Hosseinnezhad, Iurii Vozniak, Andrzej Galeski

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Shear-induced crystallization, originated from orientation of chains along the flow direction, is an inevitable part of most polymer processing technologies. It plays a dominant role in determining the final product properties and is affected by many factors such as shear rate, cooling rate, total strain, etc. Investigation of the shear-induced crystallization process become of great importance for preparation of nanocomposite, which requires crystallization of nanofibrous sheared inclusions at higher temperatures. Thus, the effects of shear time, shear rate, and also thermal condition of cooling on crystallization of two aliphatic-aromatic copolyesters have been investigated. This was performed using Linkam optical shearing system (CSS450) for both Ecoflex® F Blend C1200 produced by BASF and synthesized copolyester of butylene terephthalate and a mixture of butylene esters: adipate, succinate, and glutarate, (PBASGT), containing 60% of aromatic comonomer. Crystallization kinetics of these biodegradable copolyesters was studied at two different conditions of shearing. First, sample with a thickness of 60µm was heated to 60˚C above its melting point and subsequently subjected to different shear rates (100–800 sec-1) while cooling with specific rates. Second, the same type of sample was cooled down when shearing at constant temperature was finished. The intensity of transmitted depolarized light, recorded by a camera attached to the optical microscope, was used as a measure to follow the crystallization. Temperature dependencies of conversion degree of samples during cooling were collected and used to determine the half-temperature (Th), at which 50% conversion degree was reached. Shearing ecoflex films for 45 seconds with a shear rate of 100 sec-1 resulted in significant increase of Th from 56˚C to 70˚C. Moreover, the temperature range for the transition of molten samples to crystallized state decreased from 42˚C to 20˚C. Comparatively low shift of 10˚C in Th towards higher temperature was observed for PBASGT films at shear rate of 600 sec-1 for 45 seconds. However, insufficient melt flow strength and non-laminar flow due to Taylor vortices was a hindrance to reach more elevated Th at very high shear rates (600–800 sec-1). The shift in Th was smaller for the samples sheared at a constant temperature and subsequently cooled down. This may be attributed to the longer time gap between cessation of shearing and the onset of crystallization. The longer this time gap, the more possibility for crystal nucleus to re-melt at temperatures above Tm and for polymer chains to recoil and relax. It is found that the crystallization temperature, crystallization induction time and spherulite growth of aliphatic-aromatic copolyesters are dramatically influenced by both the cooling rate and the shear imposed during the process.

Keywords: induced crystallization, shear rate, aliphatic-aromatic copolyester, ecoflex

Procedia PDF Downloads 452
548 Flux-Gate vs. Anisotropic Magneto Resistance Magnetic Sensors Characteristics in Closed-Loop Operation

Authors: Neoclis Hadjigeorgiou, Spyridon Angelopoulos, Evangelos V. Hristoforou, Paul P. Sotiriadis

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The increasing demand for accurate and reliable magnetic measurements over the past decades has paved the way for the development of different types of magnetic sensing systems as well as of more advanced measurement techniques. Anisotropic Magneto Resistance (AMR) sensors have emerged as a promising solution for applications requiring high resolution, providing an ideal balance between performance and cost. However, certain issues of AMR sensors such as non-linear response and measurement noise are rarely discussed in the relevant literature. In this work, an analog closed loop compensation system is proposed, developed and tested as a means to eliminate the non-linearity of AMR response, reduce the 1/f noise and enhance the sensitivity of magnetic sensor. Additional performance aspects, such as cross-axis and hysteresis effects are also examined. This system was analyzed using an analytical model and a P-Spice model, considering both the sensor itself as well as the accompanying electronic circuitry. In addition, a commercial closed loop architecture Flux-Gate sensor (calibrated and certified), has been used for comparison purposes. Three different experimental setups have been constructed for the purposes of this work, each one utilized for DC magnetic field measurements, AC magnetic field measurements and Noise density measurements respectively. The DC magnetic field measurements have been conducted in laboratory environment employing a cubic Helmholtz coil setup in order to calibrate and characterize the system under consideration. A high-accuracy DC power supply has been used for providing the operating current to the Helmholtz coils. The results were recorded by a multichannel voltmeter The AC magnetic field measurements have been conducted in laboratory environment employing a cubic Helmholtz coil setup in order to examine the effective bandwidth not only of the proposed system but also for the Flux-Gate sensor. A voltage controlled current source driven by a function generator has been utilized for the Helmholtz coil excitation. The result was observed by the oscilloscope. The third experimental apparatus incorporated an AC magnetic shielding construction composed of several layers of electric steel that had been demagnetized prior to the experimental process. Each sensor was placed alone and the response was captured by the oscilloscope. The preliminary experimental results indicate that closed loop AMR response presented a maximum deviation of 0.36% with respect to the ideal linear response, while the corresponding values for the open loop AMR system and the Fluxgate sensor reached 2% and 0.01% respectively. Moreover, the noise density of the proposed close loop AMR sensor system remained almost as low as the noise density of the AMR sensor itself, yet considerably higher than that of the Flux-Gate sensor. All relevant numerical data are presented in the paper.

Keywords: AMR sensor, chopper, closed loop, electronic noise, magnetic noise, memory effects, flux-gate sensor, linearity improvement, sensitivity improvement

Procedia PDF Downloads 423
547 Development of Agomelatine Loaded Proliposomal Powders for Improved Intestinal Permeation: Effect of Surface Charge

Authors: Rajasekhar Reddy Poonuru, Anusha Parnem

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Purpose: To formulate proliposome powder of agomelatine, an antipsychotic drug, and to evaluate physicochemical, in vitro characters and effect of surface charge on ex vivo intestinal permeation. Methods: Film deposition technique was employed to develop proliposomal powders of agomelatin with varying molar ratios of lipid Hydro Soy PC L-α-phosphatidylcholine (HSPC) and cholesterol with fixed sum of drug. With the aim to derive free flowing and stable proliposome powder, fluid retention potential of various carriers was examined. Liposome formation and number of vesicles formed for per mm3 up on hydration, vesicle size, and entrapment efficiency was assessed to deduce an optimized formulation. Sodium cholate added to optimized formulation to induce surface charge on formed vesicles. Solid-state characterization (FTIR, DSC, and XRD) was performed with the intention to assess native crystalline and chemical behavior of drug. The in vitro dissolution test of optimized formulation along with pure drug was evaluated to estimate dissolution efficiency (DE) and relative dissolution rate (RDR). Effective permeability co-efficient (Peff(rat)) in rat and enhancement ratio (ER) of drug from formulation and pure drug dispersion were calculated from ex vivo permeation studies in rat ileum. Results: Proliposomal powder formulated with equimolar ratio of HSPC and cholesterol ensued in higher no. of vesicles (3.95) with 90% drug entrapment up on hydration. Neusilin UFL2 was elected as carrier because of its high fluid retention potential (4.5) and good flow properties. Proliposome powder exhibited augmentation in DE (60.3 ±3.34) and RDR (21.2±01.02) of agomelation over pure drug. Solid state characterization studies demonstrated the transformation of native crystalline form of drug to amorphous and/or molecular state, which was in correlation with results obtained from in vitro dissolution test. The elevated Peff(rat) of 46.5×10-4 cm/sec and ER of 2.65 of drug from charge induced proliposome formulation with respect to pure drug dispersion was assessed from ex vivo intestinal permeation studies executed in ileum of wistar rats. Conclusion: Improved physicochemical characters and ex vivo intestinal permeation of drug from charge induced proliposome powder with Neusilin UFL2 unravels the potentiality of this system in enhancing oral delivery of agomelatin.

Keywords: agomelatin, proliposome, sodium cholate, neusilin

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546 Relationship between Glycated Hemoglobin in Adolescents with Type 1 Diabetes Mellitus and Parental Anxiety and Depression

Authors: Evija Silina, Maris Taube, Maksims Zolovs

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Background: Type 1 diabetes mellitus (T1D) is the most common chronic endocrine pathology in children. The management of type 1 diabetes requires a strong diet, physical activity, lifelong insulin therapy, and proper self-monitoring of blood glucose and is usually complicated and, therefore, may result in a variety of psychosocial problems for children, adolescents, and their families. Metabolic control of the disease is determined by glycated haemoglobin (HbA1c), the main criterion for diabetes compensation. A correlation was observed between anxiety and depression levels and glycaemic control in many previous studies. It is assumed that anxiety and depression symptoms negatively affect glycaemic control. Parental psychological distress was associated with higher child self-report of stress and depressive symptoms, and it had negative effects on diabetes management. Objective: The main objective of this paper is to evaluate the relationship between parental mental health conditions (depression and anxiety) and metabolic control of their adolescents with T1DM. Methods: This cross-sectional study recruited adolescents with T1D (N=251) and their parents (N=251). The respondents completed questionnaires. The 7-item Generalized Anxiety Disorder (GAD-7) scale measured anxiety level; The Patient Health Questionnaire – 9 (PHQ-9) measured depressive symptoms. Glycaemic control of patients was assessed using the last glycated haemoglobin (HbA1c) values. GLM mediation analysis was performed to determine the potential mediating effect of the parent’s mental health conditions (depression and anxiety) on the relationship between the mental health conditions (depression and anxiety) of a child on the level of glycated hemoglobin (HbA1c). To test the significance of the mediated effect (ME) for non-normally distributed data, bootstrapping procedures (10,000 bootstrapped samples) were used. Results: 502 respondents were eligible for screening to detect anxiety and depression symptoms. Mediation analysis was performed to assess the mediating role of parent GAD-7 on the linkage between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9). The results revealed that the total effect of child GAD-7 (B = 0.479, z = 4.30, p < 0.001) on HbA1c was significant but the total effect of child PHQ-9 (B = 0.166, z = 1.49, p = 0.135) was not significant. With the inclusion of the mediating variable (parent GAD-7), the impact of child GAD-7 on HbA1c was found insignificant (B = 0.113, z=0.98, p = 0.326), the impact of child PHQ-9 on HbA1c was found also insignificant (B = 0.068, z=0.74, p = 0.458). The indirect effect of child GAD-7 on HbA1c through parent GAD-7 was found significant (B = 0.366, z = 4.31, p < 0.001) and the indirect effect of child PHQ-9 on HbA1c through parent GAD-7 was found also significant (B = 0.098, z = 2.56, p = 0.010). This indicates that the relationship between a dependent variable (HbA1c) and independent variables (child GAD-7 un child PHQ-9) is fully mediated by parent GAD-7. Conclusion: The main result suggests that glycated haemoglobin in adolescents with Type 1 diabetes is related to adolescents’ mental health via parents’ anxiety. It means that parents’ anxiety plays a more significant role in the level of glycated haemoglobin in adolescents than depression and anxiety in the adolescent.

Keywords: type 1 diabetes, adolescents, parental diabetes-specific mental health conditions, glycated haemoglobin, anxiety, depression

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545 Rehabilitation of Orthotropic Steel Deck Bridges Using a Modified Ortho-Composite Deck System

Authors: Mozhdeh Shirinzadeh, Richard Stroetmann

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Orthotropic steel deck bridge consists of a deck plate, longitudinal stiffeners under the deck plate, cross beams and the main longitudinal girders. Due to the several advantages, Orthotropic Steel Deck (OSD) systems have been utilized in many bridges worldwide. The significant feature of this structural system is its high load-bearing capacity while having relatively low dead weight. In addition, cost efficiency and the ability of rapid field erection have made the orthotropic steel deck a popular type of bridge worldwide. However, OSD bridges are highly susceptible to fatigue damage. A large number of welded joints can be regarded as the main weakness of this system. This problem is, in particular, evident in the bridges which were built before 1994 when the fatigue design criteria had not been introduced in the bridge design codes. Recently, an Orthotropic-composite slab (OCS) for road bridges has been experimentally and numerically evaluated and developed at Technische Universität Dresden as a part of AIF-FOSTA research project P1265. The results of the project have provided a solid foundation for the design and analysis of Orthotropic-composite decks with dowel strips as a durable alternative to conventional steel or reinforced concrete decks. In continuation, while using the achievements of that project, the application of a modified Ortho-composite deck for an existing typical OSD bridge is investigated. Composite action is obtained by using rows of dowel strips in a clothoid (CL) shape. Regarding Eurocode criteria for different fatigue detail categories of an OSD bridge, the effect of the proposed modification approach is assessed. Moreover, a numerical parametric study is carried out utilizing finite element software to determine the impact of different variables, such as the size and arrangement of dowel strips, the application of transverse or longitudinal rows of dowel strips, and local wheel loads. For the verification of the simulation technique, experimental results of a segment of an OCS deck are used conducted in project P1265. Fatigue assessment is performed based on the last draft of Eurocode 1993-2 (2024) for the most probable detail categories (Hot-Spots) that have been reported in the previous statistical studies. Then, an analytical comparison is provided between the typical orthotropic steel deck and the modified Ortho-composite deck bridge in terms of fatigue issues and durability. The load-bearing capacity of the bridge, the critical deflections, and the composite behavior are also evaluated and compared. Results give a comprehensive overview of the efficiency of the rehabilitation method considering the required design service life of the bridge. Moreover, the proposed approach is assessed with regard to the construction method, details and practical aspects, as well as the economic point of view.

Keywords: composite action, fatigue, finite element method, steel deck, bridge

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544 Symptom Burden and Quality of Life in Advanced Lung Cancer Patients

Authors: Ammar Asma, Bouafia Nabiha, Dhahri Meriem, Ben Cheikh Asma, Ezzi Olfa, Chafai Rim, Njah Mansour

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Despite recent advances in treatment of the lung cancer patients, the prognosis remains poor. Information is limited regarding health related quality of life (QOL) status of advanced lung cancer patients. The purposes of this study were: to assess patient reported symptom burden, to measure their QOL, and to identify determinant factors associated with QOL. Materials/Methods: A cross sectional study of 60 patients was carried out from over the period of 03 months from February 1st to 30 April 2016. Patients were recruited in two department of health care: Pneumology department in a university hospital in Sousse and an oncology unit in a University Hospital in Kairouan. Patients with advanced stage (III and IV) of lung cancer who were hospitalized or admitted in the day hospital were recruited by convenience sampling. We used a questionnaire administrated and completed by a trained interviewer. This questionnaire is composed of three parts: demographic, clinical and therapeutic information’s, QOL measurements: based on the SF-36 questionnaire, Symptom’s burden measurement using the Lung Cancer Symptom Scale (LCSS). To assess Correlation between symptoms burden and QOL, we compared the scores of two scales two by two using the Pearson correlation. To identify factors influencing QOL in Lung cancer, a univariate statistical analysis then, a stepwise backward approach, wherein the variables with p< 0.2, were carried out to determine the association between SF-36 scores and different variables. Results: During the study period, 60 patients consented to complete symptom and quality of life questionnaires at a single point time (72% were recruited from day hospital). The majority of patients were male (88%), age ranged from 21 to 79 years with a mean of 60.5 years. Among patients, 48 (80%) were diagnosed as having non-small cell lung carcinoma (NSCLC). Approximately, 60 % (n=36) of patients were in stage IV, 25 % in stage IIIa and 15 % in stage IIIb. For symptom burden, the symptom burden index was 43.07 (Standard Deviation, 21.45). Loss of appetite and fatigue were rated as the most severe symptoms with mean scores (SD): 49.6 (25.7) and 58.2 (15.5). The average overall score of SF36 was 39.3 (SD, 15.4). The physical and emotional limitations had the lowest scores. Univariate analysis showed that factors which influence negatively QOL were: married status (p<0.03), smoking cessation after diagnosis (p<0.024), LCSS total score (p<0.001), LCSS symptom burden index (p<0.001), fatigue (p<0.001), loss of appetite (p<0.001), dyspnea (p<0.001), pain (p<0.002), and metastatic stage (p<0.01). In multivariate analysis, unemployment (p<0.014), smoking cessation after diagnosis (p<0.013), consumption of analgesic (p<0.002) and the indication of an analgesic radiotherapy (p<0.001) are revealed as independent determinants of QOL. The result of the correlation analyses between total LCSS scores and the total and individual domain SF36 scores was significant (p<0.001); the higher total LCSS score is, the poorer QOL is. Conclusion: A built in support of lung cancer patients would better control the symptoms and promote the QOL of these patients.

Keywords: quality of life, lung cancer, metastasis, symptoms burden

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543 A Multilingual App for Studying Children’s Developing Values: Developing a New Arabic Translation of the Picture-based Values Survey and Comparison of Palestinian and Jewish Children in Israel

Authors: Aysheh Maslamani, Ella Daniel, Anna Dӧring, Iyas Nasser, Ariel Knafo-Noam

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Over 250 million people globally speak Arabic, one of the most widespread languages in the world, as their first language. Yet only a minuscule fraction of developmental research studies Middle East children. As values are a core component of culture, understanding how values develop is key to understanding development across cultures. Indeed, with the advent of research on value development, significantly since the introduction of the Picture-Based Value Survey for Children, interest in cross-cultural differences in children's values is increasing. As no measure exists for Arab children, PBVS-C in Arabic developed. The online application version of the PBVS-C that can be administered on a computer, tablet, or even a smartphone to measure the 10 values whose presence has been repeatedly demonstrated across the world. The application has been developed simultaneously in Hebrew and Arabic and can easily be adapted to include additional languages. In this research, the development of the multilingual PBVS-C application version adapted for five-year-olds. The translation process discussed (including important decisions such as which dialect of Arabic, a diglossic language, is most suitable), adaptations to subgroups (e.g., Muslim, Druze and Christian Arab children), and using recorded instructions and value item captions, as well as touchscreens to enhance applicability with young children. Four hundred Palestinian and Israeli 5-12 year old children reported their values using the app (50% in Arabic, 50% in Hebrew). Confirmatory Multidimensional Scaling (MDS) analyses revealed structural patterns that closely correspond to Schwartz's theoretical structure in both languages (e.g., universalism values correlated positively with benevolence and negatively with power, whereas tradition correlated negatively with hedonism and positively with conformity). Replicating past findings, power values showed lower importance than benevolence values in both cultural groups, and there were gender differences in which girls were higher in self-transcendence values and lower in self-enhancement values than boys. Cultural value importance differences were explored and revealed that Palestinian children are significantly higher in tradition and achievement values compared to Israeli children, whereas Israeli children are significantly higher in benevolence, hedonism, self-direction, and stimulation values. Age differences in value coherence across the two groups were also studied. Exploring the cultural differences opens a window to understanding the basic motivations driving populations that were hardly studied before. This study will contribute to the developmental value research since it considers the role of critical variables such as culture and religion and tests value coherence across middle childhood. Findings will be discussed, and the potential and limitations of the computerized PBVS-C concerning future values research.

Keywords: Arab-children, culture, multilingual-application, value-development

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542 Nutrition Support Practices and Nutritional Status of Adolescents Receiving Antiretroviral Therapy in Selected Hospitals in Ethiopia

Authors: Meless Gebrie Bore, Lin Perry, Xiaoyue Xu, Andargachew Kassa, Marilyn Cruickshank

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Background: Adolescents living with HIV (ALHIV) in Ethiopia face significant health challenges, particularly related to nutrition, which is essential for optimizing antiretroviral therapy (ART) outcomes. This population is vulnerable to nutritional deficiencies due to increased energy demands and the adverse effects of HIV, alongside rapid growth and low socio-economic status. Despite advances in ART, research on nutritional care for ALHIV in Ethiopia is limited. Integrated nutritional interventions are critical for improving health outcomes, yet comprehensive guidance is lacking. This study aimed to evaluate healthcare workers' practices in ART clinics, assess the nutritional status of ALHIV, and provide recommendations for enhancing nutritional care. Method: Cross-sectional surveys were conducted, recruiting 44 healthcare professionals and 384 ALHIV across ten public hospitals in Addis Ababa and Oromia regions. Participants were selected using purposive sampling for healthcare workers and proportionate random sampling for ALHIV engaged in ART services. Data was collected using a pre-tested structured questionnaire with quantitative and qualitative components facilitated by trained healthcare workers through the Kobo Toolbox program. Results: Findings revealed that while most healthcare workers conducted basic nutritional assessments, more sensitive methods were rarely used. Only 36.4% assessed dietary intake and 27.3% evaluated food security. Nutrition counseling was limited, with only 38.6% providing such services regularly. Health Care worker participants expressed dissatisfaction with the integration of nutrition services due to a lack of training and resources. Nutritional assessments revealed that 24.2% of ALHIV were classified as thin, 21.7% as stunted, and 34.9% as malnourished based on mid-upper arm circumference, with 19.4% experiencing severe acute malnutrition. These results highlight the urgent need and opportunities to improve nutritional support tailored to ALHIV-specific needs. Conclusion and Recommendations: Study findings identified evidence of substantial nutritional deficits and critical gaps in nutritional care for ALHIV in Ethiopian ART clinics. While basic assessment and counseling were generally practiced, limited use of more sensitive methods and inadequate integration of nutrition services hindered care effectiveness. To improve health outcomes, it is essential to enhance training for healthcare workers, develop standardized nutrition guidelines, and allocate resources effectively. Conducting further research with large, diverse samples and integrating comprehensive nutritional care alongside ART services will enable better matching of the nutritional needs of this vulnerable population.

Keywords: adolescents living with HIV(ALHIV), antiretroviral therapy (ART), HIV, Ethiopia, malnutrition, nutritional support, stunting, thinness

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