Search results for: operating room nursing

Authors: Ali A. Hammadi

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In this work, a practical study on a commissioned Giga Passive Optical Network (GPON) fiber to the home access network in Kuwait is presented. The work covers the framework of the conceptual design of the deployed Passive Optical Networks (PONs), access network, optical fiber cable network distribution, technologies, and standards. The work also describes methodologies applied by system engineers for design of Optical Network Terminals (ONTs) and Optical Line Terminals (OLTs) transceivers with respect to the distance, operating wavelengths, splitting ratios. The results have demonstrated and justified the limitation of transmission distance of a PON link in Fiber to The Premises (FTTP) to not exceed 20 km. Optical Time Domain Reflector (OTDR) test has been carried for this project to confirm compliance with International Telecommunication Union (ITU) specifications regarding the total length of the deployed optical cable, total loss in dB, and loss per km in dB/km with respect to the operating wavelengths. OTDR test results with traces for segments of implemented fiber network will be provided and discussed.

Keywords: passive optical networks (PONs), fiber to the premises (FTTx), access network, OTDR

Procedia PDF Downloads 281

Authors: Elif Ates, Naile Bilgili

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Background: One of the most important medical complications that individuals with spinal cord injury (SCI) face are the neurogenic bladder. Objectives: To review methods used for management of neurogenic bladder and their effects. Methods: The study was conducted by searching CINAHL, Ebscohost, MEDLINE, Science Direct, Ovid, ProQuest, Web of Science, and ULAKBİM National Databases for studies published between 2005 and 2015. Key words used during the search included ‘spinal cord injury’, ‘bladder injury’, ‘nursing care’, ‘catheterization’ and ‘intermittent urinary catheter’. After examination of 551 studies, 21 studies which met inclusion criteria were included in the review. Results: Mean age of individuals in all study samples was 42 years. The most commonly used bladder management method was clean intermittent catheterization (CIC). Compliance with CIC was found to be significantly related to spasticity, maximum cystometric capacity, and the person performing catheterization (p < .05). The main reason for changing the existing bladder management method was urinary tract infections (UTI). Individuals who performed CIC by themselves and who voided spontaneously had better life quality. Patient age, occupation status and whether they performed CIC by themselves or not were found to be significantly associated with depression level (p ≤ .05). Conclusion: As the most commonly used method for bladder management, CIC is a reliable and effective method, and reduces the risk of UTI development. Individuals with neurogenic bladder have a higher prevalence of depression symptoms than the normal population.

Keywords: bladder management, catheterization, nursing, spinal cord injury

Procedia PDF Downloads 169

Authors: Mei-Fang Wu, Shu-Li Wang, Tsung-Yueh Lu, Feng-Tsung Cheng

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Strengthening core competitiveness is the main goal of enterprises in a fierce competitive environment. Accurate cost information is a great help for managers in dealing with operation strategies. This paper establishes a profitability management mechanism that applies the Activity-Based Benefit approach (ABBA) to solve the profitability for each customer from the market. ABBA provides financial and non-financial information for the operation, but also indicates what resources have expired in the operational process. The customer profit management model shows the level of profitability of each customer for the company. The empirical data were gathered from a case company operating in the leather industry in Taiwan. The research findings indicate that 30% of customers create little profit for the company as a result of asking for over 5% of sales discounts. Those customers ask for sales discount because of color differences of leather products. This paper provides a customer’s profitability evaluation mechanism to help enterprises to greatly improve operating effectiveness and promote operational activity efficiency and overall operation profitability.

Keywords: activity-based benefit approach, customer profit analysis, leather industry, profitability management mechanism

Procedia PDF Downloads 298

Authors: Rafal Sochaczewski, Grzegorz Baranski, Adam Majczak

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This paper presents the bench research results on a CNG injector at steady state. The quantities measured included voltage and current in a solenoid, pressure of gas behind an injector and injector’s flow rate. Accordingly, injector’s operation parameters were determined according to needle’s lift and injection pressure. The discrepancies between the theoretical (electric) and actual time of injection were defined to specify injector’s opening and closing lag times and the uniqueness of these values in successive cycles of gas injection. It has been demonstrated that needle’s lift has got a stronger impact on injector’s operating parameters than injection pressure. With increasing injection pressure, the force increases and closes an injection valve, which adversely affects uniqueness of injector’s operation. The paper also describes the concept of an injector dedicated to direct CNG injection into a combustion chamber in a dual-fuel engine. The injector’s design enables us to replace 80% of diesel fuel in a dual-fuel engine with a maximum power of 85 kW. Minimum injection pressure is 1,4 MPa then. Simultaneously, injector’s characteristics for varied needle’s lifts and injector’s nonlinear operating points were developed. Acknowledgement: This work has been financed by the Polish National Centre for Research and Development, under Grant Agreement No. PBS1/A6/4/2012.

Keywords: CNG injector, diesel engine, direct injection, dual fuel

Procedia PDF Downloads 270

Authors: Ana Miguel

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Purpose: Glaucoma is the second cause of worldwide blindness and the first cause of irreversible blindness. Trabeculectomy, the standard glaucoma surgery, has a success rate between 36.0% and 98.0% at three years and a high complication rate, leading to the development of different surgeries, micro-invasive glaucoma surgeries (MIGS). MIGS devices are diverse and have various indications, risks, and effectiveness. We intended to review MIGS’ surgical techniques, indications, contra-indications, and IOP effect. Methods: We performed a literature review of MIGS to differentiate the devices and their reported effectiveness compared to traditional surgery (tubes and blebs). We also conducted a video review of the last 1000 glaucoma surgeries of the author (including MIGS, but also trabeculectomy, deep sclerectomy, and tubes of Ahmed and Baerveldt) performed at glaucoma and advanced anterior segment fellowship in Canada and France, to describe preferred surgical techniques for each. Results: We present the videos with surgical techniques and pearls for each surgery. Glaucoma surgeries included: 1- bleb surgery (namely trabeculectomy, with releasable sutures or with slip knots, deep sclerectomy, Ahmed valve, Baerveldt tube), 2- MIGS with bleb, also known as MIBS (including XEN 45, XEN 63, and Preserflo), 3- MIGS increasing supra-choroidal flow (iStar), 4-MIGS increasing trabecular flow (iStent, gonioscopy-assisted transluminal trabeculotomy - GATT, goniotomy, excimer laser trabeculostomy -ELT), and 5-MIGS decreasing aqueous humor production (endocyclophotocoagulation, ECP). There was also needling (ab interno and ab externo) performed at the operating room and irido-zonulo-hyaloïdectomy (IZHV). Each technique had different indications and contra-indications. Conclusion: MIGS are valuable in glaucoma surgery, such as traditional surgery with trabeculectomy and tubes. All glaucoma surgery can be combined with phacoemulsification (there may be a synergistic effect on MIGS + cataract surgery). In addition, some MIGS may be combined for further intraocular pressure lowering effect (for example, iStents with goniotomy and ECP). A good surgical technique and postoperative management are fundamental to increasing success and good practice in all glaucoma surgery.

Keywords: glaucoma, migs, surgery, video, review

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Authors: Nadine Wills

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The whole life thinking of buildings (independent if these are commercial properties or residential properties) will raise if incentive systems are provided to investors, planners and users. The Use of Building Information Modelling (BIM)-Systems offers planners the possibility to plan and re-plan buildings for decades after a period of utilization without spending many capacities. The strategy-incentive should be to plan the building in a way that makes rescheduling possible by changing just parameters in the system and not re-planning the whole building. If users receive the chance to patient incentive systems, the building stock will have a long life period. Business models of tenant electricity or self-controlled operating costs are incentive systems for building –users to let fixed running costs decline without producing damages due to wrong purposes. BIM is the controlling body to ensure that users do not abuse the incentive solution and take negative influence on the building stock. The investor benefits from the planner’s and user’s incentives: the fact that the building becomes useful for the whole life without making unnecessary investments provides possibilities to make investments in different assets. Moreover, the investor gains the facility to achieve higher rents by merchandise the property with low operating costs. To execute BIM offers whole property life cycles.

Keywords: BIM, incentives, life cycle, sustainability

Procedia PDF Downloads 292

Authors: Alirıza Kaleli, M. Akif Ceviz, Erdoğan Güner, Köksal Erentürk

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The cyclic variations in spark ignition engines occurring especially under specific engine operating conditions make the maximum pressure variable for successive in-cylinder pressure cycles. Minimization of cyclic variations has a great importance in effectively operating near to lean limit, or at low speed and load. The cyclic variations may reduce the power output of the engine, lead to operational instabilities, and result in undesirable engine vibrations and noise. In this study, spark timing is controlled in order to reduce the cyclic variations in spark ignition engines. Firstly, an ARMAX model has developed between spark timing and maximum pressure using system identification techniques. By using this model, the maximum pressure of the next cycle has been predicted. Then, self-tuning minimum variance controller has been designed to change the spark timing for consecutive cycles of the first cylinder of test engine to regulate the in-cylinder maximum pressure. The performance of the proposed controller is illustrated in real time and experimental results show that the controller has a reliable effect on cycle to cycle variations of maximum cylinder pressure when the engine works under low speed conditions.

Keywords: cyclic variations, cylinder pressure, SI engines, self tuning controller

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Authors: Mohd Moiz Khan, S. M. Mahajani, G. N. Jadhav

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Waste foundry sand (total clay content 15%) contains toxic heavy metals and particulate matter which make dumping of waste sand an environmental and health hazard. Disposal of waste foundry sand (WFS) remains one of the substantial challenges faced by Indian foundries nowadays. To cope up with this issue, the chemical method was used to reclaim WFS. A stirrer tank reactor was used for chemical reclamation. Experiments were performed to reduce the total clay content from 15% to as low as 0.9% in chemical reclamation. This method, although found to be effective for WFS reclamation, it may face a challenge due to the possibly high operating cost. Reclaimed sand was found to be satisfactory in terms of sand qualities such as total clay (0.9%), active clay (0.3%), acid demand value (ADV) (2.6%), loss on igniting (LOI) (3 %), grain fineness number (GFN) (56), and compressive strength (60 kPa). The experimental data generated on chemical reactor under different conditions is further used to optimize the design and operating parameters (rotation speed, sand to acidic solution ratio, acid concentration, temperature and time) for the best performance. The use of reclaimed sand within the foundry would improve the economics and efficiency of the process and reduce environmental concerns.

Keywords: chemical reclamation, clay content, environmental concerns, recycle, waste foundry sand

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Authors: Annie B. V., Anu A. G., Harikumar R.

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Microgrid (MG) is a self-governing miniature section of the power system. Nowadays the majority of loads and energy storage devices are inherently in DC form. This necessitates a greater scope of research in the various types of energy storage devices in DC microgrids. In a modern power system, DC microgrid is a manageable electric power system usually integrated with renewable energy sources (RESs) and DC loads with the help of power electronic converters. The stability of the DC microgrid mainly depends on the power imbalance. Power imbalance due to the presence of intermittent renewable energy resources (RERs) is supplied by energy storage devices. Battery, supercapacitor, flywheel, etc. are some of the commonly used energy storage devices. Owing to the high energy density provided by the batteries, this type of energy storage system is mainly utilized in all sorts of hybrid energy storage systems. To minimize the stability issues, a Supercapacitor (SC) is usually interfaced with the help of a bidirectional DC/DC converter. SC can exchange power during transient conditions due to its high power density. This paper analyses the stability issues of DC microgrids with hybrid energy storage systems (HESSs) arises from a reduction in SC operating voltage due to self-discharge. The stability of DC microgrid and power management is analyzed with different control strategies.

Keywords: DC microgrid, hybrid energy storage system (HESS), power management, small signal modeling, supercapacitor

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Authors: Mokhlisur Rahman

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The growing consensus among scientists and world leaders indicates that immediate action should be considered regarding the climate change phenomenon. However, climate change is no more a global issue but a personal one. Thus, individual participation is necessary to address such a significant issue. Studies show that individuals who perceive climate change as a personal issue are more likely to act toward it. This abstract presents augmented reality (A.R.) technology in the social media platform Facebook video advertising. The idea involves creating a video advertisement that enables users to interact with the video by navigating its features and experiencing the result uniquely and engagingly. This advertisement uses A.R. to bring changes, such as people making changes in real-life scenarios by simple clicks on the video and hearing an instant rewarding fact about their choices. The video shows three options: room, lawn, and driveway. Users select one option and engage in interaction based on while holding the camera in their personal spaces: Suppose users select the first option, room, and hold their camera toward spots such as by the windows, balcony, corners, and even walls. In that case, the A.R. offers users different plants appropriate for those unoccupied spaces in the room. Users can change the options of the plants and see which space at their house deserves a plant that makes it more natural. When a user adds a natural element to the video, the video content explains a piece of beneficiary information about how the user contributes to the world more to be livable and why it is necessary. With the help of A.R., if users select the second option, lawn, and hold their camera toward their lawn, the options are various small trees for their lawn to make it more environmentally friendly and decorative. The video plays a beneficiary explanation here too. Suppose users select the third option, driveway, and hold their camera toward their driveway. In that case, the A.R. video option offers unique recycle bin designs using A.I. measurement of spaces. The video plays audio information on anthropogenic contribution to greenhouse gas emission. IoT embeds tracking code in the video ad on Facebook, which stores the exact number of views in the cloud for data analysis. An online survey at the end collects short qualitative answers. This study helps understand the number of users involved and willing to change their behavior; It makes personalized advertising in social media. Considering the current state of climate change, the urgency for action is increasing. This ad increases the chance to make direct connections with individuals and gives a sense of personal responsibility for climate change to act

Keywords: motivations, climate, iot, personalized-advertising, action

Procedia PDF Downloads 70

Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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Authors: Armin Amindari

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Hermetic compressors are used widely for refrigeration, heat pump, and air conditioning applications. With the improvement of energy conservation and environmental protection requirements, inverter compressors that operates at different speeds have become increasingly attractive in the industry. Although speed change capability is more efficient, passing through resonant frequencies may lead to excessive vibrations. In this work, an integrated vibration control approach based on flexible multi-body dynamics theory is used for optimizing the vibration amplitudes of the compressor at different operating speeds. To examine the compressor vibrations, all the forces and moments exerted on the cylinder block were clarified and minimized using balancers attached to the upper and lower ends of the motor rotor and crankshaft. The vibration response of the system was simulated using Motionview™ software. In addition, mass-spring optimization was adopted to shift the resonant frequencies out of the operating speeds. The modal shapes of the system were studied using Optistruct™ solver. Using this approach, the vibrations were reduced up to 56% through dynamic simulations. The results were in high agreement with various experimental test data. In addition, the vibration resonance problem observed at low speeds was solved by shifting the resonant frequencies through optimization studies.

Keywords: vibration, MBD, compressor, hermetic

Procedia PDF Downloads 94

Authors: Nikolett Deutsch, Éva Pintér, Péter Bagó, Miklós Hetényi

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Strategic technology management has emerged and evolved parallelly with strategic management paradigms. It focuses on the opportunity for organizations operating mainly in technology-intensive industries to explore and exploit technological capabilities upon which competitive advantage can be obtained. As strategic technology management involves multifunction within an organization, requires broad and diversified knowledge, and must be developed and implemented with business objectives to enable a firm’s profitability and growth, excellence in strategic technology management provides unique opportunities for organizations in terms of building a successful future. Accordingly, a framework supporting the evaluation of the technological readiness level of management can significantly contribute to developing organizational competitiveness through a better understanding of strategic-level capabilities and deficiencies in operations. In the last decade, several innovation maturity assessment models have appeared and become designated management tools that can serve as references for future practical approaches expected to be used by corporate leaders, strategists, and technology managers to understand and manage technological capabilities and capacities. The aim of this paper is to provide a comprehensive review of the state-of-the-art innovation maturity frameworks, to investigate the critical lessons learned from their application, to identify the similarities and differences among the models, and identify the main aspects and elements valid for the field and critical functions of technology management. To this end, a systematic literature review was carried out considering the relevant papers and articles published in highly ranked international journals around the 27 most widely known innovation maturity models from four relevant digital sources. Key findings suggest that despite the diversity of the given models, there is still room for improvement regarding the common understanding of innovation typologies, the full coverage of innovation capabilities, and the generalist approach to the validation and practical applicability of the structure and content of the models. Furthermore, the paper proposes an initial structure by considering the maturity assessment of the technological capacities and capabilities - i.e., technology identification, technology selection, technology acquisition, technology exploitation, and technology protection - covered by strategic technology management.

Keywords: innovation capabilities, innovation maturity models, technology audit, technology management, technology management maturity models

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Authors: Mehtap Öztürk, Adem Öğüt, Emine Öğüt

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Leader member exchange is considered as relationship-based approach to leadership. The focal point of this theory is that effective leadership processes occur when leaders and followers are able to develop mature leadership relationships and thus gain access to a variety of benefits these relationships bring. In this context, it can be claimed that the quality of leader member exchange appears to have a strong affect on perceived organizational support and reduce turnover intention. The purpose of this study is to determine the relationship between the levels of leader member exchange, perceived organizational support and turnover intention on the employees of a health institution operating in the province of Konya. A field study based on survey method on 134 physicians who are employees of a health institution operating in the mentioned sample. In accordance with this purpose, it has been observed that there is a negative and statistically significant relationship between leader member exchange and turnover intention. Furthermore, it has been also realized that there is a negative and statistically significant relationship between perceived organizational support and turnover intention.

Keywords: leader member exchange, perceived organizational support, social exchange theory, turnover intention

Procedia PDF Downloads 353

Authors: M. S. Nikitenko, S. A. Kizilov, D. Y. Khudonogov

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The paper considers an approach to a machine vision operating system combined with using a grid of light markers. This approach is used to solve several scientific and technical problems, such as measuring the capability of an apron feeder delivering coal from a lining return port to a conveyor in the technology of mining high coal releasing to a conveyor and prototyping an autonomous vehicle obstacle detection system. Primary verification of a method of calculating bulk material volume using three-dimensional modeling and validation in laboratory conditions with relative errors calculation were carried out. A method of calculating the capability of an apron feeder based on a machine vision system and a simplifying technology of a three-dimensional modelled examined measuring area with machine vision was offered. The proposed method allows measuring the volume of rock mass moved by an apron feeder using machine vision. This approach solves the volume control issue of coal produced by a feeder while working off high coal by lava complexes with release to a conveyor with accuracy applied for practical application. The developed mathematical apparatus for measuring feeder productivity in kg/s uses only basic mathematical functions such as addition, subtraction, multiplication, and division. Thus, this fact simplifies software development, and this fact expands the variety of microcontrollers and microcomputers suitable for performing tasks of calculating feeder capability. A feature of an obstacle detection issue is to correct distortions of the laser grid, which simplifies their detection. The paper presents algorithms for video camera image processing and autonomous vehicle model control based on obstacle detection machine vision systems. A sample fragment of obstacle detection at the moment of distortion with the laser grid is demonstrated.

Keywords: machine vision, machine vision operating system, light markers, measuring capability, obstacle detection system, autonomous transport

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Authors: A. U. Moreh, M. Momoh, H. N. Yahya, B. Hamza, I. G. Saidu, S. Abdullahi

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This work studies the effect of thickness on structural and electrical properties of CuAlS2 thin films grown by two stage vacuum thermal evaporation technique. CuAlS2 thin films of thicknesses 50nm, 100nm and 200nm were deposited on suitably cleaned corning 7059 glass substrate at room temperature (RT). In the first stage Cu-Al precursors were grown at room temperature by thermal evaporation and in the second stage Cu-Al precursors were converted to CuAlS2 thin films by sulfurisation under sulfur atmosphere at the temperature of 673K. The structural properties of the films were examined by X-ray diffraction (XRD) technique while electrical properties of the specimens were studied using four point probe method. The XRD studies revealed that the films are of crystalline in nature having tetragonal structure. The variations of the micro-structural parameters, such as crystallite size (D), dislocation density ( ), and micro-strain ( ), with film thickness were investigated. The results showed that the crystallite sizes increase as the thickness of the film increases. The dislocation density and micro-strain decreases as the thickness increases. The resistivity (  ) of CuAlS2 film is found to decrease with increase in film thickness, which is related to the increase of carrier concentration with film thickness. Thus thicker films exhibit the lowest resistivity and high carrier concentration, implying these are the most conductive films. Low electrical resistivity and high carrier concentration are widely used as the essential components in various optoelectronic devices such as light-emitting diode and photovoltaic cells.

Keywords: CuAlS2, evaporation, sulfurisation, thickness, resistivity, crystalline

Procedia PDF Downloads 478

Authors: Zainurrasyid Abdullah, Mohamed Fadzlee Sulaiman, Muhammad Fadzlan Zainal, M. Zabri Adil Talib, Aswami Fadillah M. Ariffin

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The Onion Router (Tor) browser is a well-known tool and widely used by people who seeking for web anonymity when browsing the internet. Criminals are taking this advantage to be anonymous over the internet. Accessing the dark web could be the significant reason for the criminal in order for them to perform illegal activities while maintaining their anonymity. For a digital forensic analyst, it is crucial to extract the trail of evidence in proving that the criminal’s computer has used Tor browser to conduct such illegal activities. By applying the digital forensic methodology, several techniques could be performed including application analysis, memory analysis, and registry analysis. Since Windows 10 is the latest operating system released by Microsoft Corporation, this study will use Windows 10 as the operating system platform that running Tor browser. From the analysis, significant artifacts left by Tor browser were discovered such as the execution date, application installation date and browsing history that can be used as an evidence. Although Tor browser was designed to achieved anonymity, there is still some trail of evidence can be found in Windows 10 platform that can be useful for investigation.

Keywords: artifacts analysis, digital forensics, forensic analysis, memory analysis, registry analysis, tor browser, Windows 10

Procedia PDF Downloads 164

Authors: Sanjay Dhiraaj, Puneet Goyal, Aditya Kapoor, Gaurav Misra

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In electrocardiography, an ECG artefact is used to indicate something that is not heart-made. Although technological advancements have produced monitors with the potential of providing accurate information and reliable heart rate alarms, despite this, interference of the displayed electrocardiogram still occurs. These interferences can be from the various electrical gadgets present in the operating room or electrical signals from other parts of the body. Artefacts may also occur due to poor electrode contact with the body or due to machine malfunction. Knowing these artefacts is of utmost importance so as to avoid unnecessary and unwarranted diagnostic as well as interventional procedures. We report a case of ECG artefacts occurring due to patient warming blanket and its consequences. A 20-year-old male with a preoperative diagnosis of exstrophy epispadias complex was posted for surgery under epidural and general anaesthesia. Just after endotracheal intubation, we observed nonspecific ECG changes on the monitor. At a first glance, the monitor strip revealed broad QRs complexes suggesting a ventricular bigeminal rhythm. Closer analysis revealed these to be artefacts because although the complexes were looking broad on the first glance there was clear presence of normal sinus complexes which were immediately followed by 'broad complexes' or artefacts produced by some device or connection. These broad complexes were labeled as artefacts as they were originating in the absolute refractory period of the previous normal sinus beat. It would be physiologically impossible for the myocardium to depolarize so rapidly as to produce a second QRS complex. A search for the possible reason for the artefacts was made and after deepening the plane of anaesthesia, ruling out any possible electrolyte abnormalities, checking of ECG leads and its connections, changing monitors, checking all other monitoring connections, checking for proper grounding of anaesthesia machine and OT table, we found that after switching off the patient’s warming apparatus the rhythm returned to a normal sinus one and the 'broad complexes' or artefacts disappeared. As misdiagnosis of ECG artefacts may subject patients to unnecessary diagnostic and therapeutic interventions so a thorough knowledge of the patient and monitors allow for a quick interpretation and resolution of the problem.

Keywords: ECG artefacts, patient warming blanket, peri-operative arrhythmias, mobile messaging services

Procedia PDF Downloads 265

Authors: Cigdem Yangin-Gomec, Aigerim Jaxybayeva, Orhan Ince

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In this study, the anaerobic treatability of chicken manure diluted with tap water (with an influent feed ratio of 1 kg of fresh chicken manure to 6 liter of tap water) was investigated in a lab-scale anaerobic sludge bed (ASB) reactor inoculated with the granular sludge already adapted to chicken manure. The raw waste digested in this study was the manure from laying-hens having average total solids (TS) of about 30% with ca. 60% volatile content. The ASB reactor was fed semi-continuously at ambient operating temperature range (17-23^◦C) at a HRT of 13 and 26 days for about 6 months, respectively. The respective average total and soluble chemical oxygen demand (COD) removals were ca. 90% and 75%, whereas average biomethane production rate was calculated ca. 180 lt per kg of COD_removed from the ASB reactor at an average HRT of 13 days. Moreover, total suspended solids (TSS) and volatile suspended solids (VSS) in the influent were reduced more than 97%. Hence, high removals of the organic compounds with respective biogas production made anaerobic stabilization of the diluted chicken manure by ASB reactor at ambient operating temperatures viable. By this way, external heating up to 35^◦C (i.e. anaerobic processes have been traditionally operated at mesophilic conditions) could be avoided in the scope of this study.

Keywords: ambient anaerobic digestion, biogas recovery, poultry manure, renewable energy

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Authors: Tayyibah Khanam, Mohammad Saad Alam, Sanchari Deb, Yasser Rafat

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Electric vehicles are considered as viable replacements to gasoline cars since they help in reducing harmful emissions and stimulate power generation through renewable energy sources, hence contributing to sustainability. However, one of the significant obstacles in the mass deployment of electric vehicles is the charging time anxiety among users and, thus, the subsequent large waiting times for available chargers at charging stations. Data analytics, on the other hand, has revolutionized the decision-making tasks of management and operating systems since its arrival. In this paper, we attempt to optimize the choice of EV charging stations for users in their vicinity by minimizing the time taken to reach the charging stations and the waiting times for available chargers. Time taken to travel to the charging station is calculated by the Google Maps API and the waiting times are predicted by polynomial regression of the historical data stored. The proposed framework utilizes real-time data and historical data from all operating charging stations in the city and assists the user in finding the best suitable charging station for their current situation and can be implemented in a mobile phone application. The algorithm successfully predicts the most optimal choice of a charging station and the minimum required time for various sample data sets.

Keywords: charging data, electric vehicles, machine learning, waiting times

Procedia PDF Downloads 183

Authors: Biswajit Seal, Dushyant Kumar, Shambhu Nath, A. B. Raju

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Extension of blast furnace campaign life is highly desired for blast furnace operators mainly because of reduction of operating cost and to avoid capital expenditure cost. Tata Steel Ltd, Jamshedpur plant operates seven blast furnaces with combination of old and new technologies. The focus of Tata Steel Ltd is to push for increasing productivity with good quality product and increasing campaign life. This has been challenging for older furnaces because older furnaces are generally equipped with less automation, old design and old equipment. Good operational practices, appropriate remedial measures, and regular planned maintenance helps to achieve long campaign life of old furnaces. Good operating practices like stable and consistent productivity, control of burden distribution, remedial measures like stack gunning and shotcreting for protection of stack wall, enhanced cooling system, and intermediate stack repair helps to achieve long campaign life of old blast furnaces. This paper describes experiences with the current old equipment and design of Tata Steel’s D Blast Furnace for campaign life extension.

Keywords: blast furnace, burden distribution, campaign life, productivity

Procedia PDF Downloads 257

Authors: Chaoren Lu

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Public policy is playing as one driving force that influencing service innovation implementation in public sector. However, public policy implications cannot be automatically derived from the analyses of innovation issues, and there lacks of researches about the influences of public policy onto innovation. Moreover, innovation in service system is hard to predictable and whether policy encourages or hidden innovation is still lack of study. Especially, by given the context that multiple actors are active involving within the service delivery process in public transport sector, the complex driving forces and challenges are emerged towards the service operation. This study is aim to analysis the service innovation practices within service operating organizations to understand the drivers and challenges of service operation based on policy requirements, and where the innovation idea generating from. The case studies of Changzhou Transit Group and Nanjing Jiangnan Public Transit Group will be launched. This paper reveals the ambidexterity between top-down and bottom-up demands within the public transport service operating organizations contribute to the innovation ideas. Meanwhile, it contributes to the understanding of fundamental elements of service innovation is the new relationship creation and new way of sharing knowledge. The policy contributes to the trigger of creation of such relationship. The research question is: what are the sources of service innovation practices in local public transport system in China in in facing the policy implementation?

Keywords: public value, service innovation, public transport service, China

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Authors: Satpal Singh, Subhash Chander

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An experimental study has been conducted to evaluate the thermal performance of the CNG/air dual flame impinging normally on to a flat surface. The stability limits for the dual flame under both impinging and free conditions have been evaluated to select experimental operating range. Dual flame shape and structure have been explained with direct flame image and schematic diagram indicating modification in recirculation zone in presence of inner flame. Effects of various operating parameters like H/Dh, Re(o), Φ(o), and θ(o) on heat transfer characteristics have been discussed. Inner non-swirling flame Reynolds number (Re(i)) and equivalence ratio (Φ(i)) were kept constant. Heating patterns in the impingement region around the stagnation point have been altered significantly with change in the values of H/Dh, Re(o), Φ(o), and θ(o). The axial flow of inner flame has been notably effected with increase in Re(o). Heating was most favorable near stoichiometeric conditions of the outer swirling flame. However, the effect of change in swirl intensity (expressed in terms of θ(o)) on overall heat transfer efficiency was not as significant as in the case of other parameters. It has been inferred that best performance (higher uniformity and efficiency) of the dual flame impinging on a flat surface can be achieved at moderate value of separation distance (H/Dh of 2-3) and outer swirling flame Reynolds number (Re(o) of 7000-9000) under stoichiometeric conditions.

Keywords: dual flame, heat transfer, impingement, swirling insert, transmission efficiency

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Authors: Saurabh Sharma, Yong Sun, Bruce Vernham

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Accurate prediction of NOx emission is a continuous challenge in the field of diesel engine-out emission modeling. Performing experiments for each conditions and scenario cost significant amount of money and man hours, therefore model-based development strategy has been implemented in order to solve that issue. NOx formation is highly dependent on the burn gas temperature and the O₂ concentration inside the cylinder. The current empirical models are developed by calibrating the parameters representing the engine operating conditions with respect to the measured NOx. This makes the prediction of purely empirical models limited to the region where it has been calibrated. An alternative solution to that is presented in this paper, which focus on the utilization of in-cylinder combustion parameters to form a predictive semi-empirical NOx model. The result of this work is shown by developing a fast and predictive NOx model by using the physical parameters and empirical correlation. The model is developed based on the steady state data collected at entire operating region of the engine and the predictive combustion model, which is developed in Gamma Technology (GT)-Power by using Direct Injected (DI)-Pulse combustion object. In this approach, temperature in both burned and unburnt zone is considered during the combustion period i.e. from Intake Valve Closing (IVC) to Exhaust Valve Opening (EVO). Also, the oxygen concentration consumed in burnt zone and trapped fuel mass is also considered while developing the reported model.  Several statistical methods are used to construct the model, including individual machine learning methods and ensemble machine learning methods. A detailed validation of the model on multiple diesel engines is reported in this work. Substantial numbers of cases are tested for different engine configurations over a large span of speed and load points. Different sweeps of operating conditions such as Exhaust Gas Recirculation (EGR), injection timing and Variable Valve Timing (VVT) are also considered for the validation. Model shows a very good predictability and robustness at both sea level and altitude condition with different ambient conditions. The various advantages such as high accuracy and robustness at different operating conditions, low computational time and lower number of data points requires for the calibration establishes the platform where the model-based approach can be used for the engine calibration and development process. Moreover, the focus of this work is towards establishing a framework for the future model development for other various targets such as soot, Combustion Noise Level (CNL), NO₂/NOx ratio etc.

Keywords: diesel engine, machine learning, NOₓ emission, semi-empirical

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

Procedia PDF Downloads 187

Authors: Abdul Murad Zainal Abidin, Azahar Mohd, Nor Idayu Arifin, Siti Nor Azila Khalid, Mohd Julzaha Zahari Mohamad Yusof

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A thermoelectric cooler (TEC) is an electronic component that uses ‘peltier’ effect to create a temperature difference by transferring heat between two electrical junctions of two different types of materials. TEC can also be used for heating by reversing the electric current flow and even power generation. A heat flow meter (HFM) is an equipment for measuring thermal conductivity of building materials. During the test, water is used as heat transfer medium to cool the HFM. The existing re-circulating cooler in the market is very costly, and the alternative is to use piped tap water to extract heat from HFM. However, the tap water temperature is insufficiently low to enable heat transfer to take place. The operating temperature for isothermal plates in the HFM is 40°C with the range of ±0.02°C. When the temperature exceeds the operating range, the HFM stops working, and the test cannot be conducted. The aim of the research is to develop a low-cost but energy-efficient TEC prototype that enables heat transfer without compromising the function of the HFM. The objectives of the research are a) to identify potential of TEC as a cooling device by evaluating its cooling rate and b) to determine the amount of water savings using TEC compared to normal tap water. Four (4) peltier sets were used, with two (2) sets used as pre-cooler. The cooling water is re-circulated from the reservoir into HFM using a water pump. The thermal conductivity readings, the water flow rate, and the power consumption were measured while the HFM was operating. The measured data has shown decrease in average cooling temperature difference (ΔTave) of 2.42°C and average cooling rate of 0.031°C/min. The water savings accrued from using the TEC is projected to be 8,332.8 litres/year with the application of water re-circulation. The results suggest the prototype has achieved required objectives. Further research will include comparing the cooling rate of TEC prototype against conventional tap water and to optimize its design and performance in terms of size and portability. The possible application of the prototype could also be expanded to portable storage for medicine and beverages.

Keywords: energy efficiency, thermoelectric cooling, pre-cooling device, heat flow meter, sustainable technology, thermal conductivity

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Authors: Lukas Kano Mangalla, Raden Rinova Sisworo, Luther Pagiling

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Torrefaction is an emerging thermo-chemical treatment process that aims to improve the quality of biomass fuels. This study focused on upgrading the waste teakwood through microwave torrefaction processes and investigating the key operating parameters to improve energy density for the quality of biochar production. The experiments were carried out in a 250 mL reactor placed in a microwave cavity on two different media, inert and non-inert. The microwave was operated at a frequency of 2.45GHz with power level variations of 540W, 720W, and 900W, respectively. During torrefaction processes, the nitrogen gas flows into the reactor at a rate of 0.125 mL/min, and the air flows naturally. The temperature inside the reactor was observed every 0.5 minutes for 20 minutes using a K-Type thermocouple. Changes in the mass and the properties of the torrefied products were analyzed to predict the correlation between calorific value, mass yield, and level power of the microwave. The results showed that with the increase in the operating power of microwave torrefaction, the calorific value and energy density of the product increased significantly, while mass and energy yield tended to decrease. Air can be a great potential media for substituting the expensive nitrogen to perform the microwave torrefaction for teakwood biomass.

Keywords: torrefaction, microwave heating, energy enhancement, mass and energy yield

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Authors: Kouorsh Zarea, Fatemeh Hassani, Samira Beiranvand, Akram Mohamadi

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Background and Objectives: Medication error in hospitals is a major cause of the errors which disrupt the health care system. The aim of this study was to assess the nurses’ medication errors and related factors. Material and methods: This was a descriptive study on 225 nurses in various hospitals, selected through multistage random sampling. Data was collected by three researcher made tools; demographic, medication error and related factors questionnaires. Data was analyzed by descriptive statistics, Chi-square, Kruskal-Wallis, One-way analysis of variance. Results: Based on the results obtained, the type of medication errors giving drugs to patients later or earlier (55.6%), multiple oral medication together regardless of their interactions (36%) and the postoperative analgesic without a prescription (34.2%), respectively. In addition, factors such as the shortage of nurses to patients’ ratio (57.3%), high load functions (51.1%) and fatigue caused by the extra work (40.4%), were the most important factors affecting the incidence of medication errors. The fear of legal issues (40%) are the most important factor is the lack of reported medication errors. Conclusions: Based on the results, effective management and promotion motivate nurses. Therefore, increasing scientific and clinical expertise in the field of nursing medication orders is recommended to prevent medication errors in various states of nursing intervention. Employing experienced staff in areas with high risk of medication errors and also supervising less-experienced staff through competent personnel are also suggested.

Keywords: medication error, nurse, clinical care, drug errors

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Authors: Thippharat Wongsilarat, Parichat tuntilanon, Chonlakan Prataksitorn

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Recurrent adverse drug reactions are harmful to patients with mild to fatal illnesses, and affect not only patients but also their relatives, and organizations. To compare safe use of medicine among patients before and after using the recurrent adverse drug reaction prevention program . Quasi-experimental research with the target population of 598 patients with drug allergy history. Data were collected through an observation form tested for its validity by three experts (IOC = 0.87), and analyzed with a descriptive statistic (percentage). The research was conducted jointly with a multidisciplinary team to analyze and determine the weak points and strong points in the recurrent adverse drug reaction prevention system during the past three years, and 546, 329, and 498 incidences, respectively, were found. Of these, 379, 279, and 302 incidences, or 69.4; 84.80; and 60.64 percent of the patients with drug allergy history, respectively, were found to have caused by incomplete warning system. In addition, differences in practice in caring for patients with drug allergy history were found that did not cover all the steps of the patient care process, especially a lack of repeated checking, and a lack of communication between the multidisciplinary team members. Therefore, the recurrent adverse drug reaction prevention program was developed with complete warning points in the information technology system, the repeated checking step, and communication among related multidisciplinary team members starting from the hospital identity card room, patient history recording officers, nurses, physicians who prescribe the drugs, and pharmacists. Including in the system were surveillance, nursing, recording, and linking the data to referring units. There were also training concerning adverse drug reactions by pharmacists, monthly meetings to explain the process to practice personnel, creating safety culture, random checking of practice, motivational encouragement, supervising, controlling, following up, and evaluating the practice. The rate of prescribing drugs to which patients were allergic per 1,000 prescriptions was 0.08, and the incidence rate of recurrent drug reaction per 1,000 prescriptions was 0. Surveillance of recurrent adverse drug reactions covering all service providing points can ensure safe use of medicine for patients.

Keywords: recurrent drug, adverse reaction, safety, use of medicine

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Authors: Eva de Mingo-Fernández, Lourdes Rubio Rico, Carmen Ortega-Segura, Montserrat Querol-García, Raúl González-Jauregui

Abstract:

Today, one of the great challenges that the university faces is to get closer to society and transfer knowledge. The competency-based training approach favours a continuous interaction between practice and theory, which is why it is essential to establish real experiences with reflection and debate and to contrast them with personal and professional knowledge. Service-learning (SL) consists of an integration of academic learning with service in the community, which enables teachers to transfer knowledge with social value and students to be trained on the basis of experience of real needs and problems with the aim of solving them. SLE combines research, teaching, and social value knowledge transfer with the real social needs and problems of a community. Goal: The objective of this study was to design, implement, and evaluate a service-learning program in the subject of adult nursing for second-year nursing students. Methodology: After establishing collaboration with eight associations of people with different pathologies, the students were divided into eight groups, and each group was assigned an association. The groups were made up of 10-12 students. The associations willing to participate were for the following conditions: diabetes, multiple sclerosis, cancer, inflammatory bowel disease, fibromyalgia, heart, lung, and kidney diseases. The methodological design consisting of 5 activities was then applied. Three activities address personal and individual reflections, where the student initially describes what they think it is like to live with a certain disease. They then express their reflections resulting from an interview conducted by peers, in person or online, with a person living with this particular condition, and after sharing the results of their reflections with the rest of the group, they make an oral presentation in which they present their findings to the other students. This is followed by a service task in which the students collaborate in different activities of the association, and finally, a third individual reflection is carried out in which the students express their experience of collaboration. The evaluation of this activity is carried out by means of a rubric for both the reflections and the presentation. It should be noted that the oral presentation is evaluated both by the rest of the classmates and by the teachers. Results: The evaluation of the activity, given by the students, is 7.80/10, commenting that the experience is positive and brings them closer to the reality of the people and the area.

Keywords: academic learning integration, knowledge transfer, service-learning, teaching methodology

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