Search results for: green capacity ratio.

Authors: Taleb L., Benarbia M., Boutira F. M., Allam H., Boukerche A.

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Introduction and purpose of the study: Meningiomas are the most common non-glial intracranial tumors in adults, accounting for approximately 30% of all central nervous system tumors. The aim of our study is to determine the epidemiological, clinical, therapeutic, and evolutionary characteristics of a cohort of patients with intracranial meningioma treated with radiotherapy at the Emir Abdelkader Cancer Center in Oran. Material and methods: This is a retrospective study of 44 patients during the period from 2014 to 2020. The overall survival and relapse-free survival curves were calculated using the Kaplan-Meier method. Results and statistical analysis: The median age of the patients was 49 years [21-76 years] with a clear female predominance (sex ratio=2.4). The average diagnostic delay was seven months [2 to 24 months], the circumstances of the discovery of which were dominated by headaches in 54.5% of cases (n=24), visual disturbances in 40.9% (n=18), and motor disorders in 15.9% (n=7). The seat of the tumor was essentially at the level of the base of the skull in 52.3% of patients (n=23), including 29.5% (n=13) at the level of the cavernous sinus, 27.3% (n=12) at the parasagittal level and 20.5% (n=9) at the convexity. The diagnosis was confirmed surgically in 36 patients (81.8%) whose anatomopathological study returned in favor of grades I, II, and III in respectively 40.9%, 29.5%, and 11.4% of the cases. Radiotherapy was indicated postoperatively in 45.5% of patients (n=20), exclusive in 27.3% (n=12) and after tumor recurrence in 27.3% of cases (n=18). The irradiation doses delivered were as follows: 50 Gy (20.5%), 54 Gy (65.9%), and 60 Gy (13.6%). With a median follow-up of 69 months, the probabilities of relapse-free survival and overall survival at three years are 93.2% and 95.4%, respectively, whereas they are 71.2% and 80.7% at five years. Conclusion: Meningiomas are common primary brain tumors. Most often benign but can also progress aggressively. Their treatment is essentially surgical, but radiotherapy retains its place in specific situations, allowing good tumor control and overall survival.

Keywords: diagnosis, meningioma, surgery, radiotherapy, survival

Procedia PDF Downloads 101

Authors: Abebe Tibebu

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This study investigates the quality of training factors in Ethiopian Technical and Vocational Education and Training (TVET) colleges and their impact on declining enrollment rates. Employing a descriptive survey design, both quantitative and qualitative data were collected from diverse stakeholders, including Grade 12 graduates, current TVET trainees, trainers, college deans, community members, high school directors, teachers, and officials from TVET government agencies. The sample included 20 TVET centers from various Ethiopian regions. Secondary data were obtained from college and government documents, while primary data were gathered through questionnaires, interviews, focus group discussions, and observations. Analysis was conducted using descriptive statistics with SPSS, capturing response frequencies and percentages. The study's findings highlight several key factors affecting TVET enrollment: limited infrastructure capacity, insufficient trainer competency, misaligned curriculum, low-quality training delivery particularly in cooperative training implementation and industry partnership and low success rates on Certification of Competency (CoC) exams. Many TVET institutions lack qualified trainers, adequate machinery, and timely provision of materials for practical skills training. Based on these findings, the study recommends enhanced infrastructure investment, professional development for trainers, curriculum adjustments to better align with industry needs, and standardized assessment practices. Addressing these areas through collaborative efforts with government bodies and industry stakeholders is essential to improving the quality and appeal of Ethiopian TVET programs, ultimately strengthening enrollment and outcomes.

Keywords: TVET, quality factors, enrollment, potentially enrolled

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Authors: Isam A. H. Al Zubaidy

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A quick process may be needed to get the benefit the big generated quantity of waste oil sludge (WOS). The process includes the mixing process of WOS with commercial diesel fuel. Different ratios of WOS to diesel fuel were prepared ranging 1:1 to 20:1 by mass. The mixture was continuously mixing for 10 minutes using bench type overhead stirrer and followed by filtration process to separate the soil waste from filtrate oil product. The quantity and the physical properties of the oil filtrate were measured. It was found that the addition of up to 15% WOS to diesel fuel was accepted without dramatic changes to the properties of diesel fuel. The amount of waste oil sludge was decreased by about 60% by mass. This means that about 60 % of the mass of sludge was recovered as light fuel oil. The physical properties of the resulting fuel from 10% sludge mixing ratio showed that the specific gravity, ash content, carbon residue, asphaltene content, viscosity, diesel index, cetane number, and calorific value were affected slightly. The color was changed to light black color. The sulfur content was increased also. This requires other processes to reduce the sulfur content of the resulting light fuel. A new desulfurization process was achieved using adsorption techniques with activated biomaterial to reduce the sulfur content to acceptable limits. Adsorption process by ZnCl₂ activated date palm kernel powder was effective for improvement of the physical properties of diesel like fuel. The final sulfur content was increased to 0.185 wt%. This diesel like fuel can be used in all tractors, buses, tracks inside and outside the refineries. The solid remaining seems to be smooth and can be mixed with asphalt mixture for asphalting the roads or can be used with other materials as an asphalt coating material for constructed buildings. Through this process, valuable fuel has been recovered, and the amount of waste material had decreased.

Keywords: oil sludge, diesel fuel, blending process, filtration process

Procedia PDF Downloads 118

Authors: El-Said. I. Shabana, Mohammad S. Tayeb, Maher M. T. Qutub, Abdulraheem A. Kinsara

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Usually, phosphate deposits contain ²³⁸U and ²³²Th in addition to their decay products. Due to their different pathways in the environment, the ²³⁸U/²³²Th activity concentration ratio usually found to be greater than unity in phosphate sediments. The presence of these radionuclides creates a potential need to control exposure of workers in the mining and processing activities of the phosphate minerals in accordance with IAEA safety standards. The greatest dose to workers comes from exposure to radon, especially ²²²Rn from the uranium series, and has to be controlled. In this regard, radon (²²²Rn) was measured in the atmosphere (indoor and outdoor) of Al-Jalamid phosphate-mines working area using a portable radon-measurement instrument RAD7, in a purpose of radiation protection. Radon was measured in 61 sites inside the open phosphate mines, the phosphate upgrading facility (offices and rooms of the workers, and in some open-air sites) and in the dwellings of the workers residence-village that lies at about 3 km from the mines working area. The obtained results indicated that the average indoor radon concentration was about 48.4 Bq/m³. Inside the upgrading facility, the average outdoor concentrations were 10.8 and 9.7 Bq/m³ in the concentrate piles and crushing areas, respectively. It was 12.3 Bq/m³ in the atmosphere of the open mines. These values are comparable with the global average values. Based on the average values, the annual effective dose due to radon inhalation was calculated and risk estimates have been done. The average annual effective dose to workers due to the radon inhalation was estimated by 1.32 mSv. The potential excess risk of lung cancer mortality that could be attributed to radon, when considering the lifetime exposure, was estimated by 53.0x10^-4. The results have been discussed in detail.

Keywords: dosimetry, environmental monitoring, phosphate deposits, radiation protection, radon

Procedia PDF Downloads 274

Authors: Ahmad Alsolami, Darren Mundy, Manuel Hernandez-Perez

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Social media networks, such as Twitter, offer the perfect opportunity to either positively or negatively affect political attitudes on large audiences. A most important factor contributing to this effect is the existence of influential users, who have developed a reputation for their awareness and experience on specific subjects. Therefore, knowledge of the mechanisms to identify influential users on social media is vital for understanding their effect on their audience. The concept of the influential user is based on the pioneering work of Katz and Lazarsfeld (1959), who created the concept of opinion leaders' to indicate that ideas first flow from mass media to opinion leaders and then to the rest of the population. Hence, the objective of this research was to provide reliable and accurate structural mechanisms to identify influential users, which could be applied to different platforms, places, and subjects. Twitter was selected as the platform of interest, and Saudi Arabia as the context for the investigation. These were selected because Saudi Arabia has a large number of Twitter users, some of whom are considerably active in setting agendas and disseminating ideas. The study considered the scientific methods that have been used to identify public opinion leaders before, utilizing metrics software on Twitter. The key findings propose multiple novel metrics to compare Twitter influencers, including the number of followers, social authority and the use of political hashtags, and four secondary filtering measures. Thus, using ratio and percentage calculations to classify the most influential users, Twitter accounts were filtered, analyzed and included. The structured approach is used as a mechanism to explore the top ten influencers on Twitter from the political domain in Saudi Arabia.

Keywords: twitter, influencers, structured mechanism, Saudi Arabia

Procedia PDF Downloads 137

Authors: Bayonle Abiola Omoniyi

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In turbidite reservoirs with volumetrically significant thin-bedded turbidites (TBTs), thin-pay intervals may be underestimated during calculation of reserve volume due to poor vertical resolution of conventional well logs. This paper demonstrates the strong control of bed-scale sedimentary heterogeneity on oil recovery using six facies distribution scenarios that were generated from outcrop data from the Eocene Itzurun Formation, Basque Basin (northern Spain). The variable net sand volume in these scenarios serves as a primary source of sedimentary heterogeneity impacting sandstone-mudstone ratio, sand and shale geometry and dimensions, lateral and vertical variations in bed thickness, and attribute indices. The attributes provided input parameters for modeling the scenarios. The models are 20-m (65.6 ft) thick. Simulation of the scenarios reveals that oil production is markedly enhanced where degree of sedimentary heterogeneity and resultant permeability contrast are low, as exemplified by Scenarios 1, 2, and 3. In these scenarios, bed architecture encourages better apparent vertical connectivity across intervals of laterally continuous beds. By contrast, low net-to-gross Scenarios 4, 5, and 6, have rapidly declining oil production rates and higher water cut with more oil effectively trapped in low-permeability layers. These scenarios may possess enough lateral connectivity to enable injected water to sweep oil to production well; such sweep is achieved at a cost of high-water production. It is therefore imperative to consider not only net-to-gross threshold but also facies stack pattern and related attribute indices to better understand how to effectively manage water production for optimum oil recovery from basin-plain reservoirs.

Keywords: architecture, connectivity, modeling, turbidites

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Authors: Liliia N. Butymova, Vladimir Y. Modorsky, Nikolai A. Shevelev

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Prediction of vibration processes in gas transmittal units (GTU) is an urgent problem. Despite numerous scientific publications on the problem of vibrations in general, there are not enough works concerning FSI-modeling interaction processes between several deformable blades in gas-dynamic flow. Since it is very difficult to solve the problem in full scope, with all factors considered, a unidirectional dynamic coupled 1FSI model is suggested for use at the first stage, which would include, from symmetry considerations, two blades, which might be considered as the first stage of solving more general bidirectional problem. ANSYS CFX programmed multi-processor was chosen as a numerical computation tool. The problem was solved on PNRPU high-capacity computer complex. At the first stage of the study, blades were believed oscillating with the same frequency, although oscillation phases could be equal and could be different. At that non-stationary gas-dynamic forces distribution over the blades surfaces is calculated in run of simulation experiment. Oscillations in the “gas — structure” dynamic system are assumed to increase if the resultant of these gas-dynamic forces is in-phase with blade oscillation, and phase shift (φ=0). Provided these oscillation occur with phase shift, then oscillations might increase or decrease, depending on the phase shift value. The most important results are as follows: the angle of phase shift in inter-blade oscillation and the gas-dynamic force depends on the flow velocity, the specific inter-blade gap, and the shaft rotation speed; a phase shift in oscillation of adjacent blades does not always correspond to phase shift of gas-dynamic forces affecting the blades. Thus, it was discovered, that asynchronous oscillation of blades might cause either attenuation or intensification of oscillation. It was revealed that clocking effect might depend not only on the mutual circumferential displacement of blade rows and the gap between the blades, but also on the blade dynamic deformation nature.

Keywords: aeroelasticity, ANSYS CFX, oscillation, phase shift, clocking effect, vibrations

Procedia PDF Downloads 269

Authors: Si-Geun Choi, Hoon-Jae Park, Jung-Woo Cho, Jin-Ho Lim, Jin-Young Park, Joo-Young Oh, Jae-Il Jeong Seock-Sam Kim, Young Tae Cho, Chan Gyu Kim, Jong-Hyoung Kim

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The tilting pad bearing is a kind of the fluid film bearing and it can contribute to the high speed and the high load performance compared to other bearings including the rolling element bearing. Furthermore, the tilting bearing has many advantages such as high stability at high-speed performance, long life, high damping, high impact resistance and low noise. Therefore, it mostly used in mid to large size turbomachines, despite the high price disadvantage. Recently, manufacture and process employing laser techniques advancing at a fast-growing rate in mechanical industry, the dissimilar metal weld process employing laser techniques is actively studied. Moreover, also, Industry fields try to apply for welding the white metal and the back metal using laser cladding method for high durability. Furthermore, it has followed that laser cladding method has a lot better bond strength, toughness, anti-abrasion and environment-friendly than centrifugal casting method through preceding research. Therefore, the laser cladding method has a lot better quality, cost reduction, eco-friendliness and permanence of technology than the centrifugal casting method or the gravity casting method. In this study, we compare the mechanical properties of different bearing materials by evaluating the behavior of laser cladding layer with various materials (i.e. SS400, SCM440, S20C) under the same parameters. Furthermore, we analyze the porosity of various tilting pad bearing materials which white metal treated on samples. SEM, EDS analysis and hardness tests of three materials are shown to understand the mechanical properties and tribological behavior. W/D ratio, surface roughness results with various materials are performed in this study.

Keywords: laser cladding, tilting pad bearing, white metal, mechanical properties

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Authors: Adel A. Ghoneim

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Air conditioning devices are substantially utilized in the summer months, as a result maximum loads in Kuwait take place in these intervals. Peak energy consumption are usually more expensive to satisfy compared to other standard power sources. The primary objective of the current work is to enhance the performance of high concentrated photovoltaic (HCPV) systems in an attempt to minimize peak power usage in Kuwait using HCPV modules. High concentrated PV multi-junction solar cells provide a promising method towards accomplishing lowest pricing per kilowatt-hour. Nevertheless, these cells have various features that should be resolved to be feasible for extensive power production. A single diode equivalent circuit model is formulated to analyze multi-junction solar cells efficiency in Kuwait weather circumstances taking into account the effects of both the temperature and the concentration ratio. The diode shunt resistance that is commonly ignored in the established models is considered in the present numerical model. The current model results are successfully validated versus measurements from published data to within 1.8% accuracy. Present calculations reveal that the single diode model considering the shunt resistance provides accurate and dependable results. The electrical efficiency (η) is observed to increase with concentration to a specific concentration level after which it reduces. Implementing grid systems is noticed to increase with concentration to a certain concentration degree after which it decreases. Employing grid connected HCPV systems results in significant peak load reduction.

Keywords: grid connected, high concentrated photovoltaic systems, peak load, solar cells

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Authors: Fadi Saleh, Çığdem Sezer Zhmurov

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Biopharmaceuticals represent one of the wildest developing fields within biotechnology, and the biological macromolecules being produced inside cells have a variety of applications for therapies. In the past, mammalian cells, especially CHO cells, have been employed in the production of biopharmaceuticals. This is because these cells can achieve human-like completion of PTM. These systems, however, carry apparent disadvantages like high production costs, vulnerability to contamination, and limitations in scalability. This research is focused on the utilization of microalgae as a bioreactor system for the synthesis of biopharmaceutical glycoproteins in relation to PTMs, particularly N-glycosylation. The research points to a growing interest in microalgae as a potential substitute for more conventional expression systems. A number of advantages exist in the use of microalgae, including rapid growth rates, the lack of common human pathogens, controlled scalability in bioreactors, and the ability of some PTMs to take place. Thus, the potential of microalgae to produce recombinant proteins with favorable characteristics makes this a promising platform in order to produce biopharmaceuticals. The study focuses on the examination of the N-glycosylation pathways across different species of microalgae. This investigation is important as N-glycosylation—the process by which carbohydrate groups are linked to proteins—profoundly influences the stability, activity, and general performance of glycoproteins. Additionally, bioinformatics methodologies are employed to explain the genetic pathways implicated in N-glycosylation within microalgae, with the intention of modifying these organisms to produce glycoproteins suitable for human consumption. In this way, the present comparative analysis of the N-glycosylation pathway in humans and microalgae can be used to bridge both systems in order to produce biopharmaceuticals with humanized glycosylation profiles within the microalgal organisms. The results of the research underline microalgae's potential to help improve some of the limitations associated with traditional biopharmaceutical production systems. The study may help in the creation of a cost-effective and scale-up means of producing quality biopharmaceuticals by modifying microalgae genetically to produce glycoproteins with N-glycosylation that is compatible with humans. Improvements in effectiveness will benefit biopharmaceutical production and the biopharmaceutical sector with this novel, green, and efficient expression platform. This thesis, therefore, is thorough research into the viability of microalgae as an efficient platform for producing biopharmaceutical glycoproteins. Based on the in-depth bioinformatic analysis of microalgal N-glycosylation pathways, a platform for their engineering to produce human-compatible glycoproteins is set out in this work. The findings obtained in this research will have significant implications for the biopharmaceutical industry by opening up a new way of developing safer, more efficient, and economically more feasible biopharmaceutical manufacturing platforms.

Keywords: microalgae, glycoproteins, post-translational modification, genome

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Authors: C. Y. Ng, A. M. Johan, A. E. Kajuputra

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Wave-in-deck phenomenon for fixed jacket platforms at shallow water condition has been reported as a notable risk to the workability and reliability of the platform. Reduction in reservoir pressure, due to the extraction of hydrocarbon for an extended period of time, has caused the occurrence of seabed subsidence. Platform experiencing subsidence promotes reduction of air gaps, which eventually allows the waves to attack the bottom decks. The impact of the wave-in-deck generates additional loads to the structure and therefore increases the values of the moment arms. Higher moment arms trigger instability in terms of overturning, eventually decreases the reserve strength ratio (RSR) values of the structure. The mechanics of wave-in-decks, however, is still not well understood and have not been fully incorporated into the design codes and standards. Hence, it is necessary to revisit the current design codes and standards for platform design optimization. The aim of this study is to evaluate the effects of RSR due to wave-in-deck on four-legged jacket platforms in Malaysia. Base shear values with regards to calibration and modifications of wave characteristics were obtained using SESAM GeniE. Correspondingly, pushover analysis is conducted using USFOS to retrieve the RSR. The effects of the contributing factors i.e. the wave height, wave period and water depth with regards to the RSR and base shear values were analyzed and discussed. This research proposal is important in optimizing the design life of the existing and aging offshore structures. Outcomes of this research are expected to provide a proper evaluation of the wave-in-deck mechanics and in return contribute to the current mitigation strategies in managing the issue.

Keywords: wave-in-deck loads, wave effects, water depth, fixed jacket platforms

Procedia PDF Downloads 427

Authors: Ayush Satija, Ritu Raj

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Escalating demand for elevated structures as a remedy for traffic congestion has led to a surge in the construction of viaducts and bridges predominantly employing prestressed beams. However, post-tensioned I-girder superstructures are gaining traction for their attributes like structural efficiency, cost-effectiveness, and easy construction. Recently, Ultra-high-performance fiber-reinforced concrete (UHPFRC) has emerged as a revolutionary material in reshaping conventional infrastructure engineering. UHPFRC offers exceptional properties including high compressive and tensile strength, alongside enhanced durability. Its adoption in bridges yields benefits, notably a remarkable strength-to-weight ratio enabling the design of lighter and slender structural elements, enhancing functionality and sustainability. Despite its myriad advantages, integration of UHPFRC in construction is still evolving, hindered by factors like cost, material availability, and design standardization. Consequently, there's a need to assess the feasibility of substituting ordinary concrete (OC) with UHPFRC in bridges, focusing on economic considerations. This research undertakes an efficacy study between post-tensioned I-girders fabricated from UHPFRC and OC, evaluating cost parameters associated with concrete production, reinforcement, and erection. The study reveals that UHPFRC becomes economically viable for spans exceeding 40.0m. This shift in cost-effectiveness is attributed to factors like reduced girder depth, elimination of un-tensioned steel, diminished need for shear reinforcement and decreased erection costs.

Keywords: post tensioned I girder, superstructure, ultra-high-performance fiber reinforced concrete, ordinary concrete

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Authors: Beata Ślusarczyk, Sebastian Kot

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In subjective terms, Polish SME sector occupies a prominent position in the national economic development, in which planning of the management strategies should be primarily based on identifying and meeting the innovation needs. As a research sample, there is chosen a printing sector of industry. SMEs share in printing sector in Poland is estimated at the level of 81% of all enterprises. In recent years, the printing industry achieved one of the highest levels of EU support in Poland. There is a relatively high increase in the development of technological innovations in equipment and the associated significant increase in production capacity. It can be also noticed that on average, every third enterprise belonging to the printing industry has implemented innovations, but not all of them effected in better economic results. Therefore, the aim of this article is to evaluate the impact of the implementation of innovation projects financed from the EU funds for performance of SMEs in the printing industry. As the results of research of EU funds co-financing effects on the development of innovation in the printing industry, it was specified that examined SMEs prefer to implement product innovation to receive a grant to the project at a level between 40% to 60%, the remaining part of the investment is usually covered with equity. The most common type of innovation had indicated a single implementation, related only to the change in process, technology, or organization. The relationship between variables of the EU funds and management of innovative activities was verified. It has been observed that the identified variables arising from the support in a form of the EU funds had a positive effect on the level of earned revenue, the increase in margin and in increase in employment as well. It was confirmed that the implemented innovations supported by the European funds have a positive impact on the performance of the printing companies. Although there is a risk that due to the decreasing demand for printing services such a high level of funding the companies in this sector will significantly increase competition in the long term, that may also contribute to the economic problems of the enterprises belonging to the analyzed branch.

Keywords: innovations, SMEs, performance, results

Procedia PDF Downloads 316

Authors: Sujata Kulkarni, Udhav Bhosle, Vijaykumar T.

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Due to the closeness between seismic signals and non-seismic signals, it is vital to detect earthquakes using conventional methods. In order to distinguish between seismic events and non-seismic events depending on their amplitude, our study processes the data that come from seismic sensors. The authors suggest a robust noise suppression technique that makes use of a bandpass filter, an IIR Wiener filter, recursive short-term average/long-term average (STA/LTA), and Carl short-term average (STA)/long-term average for event identification (LTA). The trigger ratio used in the proposed study to differentiate between seismic and non-seismic activity is determined. The proposed work focuses on significant feature extraction for machine learning-based seismic event detection. This serves as motivation for compiling a dataset of all features for the identification and forecasting of seismic signals. We place a focus on feature vector dimension reduction techniques due to the temporal complexity. The proposed notable features were experimentally tested using a machine learning model, and the results on unseen data are optimal. Finally, a presentation using a hybrid dataset (captured by different sensors) demonstrates how this model may also be employed in a real-time setting while lowering false alarm rates. The planned study is based on the examination of seismic signals obtained from both individual sensors and sensor networks (SN). A wideband seismic signal from BSVK and CUKG station sensors, respectively located near Basavakalyan, Karnataka, and the Central University of Karnataka, makes up the experimental dataset.

Keywords: Carl STA/LTA, features extraction, real time, dataset, machine learning, seismic detection

Procedia PDF Downloads 124

Authors: Lingxia Li, Frédéric Schnell, Shuzhe Ding, Solène Le Douairon Lahaye

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Background: The risk of sudden cardiac arret/death (SCA/D) in athletes is controversial. There is a lack of meta-analyses assessing the sex differences in the risk of SCA/D in competitive athletes. Purpose: The aim of the present study was to evaluate sex differences in the incidence of SCA/D in competitive athletes using meta-analyses. Methods: The systematic review was registered in the PROSPERO database (registration ID: CRD42023432022) and was conducted according to the PRISMA guidelines. PubMed, Embase, Scopus, SPORT Discus and Cochrane Library were searched up to July 2023. To avoid systematic bias in data pooling, only studies with data for both sexes were included. Results: From the 18 included studies, 2028 cases of SCA/D were observed (males 1821 (89.79%), females 207 (10.21%)). The age ranges from the adolescents (<26 years) to the elderly (>45 years). The incidence in male athletes was 1.32/100,000 AY (95% CI: [0.90, 1.93]) and in females was 0.26/100,000 AY (95% CI: [0.16, 0.43]), the incidence rate ratio (IRR) was 6.43 (95% CI: [4.22, 9.79]). The subgroup synthesis showed a higher incidence in males than in females in both age groups <25 years and ≤35 years, the IRR was 5.86 (95% CI: [4.69, 7.32]) and 5.79 (95% CI: [4.73, 7.09]), respectively. When considering the events, the IRR was 6.73 (95%CI: [3.06, 14.78]) among studies involving both SCA/D events and 7.16 (95% CI: [4.93, 10.40]) among studies including only cases of SCD. The available clinical evidence showed that cardiac events were most frequently seen in long-distance running races (26, 35.1%), marathon (16, 21.6%) and soccer (10, 13.5%). Coronary artery disease (14, 18.9%), hypertrophic cardiomyopathy (8, 10.8%), and arrhythmogenic right ventricular cardiomyopathy (7, 9.5%) are the most common causes of SCA/D in competitive athletes. Conclusion: The meta-analysis provides evidence of sex differences in the incidence of SCA/D in competitive athletes. The incidence of SCA/D in male athletes was 6 to 7 times higher than in females. Identifying the reasons for this difference may have implications for targeted the prevention of fatal evets in athletes.

Keywords: incidence, sudden cardiac arrest, sudden cardiac death, sex difference, athletes

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Authors: Ronald Collins, Jonathon Coleman, Joel Dasari, George Holt, Carl Metelko, Matthew Murdoch, Alexander Morgan, Yan-Jie Schnellbach, Robert Mills, Gareth Edwards, Alexander Roberts

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At the Wylfa Magnox Power Plant between 2014–2016, the VIDARR prototype anti-neutrino detector was deployed. It is comprised of extruded plastic scintillating bars measuring 4 cm × 1 cm × 152 cm and utilised wavelength shifting fibres (WLS) and multi-pixel photon counters (MPPCs) to detect and quantify radiation. During deployment, it took cosmic muon data in accidental coincidence with the anti-neutrino measurements with the power plant site buildings obscuring the muon sky. Cosmic muons have a significantly higher probability of being attenuated and/or absorbed by denser objects, and so one-sided cosmic muon tomography was utilised to image the reactor site buildings. In order to achieve clear building outlines, a control data set was taken at the University of Liverpool from 2016 – 2018, which had minimal occlusion of the cosmic muon flux by dense objects. By taking the ratio of these two data sets and using GEANT4 simulations, it is possible to perform a one-sided cosmic muon tomography analysis. This analysis can be used to discern specific buildings, building heights, and features at the Wylfa reactor site, including the reactor core/reactor core shielding using ∼ 3 hours worth of cosmic-ray detector live time. This result demonstrates the feasibility of using cosmic muon analysis to determine a segmented detector’s location with respect to surrounding buildings, assisted by aerial photography or satellite imagery.

Keywords: anti-neutrino, GEANT4, muon, tomography, occlusion

Procedia PDF Downloads 187

Authors: Panos Xenos, Milton Nektarios, John Yfantopoulos

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Background: Policy makers, professional organizations and payers have introduced a variety of initiatives and reforms for the health systems worldwide, aimed at improving hospital efficiency. Their efforts are concentrated in two main categories: to constrain increasing healthcare costs and to enhance quality of services provided. Research Objectives: This study examines the efficiency of 112 Greek public hospitals for the year 2009, evaluates the importance of bootstrapping techniques and investigates the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored using data from 28 large hospitals. Methods: We applied Data Envelopment Analysis, augmented by bootstrapping techniques, to estimate efficiency scores. In order to measure the effect of environmental factors on hospital efficiency we used Tobit regression analysis. The significance of our models is evaluated using statistical tests to compare distributions. Results: The Kolmogorov-Smirnov test between the original and the bootstrap-corrected efficiency indicates that their distributions are significantly different (p-value<0.01). The environmental factors, that seem to influence efficiency, are Occupancy Rating and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of the quality variable in DEA modelling generates statistically significant variations in efficiency scores (p-value<0.05). Conclusions: The inclusion of quality variables and the use of bootstrap resampling in efficiency analysis impose a statistically significant effect on the distribution of efficiency scores. As a policy conclusion we highlight the importance of these methods on hospital efficiency analysis and, by implication, on healthcare resource allocation.

Keywords: hospitals, efficiency, quality, data envelopment analysis, Greek public hospital sector

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Authors: Almutazballlah Bassam Qablan, Jihan M. Muhaidat, bana Abu Rajab

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Background: Acne vulgaris is considered one of the most common skin conditions encountered by dermatologists. It is a chronic inflammation affecting the pilosebaceous unit. Although acne vulgaris is not fatal, it leads to permanent scarring and disfigurement, and even without scarring, it has a huge effect on patients, causing negative health outcomes. Acne vulgaris patients experience psychological, and emotional ramifications as those with chronic health problems; they feel depressed, angry, anxious, and confused. Although acne is a popular disease, many thoughts and myths are still discussed about its origins and triggering factors. These myths can make you feel guilt as if you were somehow responsible for your acne. In this case control study, we want to define the relationship between two modifiable risk factors ;BMI and smoking, with acne vulgaris. Methods: A case-control study was conducted at King Abdullah University Hospital in Ramtha, Jordan in 2019/2020. A total number of 325 participants between 14 and 33 years of age were interviewed by the authors; including 163 acne vulgaris cases and 162 controls without acne vulgaris. Anthropometric measures and smoking for Acne patients and control participants were the independent variables used to assess acne. Univariate and multivariate analysis were used to compare the characteristics of people who reported acne with those with no acne. The collected data analyzed by using the Statistical Package for Social Sciences (SPSS). Results: Cigarette smoking was highly associated with controls; odds ratio 0.4 (95% CI: 0.2–0.9) , P-value = 0.018. BMI and waterpipe smoking were statistically insignificant with acne in the multivariate analysis. Conclusion: We found that cigarette smoking was protective against Acne. There was a statistically insignificant relation between BMI, waterpipe smoking and the development of Acne Vulgaris.

Keywords: acne, adolescents, BMI, smoking, case-control, risk factors

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Authors: Elfatih M. Abdel-Rahman, Tobias Landmann, Richard Kyalo, George Ong’amo, Bruno Le Ru

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Maize (Zea mays L.) is a major staple food crop in Africa, particularly in the eastern region of the continent. The maize growing area in Africa spans over 25 million ha and 84% of rural households in Africa cultivate maize mainly as a means to generate food and income. Average maize yields in Sub Saharan Africa are 1.4 t/ha as compared to global average of 2.5–3.9 t/ha due to biotic and abiotic constraints. Amongst the biotic production constraints in Africa, stem borers are the most injurious. In East Africa, yield losses due to stem borers are currently estimated between 12% to 40% of the total production. The objective of the present study was therefore to predict stem borer larvae density in maize fields using RapidEye reflectance data and generalized linear models (GLMs). RapidEye images were captured for a test site in Kenya (Machakos) in January and in February 2015. Stem borer larva numbers were modeled using GLMs assuming Poisson (Po) and negative binomial (NB) distributions with error with log arithmetic link. Root mean square error (RMSE) and ratio prediction to deviation (RPD) statistics were employed to assess the models performance using a leave one-out cross-validation approach. Results showed that NB models outperformed Po ones in all study sites. RMSE and RPD ranged between 0.95 and 2.70, and between 2.39 and 6.81, respectively. Overall, all models performed similar when used the January and the February image data. We conclude that reflectance data from RapidEye data can be used to estimate stem borer larvae density. The developed models could to improve decision making regarding controlling maize stem borers using various integrated pest management (IPM) protocols.

Keywords: maize, stem borers, density, RapidEye, GLM

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Authors: Zoe Boon Suan Loy

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An exploratory research undertaken in 2000 at the beginning of the COVID-19 pandemic examined the changing roles of Singapore school leaders as they lead teachers in developing future-ready learners. While it is evident that ‘LEADER’ qualities epitomize the knowledge, competencies, and skills required, recent events in an increasing VUCA and BANI world characterized by massively disruptive Ukraine -Russian war, unabating tense US-Sino relations, issues related to sustainability, and rapid ageing will have an impact on school leadership. As an increasingly complex endeavour, this requires a relook as they lead teachers in nurturing holistically-developed future-ready students. Digitalisation, new technology, and the push for a green economy will be the key driving forces that will have an impact on job availability. Similarly, the rapid growth of artificial intelligence (AI) capabilities, including ChatGPT, will aggravate and add tremendous stress to the work of school leaders. This paper seeks to explore the key school leadership shifts required beyond the ‘LEADER’ qualities as school leaders respond to the changes, challenges, and opportunities in the 21st C new normal. The research findings for this paper are based on an exploratory qualitative study on the perceptions of 26 school leaders (vice-principals) who were attending a milestone educational leadership course at the National Institute of Education, Nanyang Technological University, Singapore. A structured questionnaire is designed to collect the data, which is then analysed using coding methodology. Broad themes on key competencies and skills of future-ready leaders in the Singapore education system are then identified. Key Findings: In undertaking their leadership roles as leaders of future-ready learners, school leaders need to demonstrate the ‘LEADER’ qualities. They need to have a long-term view, understand the educational imperatives, have a good awareness of self and the dispositions of a leader, be effective in optimizing external leverages and are clear about their role expectations. These ‘LEADER’ qualities are necessary and relevant in the post-Covid era. Beyond this, school leaders with ‘LEADER’ qualities are well supported by the Ministry of Education, which takes cognizance of emerging trends and continually review education policies to address related issues. Concluding Statement: Discussions within the education ecosystem and among other stakeholders on the implications of the use of artificial intelligence and ChatGPT on the school curriculum, including content knowledge, pedagogy, and assessment, are ongoing. This augurs well for school leaders as they undertake their responsibilities as leaders of future-ready learners.

Keywords: Singapore education system, ‘LEADER’ qualities, school leadership, future-ready leaders, future-ready learners

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Authors: Fabio R. Pires, Paulo R. C. C. Ribeiro, Douglas G. Viana, Robson Bonomo, Fernando B. Egreja Filho, Alberto Cargnelutti Filho, Luiz F. Martins, Leila B. S. Cruz, Mauro C. P. Nascimento

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The use of barite (BaSO₄) as a weighting agent in drilling fluids for oil and gas activities makes barium a potential contaminant in the case of spills onto flooded soils, where barium sulfate solubility is increased due to low redox conditions. In order to select plants able to remove barium in such scenarios, seven plant species were evaluated on barium phytoextraction capacity: Brachiaria arrecta; Cyperus cf. papyrus; Eleocharis acutangula; Eleocharis interstincta; Nephrolepsis cf. rivularis; Paspalum conspersum and Typha domingensis. Plants were grown in pots with 13 kg of soil each, and exposed to six barium concentrations (established with BaCl₂): 0; 2.5; 5.0; 10.0; 30.0; 65.0 mg kg-1. To simulate flooding conditions, every pot was manteined with a thin irrigation water depth over soil surface (~1.0 cm). Treatments were carried out in triplicate, and pots were distributed randomly inside the greenhouse. Biometric and chemical analyses were performed throughout the experiment, including Ba²⁺ accumulation in shoots and roots. The highest amount of barium was observed in T. domingensis biomass, followed by C. cf. papyrus. However, the latter exported most of the barium to shoot, especially in higher BaCl₂ doses, while the former accumulated barium preferentially in roots. Thus, barium removal with C. cf. papyrus could be achieved by simply harvesting aerial biomass. The amount of barium in C. cf. papyrus was a consequence of high biomass production rather than barium concentration in plant tissues, whereas T. domingensis showed high barium concentration in plant tissues and high biomass production as well. These results make T. domingensis and C. cf. papyrus potential candidates to be applied in phytoremediation schemes to remove barium from flooded soils.

Keywords: barium sulfate, cyperus, drilling fluids, phytoextraction, Typha

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Authors: Mohammad Yousaf Safi Mohibullah Afghan

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The study made on Islamic and conventional banks scrutinizes the risks interconnected with credit and liquidity on the productivity performance of Islamic and conventional banks that operate in Pakistan. Among the banks, only 4 Islamic and 18 conventional banks have been selected to enrich the result of our study on Islamic banks performance in connection to conventional banks. The selection of the banks to the panel is based on collecting quarterly unbalanced data ranges from the first quarter of 2007 to the last quarter of 2017. The data are collected from the Bank’s web sites and State Bank of Pakistan. The data collection is carried out based on Delta-method test. The mentioned test is used to find out the empirical results. In the study, while collecting data on the banks, the return on assets and return on equity have been major factors that are used assignificant proxies in determining the profitability of the banks. Moreover, another major proxy is used in measuring credit and liquidity risks, the loan loss provision to total loan and the ratio of liquid assets to total liability. Meanwhile, with consideration to the previous literature, some other variables such as bank size, bank capital, bank branches, and bank employees have been used to tentatively control the impact of those factors whose direct and indirect effects on profitability is understood. In conclusion, the study emphasizes that credit risk affects return on asset and return on equity positively, and there is no significant difference in term of credit risk between Islamic and conventional banks. Similarly, the liquidity risk has a significant impact on the bank’s profitability, though the marginal effect of liquidity risk is higher for Islamic banks than conventional banks.

Keywords: islamic & conventional banks, performance return on equity, return on assets, pakistan banking sectors, profitibility

Procedia PDF Downloads 165

Authors: J. P. Chica Cano, G. Cabot, S. de Persis, F. Foucher

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Among all possibilities to combat global warming, CO₂ capture and sequestration (CCS) is presented as a great alternative to reduce greenhouse gas (GHG) emission. Several strategies for CCS from industrial and power plants are being considered. The concept of combined oxy-fuel combustion has been the most alternative solution. Nevertheless, due to the high cost of pure O₂ production, additional ways recently emerged. In this paper, an innovative combustion process for a gas turbine cycle was studied: it was composed of methane combustion with oxygen enhanced air (OEA), exhaust gas recirculation (EGR) and H₂O issuing from STIG (Steam Injection Gas Turbine), and the CO₂ capture was realized by membrane separator. The effect on this combustion process was emphasized, and it was shown that a study of the influence of H₂O dilution on the combustion parameters by experimental and numerical approaches had to be carried out. As a consequence, the laminar burning velocities measurements were performed in a stainless steel spherical combustion from atmospheric pressure to high pressure (up to 0.5 MPa), at 473 K for an equivalence ratio at 1. These experimental results were satisfactorily compared with Chemical Workbench v.4.1 package in conjunction with GRIMech 3.0 reaction mechanism. The good correlations so obtained between experimental and calculated flame speed velocities showed the validity of the GRIMech 3.0 mechanism in this domain of combustion: high H₂O dilution, low N₂, medium pressure. Finally, good estimations of flame speed and pollutant emissions were determined in other conditions compatible with real gas turbine. In particular, mixtures (composed of CH₄/O₂/N₂/H₂O/ or CO₂) leading to the same adiabatic temperature were investigated. Influences of oxygen enrichment and H₂O dilution (compared to CO₂) were disused.

Keywords: CO₂ capture, oxygen enrichment, water dilution, laminar burning velocity, pollutants emissions

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Authors: J. Chakwizira, P. Bikam, T. A. Adeboyejo

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This paper seeks to illustrate the impact of rapid urbanization (in terms of both increase in people and vehicles) in the Gauteng region (which includes Johannesburg, Pretoria and Ekurhuleni). The impact that existing transport systems and options place on the capacity of residents from low income areas to travel and conduct various socio-economic activities is discussed. The findings are drawn from a 2013 analysis of a random transport household survey of 1550 households carried out in Gauteng province. 91.4% of the study respondents had access to public transport, while 8.6% had no access to public transport. Of the 91.4% who used public transport, the main reason used to explain this state of affairs was that it was affordable (54.3%), convenient (15.9%), Accessible (11.9%), lack of alternatives (6.4%) and reliable at 4.1%. Recommendations advanced revolve around the need to reverse land use and transportation effects of apartheid planning, growing and developing a sustainable critical mass of public transport interventions supported by appropriate transport systems that are environmentally sustainable through proper governance. 38.5% of the respondents indicated that developing compact, smart and integrated urban land spaces was key to reducing travel challenges in the study area. 23.4% indicated that the introduction and upgrading of BRT buses to cover all areas in the study area was a step in the right direction because it has great potential in shifting travel patterns to favor public modes of transport. 15.1% indicated that all open spaces should be developed so that fragmentation of land uses can be addressed. This would help to fight disconnected and fragmented space and trip making challenges in Gauteng. 13.4% indicated that improving the metro rail services was critical since this is a mass mover of commuters. 9.6% of the respondents highlighted that the bus subsidy policy has to be retained in the short to medium term since the spatial mismatches and challenges created by apartheid are yet to be fully reversed.

Keywords: urbanisation, population, public, transport systems, Gauteng

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Authors: Biaou Jean-Baptiste Kouchoro, Anissa Meziane, Philippe Micheau, Mathieu Renier, Nicolas Quaegebeur

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Numerous experimental and numerical studies have shown the interest of the local defects resonance (LDR) for the Non-Destructive Testing of metallic and composite plates. Indeed, guided ultrasonic waves such as Lamb waves, which are increasingly used for the inspection of these flat structures, enable the generation of local resonance phenomena by their interaction with a damaged area, allowing the detection of defects. When subjected to a large amplitude motion, a nonlinear behavior can predominate in the damaged area. This work presents a 2D Finite Element Model of the local resonance of a 12 mm long and 5 mm deep Flat Bottom Hole (FBH) in a 6 mm thick aluminum plate under the excitation induced by an incident A0 Lamb mode. The analysis of the transient response of the FBH enables the precise determination of its resonance frequencies and the associate modal deformations. Then, a linear parametric study varying the geometrical properties of the FBH highlights the sensitivity of the resonance frequency with respect to the plate thickness. It is demonstrated that the resonance effect disappears when the ratio of thicknesses between the FBH and the plate is below 0.1. Finally, the nonlinear behavior of the FBH is considered and studied introducing geometrical (taken into account the nonlinear component of the strain tensor) nonlinearities that occur at large vibration amplitudes. Experimental analysis allows observation of the resonance effects and nonlinear response of the FBH. The differences between these experimental results and the numerical results will be commented on. The results of this study are promising and allow to consider more realistic defects such as delamination in composite materials.

Keywords: guided waves, non-destructive testing, dynamic field testing, non-linear ultrasound/vibration

Procedia PDF Downloads 134

Authors: S. Farzad, M. Ali Mandegari, J. F. Görgens

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The South African Sugar Industry, which has a significant impact on the national economy, is currently facing problems due to increasing energy price and low global sugar price. The available bagasse is already combusted in low-efficiency boilers of the sugar mills while bagasse is generally recognized as a promising feedstock for second generation bioethanol production. Establishment of biorefinery annexed to the existing sugar mills, as an alternative for the revitalization of sugar industry producing biofuel and electricity has been proposed and considered in this study. Since the scale is an important issue in the feasibility of the technology, this study has taken into account a typical sugar mill with 300 ton/hr sugar cane capacity. The biorefinery simulation is carried out using Aspen PlusTM V8.6, in which the sugar mill’s power and steam demand has been considered. Hence, sugar mills in South Africa can be categorized as highly efficient, efficient, and not efficient with steam consumption of 33, 40, and 60 tons of steam per ton of cane and electric power demand of 10 MW; three different scenarios are studied. The sugar cane bagasse and tops/trash are supplied to the biorefinery process and the wastes/residues (mostly lignin) from the process are burnt in the CHP plant in order to produce steam and electricity for the biorefinery and sugar mill as well. Considering the efficient sugar mill, the CHP plant has generated 5 MW surplus electric powers, but the obtained energy is not enough for self-sufficiency of the plant (Biorefinery and Sugar mill) due to lack of 34 MW heat. One of the advantages of second generation biorefinery is its low impact on the environment and carbon footprint, thus the plant should be self-sufficient in energy without using fossil fuels. For this reason, a portion of fresh bagasse should be sent to the CHP plant to meet the energy requirements. An optimization procedure was carried out to find out the appropriate portion to be burnt in the combustor. As a result, 20% of the bagasse is re-routed to the combustor which leads to 5 tons of LP Steam and 8.6 MW electric power surpluses.

Keywords: biorefinery, sugarcane bagasse, sugar mill, energy analysis, bioethanol

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Authors: Pardis Abolghasemi, Benyamin Hatamsaz

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Background: Diabetic nephropathy is a serious health problem described by specific kidney structure and functional disturbance. Renoprotective effects of the stem cells secretase have been shown in many kidney diseases. The aim is to evaluate the capability of human Wharton’s jelly mesenchymal stem cells conditioned media (hWJMSCs-CM) to alleviate DN in streptozotocin (STZ)-induced diabetes. Methods: Diabetic nephropathy was induced by injection of STZ (60 mg/kg, IP) in twenty rats. Conditioned media was extracted from hWJMSCs at third passages. At week 8, diabetic rats were divided into two groups: treated (hWJMSCs-CM, 500 μl/rat for three weeks, IP) and not treated (DN). In the 11th week, three groups (control, DN and DN+hWJMSCs-CM) were kept in metabolic cages and urine was collected for 24h. Blood pressure (BP) and heart rate (HR) were continuously recorded. The serum samples were maintained for measuring BUN, Cr and angiotensin-converting enzyme (ACE) activity. The left kidney was kept at -80°C for ACE activity assessment. The right kidney and pancreas were used for histopathologic evaluation. Result: Diabetic nephropathy was detected by microalbuminuria and increased albumin/creatinine ratio, as well as the pancreas and renal structural disturbance. Glomerular filtration rate, BP and HR increased in the DN group. The ACE activity was elevated in the serum and kidneys of the DN group. Administration of hWJMSCs-CM modulated the renal functional and structural disturbance and decreased the ACE activity. Conclusion: Conditioned media was extracted from hWJMSCs may have a Renoprotective effect in diabetic nephropathy. This may happen through regulation of ACE activity and renin-angiotensin system inhibition.

Keywords: diabetic nephropathy, mesenchymal stem cells, immunomodulation, anti-inflammation

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Authors: Kopal Verma, Umesh C. Kulshrestha

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India is a rural major country and majority of rural population is dependent on burning of biomass as fuel for domestic cooking on traditional stoves (Chullahs) and heating purposes. This results into indoor air pollution and ultimately affects health of the residents. Still, a very small fraction of rural population has been benefitted by the facilities of Liquefied Petroleum Gas (LPG) cylinders. Different regions of country follow different methods and use different type of biomass for cooking. So in order to study the differences in cooking practices and resulting indoor air pollution, this study was carried out in two rural areas of India viz. Budhwada, Madhya Pradesh and Baggi, Himachal Pradesh. Both the regions have significant differences in terms of topography, culture and daily practices. Budhwada lies in plain area and Baggi belongs to hilly terrain. The study of carbonaceous aerosols was carried out in four different houses of each village. The residents were asked to bring slight change in their practices by cooking only with biomass (BB) then with a mix of biomass and LPG (BL) and then finally only with LPG (LP). It was found that in BB, average values of organic carbon (OC) and elemental carbon (EC) were 28% and 44% lower in Budhwada than in Baggi whereas a reverse trend was found where OC and EC was respectively more by 56% and 26% with BL and by 54% and 29% with LP in Budhwada than in Baggi. Although, a significant reduction was found both in Budhwada (OC by 49% and EC by 34%) as well as in Baggi (OC by 84% and EC by 73%) when cooking was shifted from BB to LP. The OC/EC ratio was much higher for Budhwada (BB=9.9; BL=2.5; LP=6.1) than for Baggi (BB=1.7; BL=1.6; LP=1.3). The correlation in OC and EC was found to be excellent in Baggi (r²=0.93) and relatively poor in Budhwada (r²=0.65). A questionnaire filled by the residents suggested that they agree to the health benefits of using LPG over biomass burning but the challenges of supply of LPG and changing the prevailing tradition of cooking on Chullah are making it difficult for them to make this shift.

Keywords: biomass burning, elemental carbon, liquefied petroluem gas, organic carbon

Procedia PDF Downloads 191

Authors: Salwa M. Almomen, Mona A. Almaghrabi, Saja M. Alhabardi, Adel A. Alrwisan

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Background: Hepatotoxicity is a major reason for medication withdrawal from the markets. Unfortunately, serious adverse hepatic effects can occur after marketing with limited indicators during clinical development. Therefore, finding possible predictors for hepatotoxicity might guide the monitoring program of various stakeholders. Methods: We examined the clinical review documents for drugs approved in the US from 2011 to 2016 to evaluate their hepatic safety profile. Predictors: we assessed whether these medications meet Hy’s Law with hepatotoxicity grade ≥ 3, labeled hepatic adverse effects at approval, or accelerated approval status. Outcome: post-marketing regulatory action related to hepatotoxicity, including product withdrawal or updates to warning, precaution, or adverse effects sections. Statistical analysis: drugs were included in the analysis from the time of approval until the end of 2019 or the first post-marketing regulatory action related to hepatotoxicity, whichever occurred first. The hazard ratio (HR) was estimated using Cox-regression analysis. Results: We included 192 medications in the study. We classified 48 drugs as having grade ≥ 3 hepatotoxicities, 43 had accelerated approval status, and 74 had labeled information about hepatotoxicity prior to marketing. The adjusted HRs for post-marketing regulatory action for products with grade ≥ 3 hepatotoxicity was 0.61 (95% confidence interval [CI], 0.17-2.23), 0.92 (95%CI, 0.29-2.93) for a drug approved via accelerated approval program, and was 0.91 (95%CI, 0.33-2.56) for drugs with labeled hepatotoxicity information at approval time. Conclusion: This study does not provide conclusive evidence on the association between post-marketing regulatory action and grade ≥ 3 hepatotoxicity, accelerated approval status, or availability of labeled information at approval due to sampling size and channeling bias.

Keywords: accelerated approvals, hepatic adverse effects, drug-induced liver injury, hepatotoxicity predictors, post-marketing withdrawal

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

Procedia PDF Downloads 94