Search results for: clinical simulation

Authors: Malte Brettel, Niklas Friederichsen, Michael Keller, Marius Rosenberg

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The German manufacturing industry has to withstand an increasing global competition on product quality and production costs. As labor costs are high, several industries have suffered severely under the relocation of production facilities towards aspiring countries, which have managed to close the productivity and quality gap substantially. Established manufacturing companies have recognized that customers are not willing to pay large price premiums for incremental quality improvements. As a consequence, many companies from the German manufacturing industry adjust their production focusing on customized products and fast time to market. Leveraging the advantages of novel production strategies such as Agile Manufacturing and Mass Customization, manufacturing companies transform into integrated networks, in which companies unite their core competencies. Hereby, virtualization of the process- and supply-chain ensures smooth inter-company operations providing real-time access to relevant product and production information for all participating entities. Boundaries of companies deteriorate, as autonomous systems exchange data, gained by embedded systems throughout the entire value chain. By including Cyber-Physical-Systems, advanced communication between machines is tantamount to their dialogue with humans. The increasing utilization of information and communication technology allows digital engineering of products and production processes alike. Modular simulation and modeling techniques allow decentralized units to flexibly alter products and thereby enable rapid product innovation. The present article describes the developments of Industry 4.0 within the literature and reviews the associated research streams. Hereby, we analyze eight scientific journals with regards to the following research fields: Individualized production, end-to-end engineering in a virtual process chain and production networks. We employ cluster analysis to assign sub-topics into the respective research field. To assess the practical implications, we conducted face-to-face interviews with managers from the industry as well as from the consulting business using a structured interview guideline. The results reveal reasons for the adaption and refusal of Industry 4.0 practices from a managerial point of view. Our findings contribute to the upcoming research stream of Industry 4.0 and support decision-makers to assess their need for transformation towards Industry 4.0 practices.

Keywords: Industry 4.0., mass customization, production networks, virtual process-chain

Procedia PDF Downloads 279

Authors: N. Schneider, M. Bruchhage, M. Hartweg, G. Mutungi, J. O Regan, S. Deoni

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Observational neuroimaging studies suggest differences between breast-fed and formula-fed infants in developmental myelination, a key brain process for learning and cognitive development. However, the possible effects of a nutrient formulation on myelin development in healthy term infants in an intervention study have not been investigated. Objective was, therefore, to investigate the efficacy of a nutrient formulation with higher levels of myelin-relevant nutrients as compared to a control formulation with lower levels of the same nutrients on brain myelination and cognitive development in the first 6 months of life. The study is an ongoing randomized, controlled, double-blind, two-center, parallel-group clinical trial with a nonrandomized, non-blinded arm of exclusively breastfed infants. The current findings result from a staged statistical analysis at 6 months; the recruitment and intervention period has been completed for all participants. Follow-up visits at 12, 18 and 24 months are still ongoing. N= 81 enrolled full term, neurotypical infants of both sexes were randomized into either the investigational (N= 42) or the control group (N= 39), and N= 108 children in the breast-fed arm served as a natural reference group. The effect of a blend of docosahexaenoic acid, arachidonic acid, iron, vitamin B12, folic acid as well as sphingomyelin from a uniquely proceed whey protein concentrate enriched in alpha-lactalbumin and phospholipids in an infant nutrition product matrix was investigated. The main outcomes for the staged statistical analyses at 6 months included brain myelination measures derived from MRI. Additional outcomes were brain volume, cognitive development and safety. The full analyses set at 6 months comprised N= 66 infants. Higher levels of myelin-relevant nutrients compared to lower levels resulted in significant differences in myelin structure, volume, and rate of myelination as early as 3 and 6 months of life. The cross-sectional change of means between groups for whole-brain myelin volume was 8.4% for investigational versus control formulation (3.5% versus the breastfeeding reference) group at 3 months and increased to 36.4% for investigational versus control formulation (14.1% versus breastfeeding reference) at 6 months. No statistically significant differences were detected for early cognition scores. Safety findings were largely similar across groups. This is the first pediatric nutritional neuroimaging study demonstrating the efficacy of a myelin nutrient blend on developmental myelination in well-nourished term infants. Myelination is a critical process in learning and development. The effects were demonstrated across the brain, particularly in temporal and parietal regions, known to be functionally involved in sensory, motor and language skills. These first results add to the field of nutritional neuroscience by demonstrating early life nutrition benefits for brain architecture which may be foundational for later cognitive and behavioral outcomes. ClinicalTrials.gov Identifier: NCT03111927 (Infant Nutrition and Brain Development - Full-Text View - ClinicalTrials.gov).

Keywords: brain development, infant nutrition, MRI, myelination

Procedia PDF Downloads 196

Authors: Antti Lanki, Justiina Halonen, Juuso Punnonen, Emmi Rantavuo

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Marine oil spill response operation requires extensive vessel maneuvering and navigation skills. At-sea oil containment and recovery include both single vessel and multi-vessel operations. Towing long oil containment booms that are several hundreds of meters in length, is a challenge in itself. Boom deployment and towing in multi-vessel configurations is an added challenge that requires precise coordination and control of the vessels. Efficient communication, as a prerequisite for shared situational awareness, is needed in order to execute the response task effectively. To gain and maintain adequate maritime skills, practical training is needed. Field exercises are the most effective way of learning, but especially the related vessel operations are resource-intensive and costly. Field exercises may also be affected by environmental limitations such as high sea-state or other adverse weather conditions. In Finland, the seasonal ice-coverage also limits the training period to summer seasons only. In addition, environmental sensitiveness of the sea area restricts the use of real oil or other target substances. This paper examines, whether maritime simulator training can offer a complementary method to overcome the training challenges related to field exercises. The objective is to assess the efficiency and the learning impact of simulator training, and the specific skills that can be trained most effectively in simulators. This paper provides an overview of learning results from two oil spill response pilot courses, in which maritime navigational bridge simulators were used to train the oil spill response authorities. The simulators were equipped with an oil spill functionality module. The courses were targeted at coastal Fire and Rescue Services responsible for near shore oil spill response in Finland. The competence levels of the participants were surveyed before and after the course in order to measure potential shifts in competencies due to the simulator training. In addition to the quantitative analysis, the efficiency of the simulator training is evaluated qualitatively through feedback from the participants. The results indicate that simulator training is a valid and effective method for developing marine oil spill response competencies that complement traditional field exercises. Simulator training provides a safe environment for assessing various oil containment and recovery tactics. One of the main benefits of the simulator training was found to be the immediate feedback the spill modelling software provides on the oil spill behaviour as a reaction to response measures.

Keywords: maritime training, oil spill response, simulation, vessel manoeuvring

Procedia PDF Downloads 172

Authors: Naohiro Nakamura, Takuya Kinoshita, Hiroshi Fukuyama

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The 2011 off The Pacific Coast of Tohoku Earthquake caused considerable damage to wide areas of eastern Japan. A large number of earthquake observation records were obtained at various places. To design more earthquake-resistant buildings and improve earthquake disaster prevention, it is necessary to utilize these data to analyze and evaluate the behavior of a building during an earthquake. This paper presents an earthquake response simulation analysis (hereafter a seismic response analysis) that was conducted using data recorded during the main earthquake (hereafter the main shock) as well as the earthquakes before and after it. The data were obtained at a high-rise steel-reinforced concrete (SRC) building in the bay area of Tokyo. We first give an overview of the building, along with the characteristics of the earthquake motion and the building during the main shock. The data indicate that there was a change in the natural period before and after the earthquake. Next, we present the results of our seismic response analysis. First, the analysis model and conditions are shown, and then, the analysis result is compared with the observational records. Using the analysis result, we then study the effect of soil-structure interaction on the response of the building. By identifying the characteristics of the building during the earthquake (i.e., the 1st natural period and the 1st damping ratio) by the Auto-Regressive eXogenous (ARX) model, we compare the analysis result with the observational records so as to evaluate the accuracy of the response analysis. In this study, a lumped-mass system SR model was used to conduct a seismic response analysis using observational data as input waves. The main results of this study are as follows: 1) The observational records of the 3/11 main shock put it between a level 1 and level 2 earthquake. The result of the ground response analysis showed that the maximum shear strain in the ground was about 0.1% and that the possibility of liquefaction occurring was low. 2) During the 3/11 main shock, the observed wave showed that the eigenperiod of the building became longer; this behavior could be generally reproduced in the response analysis. This prolonged eigenperiod was due to the nonlinearity of the superstructure, and the effect of the nonlinearity of the ground seems to have been small. 3) As for the 4/11 aftershock, a continuous analysis in which the subject seismic wave was input after the 3/11 main shock was input was conducted. The analyzed values generally corresponded well with the observed values. This means that the effect of the nonlinearity of the main shock was retained by the building. It is important to consider this when conducting the response evaluation. 4) The first period and the damping ratio during a vibration were evaluated by an ARX model. Our results show that the response analysis model in this study is generally good at estimating a change in the response of the building during a vibration.

Keywords: ARX model, response analysis, SRC building, the 2011 off the Pacific Coast of Tohoku Earthquake

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Authors: Julia Kapr, Andrea Rossi, Haribaskar Ramachandran, Marius Pollet, Ilka Egger, Selina Dangeleit, Katharina Koch, Jean Krutmann, Ellen Fritsche

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It is widely acknowledged that animal models do not always represent human disease. Especially human brain development is difficult to model in animals due to a variety of structural and functional species-specificities. This causes significant discrepancies between predicted and apparent drug efficacies in clinical trials and their subsequent failure. Emerging alternatives based on 3D in vitro approaches, such as human brain spheres or organoids, may in the future reduce and ultimately replace animal models. Here, we present a human induced pluripotent stem cell (hiPSC)-based 3D neural in a vitro disease model for the Cockayne Syndrome B (CSB). CSB is a rare hereditary disease and is accompanied by severe neurologic defects, such as microcephaly, ataxia and intellectual disability, with currently no treatment options. Therefore, the aim of this study is to investigate the molecular and cellular defects found in neural hiPSC-derived CSB models. Understanding the underlying pathology of CSB enables the development of treatment options. The two CSB models used in this study comprise a patient-derived hiPSC line and its isogenic control as well as a CSB-deficient cell line based on a healthy hiPSC line (IMR90-4) background thereby excluding genetic background-related effects. Neurally induced and differentiated brain sphere cultures were characterized via RNA Sequencing, western blot (WB), immunocytochemistry (ICC) and multielectrode arrays (MEAs). CSB-deficiency leads to an altered gene expression of markers for autophagy, focal adhesion and neural network formation. Cell migration was significantly reduced and electrical activity was significantly increased in the disease cell lines. These data hint that the cellular pathologies is possibly underlying CSB. By induction of autophagy, the migration phenotype could be partially rescued, suggesting a crucial role of disturbed autophagy in defective neural migration of the disease lines. Altered autophagy may also lead to inefficient mitophagy. Accordingly, disease cell lines were shown to have a lower mitochondrial base activity and a higher susceptibility to mitochondrial stress induced by rotenone. Since mitochondria play an important role in neurotransmitter cycling, we suggest that defective mitochondria may lead to altered electrical activity in the disease cell lines. Failure to clear the defective mitochondria by mitophagy and thus missing initiation cues for new mitochondrial production could potentiate this problem. With our data, we aim at establishing a disease adverse outcome pathway (AOP), thereby adding to the in-depth understanding of this multi-faced disorder and subsequently contributing to alternative drug development.

Keywords: autophagy, disease modeling, in vitro, pluripotent stem cells

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Authors: Simone Raimondi De Souza, Glaucia Maria Moraes De Oliveira, Ronir Raggio Luiz, Glorimar Rosa

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Introduction: Obesity is among the main risk factors for cardiovascular disease (CVD). Genesis is multifactorial, including genetic, hormonal and environmental factors disorders, among which inadequate feeding pattern, for which nutritional counseling strategies have proven effective. The consumption of beta-glucans (soluble fibers that reportedly promote satiety) present in oat bran can be an effective strategy for preventing and treating obesity. Other benefits have been observed with oat bran consumption, such as reduction of hypercholesterolemia and hyperglycemia, two other risk factors for CVD. Objectives: To analyze the effect of oat bran consumption associated with nutritional counseling in reducing body mass index (BMI), blood cholesterol, glucose profile, waist and neck circumference in obese individuals, and to evaluate the change in eating pattern. Methods: clinical trial, randomized, double-blind, placebo-controlled, lasting 90 days with adults of both genders, with BMI ≥30kg/m2. The study was approved by the Ethics in Research involving human beings in a public institute of cardiology, in Rio de Janeiro, Brazil. Individuals were invited to participate and accepted formally by signing the Terms of Consent. Participants were randomized into oat bran group (gOB) or placebo group (gPCB) and received, respectively: morning prepared consisting of 40g oat bran, 30g of skimmed milk powder and 1g sweetener sucralose; refined flour 40g rice, 30g of milk powder and 1g sweetener sucralose. The Ten Steps to Healthy Eating, of Brazilian Ministry of Health were used to support the nutritional counseling. Variables analyzed: gender; age; BMI, waist circumference (WC) neck circumference (NC); systolic blood pressure (SBP); diastolic blood pressure (DBP); food consumption, total cholesterol (TC), LDL-cholesterol (LDL-c), HDL-cholesterol (HDL-c), non-HDL cholesterol (nHDLc), triglycerides (TG), fasting glucose (FG), fasting insulin (FI) and HOMA-IR. Dietary intake was assessed by 24-hour dietary recall. The Diet Quality Index revised for the Brazilian population (IQD-R) assessed quality of feeding pattern. Statistical analyzes were performed using SPSS version 21, considering statistically significant p-value less than 0.05. Results: A total of 38 participants were included, age = 50 ± 7,6years, 63% women. 19 subjects were placed in gOB and 19 in gPCB. After intervention, statistically significant reductions were observed in the following parameters: in gOB: IQD-R, TC, LDL-c, nHDL-c, FI, SBP, DBP, BMI, WC, NC; in gPCB: IQD-R, LDL-c, SBP, DBP, BMI, WC, NC. No statistically significant differences were observed in the results between groups. Conclusion: Our results reinforce nutritional counseling as important strategy for prevention and treatment of obesity and suggest that inclusion of oat bran in daily diet can bring additional benefits controlling risk factors for CVD. More studies are needed to establish all benefits of oat bran to human health as well as the ideal daily dose for consumption.

Keywords: oat bran, cardiovascular disease, nutritional counseling, obesity

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Authors: Xiang Zheng, Zhaoping Zhong

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

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

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Authors: Rasha Al-Saedi, Anthony Meijer

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The progress of new porous materials has increased rapidly over the past decade for use in applications such as catalysis, gas storage and removal of environmentally unfriendly species due to their high surface area and high thermal stability. In this work, a theoretical study of the zirconium-based metal organic framework (MOFs) were examined in order to determine their potential for gas adsorption of various guest molecules: CO2, N2, CH4 and H2. The zirconium cluster consists of an inner Zr6O4(OH)4 core in which the triangular faces of the Zr6- octahedron are alternatively capped by O and OH groups which bound to nine formate groups and three benzoate groups linkers. General formula is [Zr(μ-O)4(μ-OH)4(HCOO)9((phyO2C)3X))] where X= CH2OH, CH2NH2, CH2CONH2, n(NH2); (n = 1-3). Three types of adsorption sites on the Zr metal center have been studied, named according to capped chemical groups as the ‘−O site’; the H of (μ-OH) site removed and added to (μ-O) site, ‘–OH site’; (μ-OH) site removed, the ‘void site’ where H2O molecule removed; (μ-OH) from one site and H from other (μ-OH) site, in addition to no defect versions. A series of investigations have been performed aiming to address this important issue. First, density functional theory DFT-B3LYP method with 6-311G(d,p) basis set was employed using Gaussian 09 package in order to evaluate the gas adsorption performance of missing-linker defects in zirconium cluster. Next, study the gas adsorption behaviour on different functionalised zirconium clusters. Those functional groups as mentioned above include: amines, alcohol, amide, in comparison with non-substitution clusters. Then, dispersion-corrected density functional theory (DFT-D) calculations were performed to further understand the enhanced gas binding on zirconium clusters. Finally, study the water effect on CO2 and N2 adsorption. The small functionalized Zr clusters were found to result in good CO2 adsorption over N2, CH4, and H2 due to the quadrupole moment of CO2 while N2, CH4 and H2 weakly polar or non-polar. The adsorption efficiency was determined using the dispersion method where the adsorption binding improved as most of the interactions, for example, van der Waals interactions are missing with the conventional DFT method. The calculated gas binding strengths on the no defect site are higher than those on the −O site, −OH site and the void site, this difference is especially notable for CO2. It has been stated that the enhanced affinity of CO2 of no defect versions is most likely due to the electrostatic interactions between the negatively charged O of CO2 and the positively charged H of (μ-OH) metal site. The uptake of the gas molecule does not enhance in presence of water as the latter binds to Zr clusters more strongly than gas species which attributed to the competition on adsorption sites.

Keywords: density functional theory, gas adsorption, metal- organic frameworks, molecular simulation, porous materials, theoretical chemistry

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Authors: Mindaye Teshome, Evaldo Muñoz Braz, Carlos M. M. Eleto Torres, Patricia Mattos

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Sustainable forest management planning requires up-to-date information on the structure, standing volume, biomass, and growth rate of trees from a given forest. This kind of information is lacking in many forests in Ethiopia. The objective of this study was to quantify the population structure, diameter growth rate, and standing volume of wood from Juniperus procera trees in the Chilimo forest. A total of 163 sample plots were set up in the forest to collect the relevant vegetation data. Growth ring measurements were conducted on stem disc samples collected from 12 J. procera trees. Diameter and height measurements were recorded from a total of 1399 individual trees with dbh ≥ 2 cm. The growth rate, maximum current and mean annual increments, minimum logging diameter, and cutting cycle were estimated, and alternative cutting cycles were established. Using these data, the harvestable volume of wood was projected by alternating four minimum logging diameters and five cutting cycles following the stand table projection method. The results show that J. procera trees have an average density of 183 stems ha⁻¹, a total basal area of 12.1 m² ha⁻¹, and a standing volume of 98.9 m³ ha⁻¹. The mean annual diameter growth ranges between 0.50 and 0.65 cm year⁻¹ with an overall mean of 0.59 cm year⁻¹. The population of J. procera tree followed a reverse J-shape diameter distribution pattern. The maximum current annual increment in volume (CAI) occurred at around 49 years when trees reached 30 cm in diameter. Trees showed the maximum mean annual increment in volume (MAI) around 91 years, with a diameter size of 50 cm. The simulation analysis revealed that 40 cm MLD and a 15-year cutting cycle are the best minimum logging diameter and cutting cycle. This combination showed the largest harvestable volume of wood potential, volume increments, and a 35% recovery of the initially harvested volume. It is concluded that the forest is well stocked and has a large amount of harvestable volume of wood from J. procera trees. This will enable the country to partly meet the national wood demand through domestic wood production. The use of the current population structure and diameter growth data from tree ring analysis enables the exact prediction of the harvestable volume of wood. The developed model supplied an idea about the productivity of the J. procera tree population and enables policymakers to develop specific management criteria for wood harvesting.

Keywords: logging, growth model, cutting cycle, minimum logging diameter

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Authors: Demet Devrimsel Dogan, Ecem Deniz Kirkpantur, Muharrem Dogan, Ahmet Aykut, Ebru Unal Akoglu, Ozge Ecmel Onur

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Introduction: Median Arcuate Ligament Syndrome (MALS) is a rare cause of chronic abdominal pain due to external compression of the celiac trunk by a fibrous arch that unites diaphragmatic crura on each side of the aortic hiatus. While 10-24% of the population may suffer from compression of celiac trunk, it rarely causes patients to develop symptoms. The typical clinical triad of symptoms includes postprandial epigastric pain, weight loss and vomiting. The diagnosis can be made using thin section multi-detector computed tomography (CT) scans which delineate the ligament and the compressed vessel. The treatment of MALS is aimed at relieving the compression of the celiac artery to restore adequate blood flow through the vessel and neurolysis to address chronic pain. Case: A 68-year-old male presented to our clinic with acute postprandial epigastric pain. This was patients’ first attack, and the pain was the worst pain of his life. The patient did not have any other symptoms like nausea, vomiting, chest pain or dyspnea. In his medical history, the patient has had an ischemic cerebrovascular stroke 5 years ago which he recovered with no sequel, and he was using 75 mg clopidogrel and 100 mg acetylsalicylic acid. He was not using any other medication and did not have a story of cardiovascular disease. His vital signs were stable (BP:113/72 mmHg, Spo2:97, temperature:36.3°C, HR:90/bpm). In his electrocardiogram, there was ST depression in leads II, III and AVF. In his physical examination, there was only epigastric tenderness, other system examinations were normal. Physical examination through his upper gastrointestinal system showed no bleeding. His laboratory results were as follows: creatinine:1.26 mg/dL, AST:42 U/L, ALT:17 U/L, amylase:78 U/L, lipase:26 U/L, troponin:10.3 pg/ml, WBC:28.9 K/uL, Hgb:12.7 gr/dL, Plt:335 K/uL. His serial high-sensitive troponin levels were also within normal limits, his echocardiography showed no segmental wall motion abnormalities, an acute myocardial infarction was excluded. In his abdominal ultrasound, no pathology was founded. Contrast-enhanced abdominal CT and CT angiography reported ‘thickened diaphragmatic cruras are compressing and stenosing truncus celiacus superior, this is likely compatible with MALS’. The patient was consulted to general surgery, and they admitted the patient for laparoscopic ligament release. Results: MALS is a syndrome that causes postprandial pain, nausea and vomiting as its most common symptoms. Affected patients are normally young, slim women between the ages of 30 and 50 who have undergone extensive examinations to find the source of their symptoms. To diagnose MALS, other underlying pathologies should initially be excluded. The gold standard is aortic angiography. Although diagnosis and treatment of MALS are unclear, symptom resolution has been achieved with multiple surgical modalities, including open, laparoscopic or robotic ligament release as well as celiac ganglionectomy, which often requires celiac artery revascularisation.

Keywords: differential diagnosis, epigastric pain, median arcuate ligament syndrome, celiac trunk

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Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán

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Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.

Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education

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Authors: Hemant Upadhyay, Tarun Kumar Kundu

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It is utmost important for a blast furnace operator to understand the mechanisms governing the liquid flow, accumulation, drainage and heat transfer between various phases in blast furnace hearth for a stable and efficient blast furnace operation. Abnormal drainage behavior may lead to high liquid build up in the hearth. Operational problems such as pressurization, low wind intake, and lower material descent rates, normally be encountered if the liquid levels in the hearth exceed a critical limit when Hearth coke and Deadman start to float. Similarly, hot metal temperature is an important parameter to be controlled in the BF operation; it should be kept at an optimal level to obtain desired product quality and a stable BF performance. It is not possible to carry out any direct measurement of above due to the hostile conditions in the hearth with chemically aggressive hot liquids. The objective here is to develop a mathematical model to simulate the variation in hot metal / slag accumulation and temperature during the tapping of the blast furnace based on the computed drainage rate, production rate, mass balance, heat transfer between metal and slag, metal and solids, slag and solids as well as among the various zones of metal and slag itself. For modeling purpose, the BF hearth is considered as a pressurized vessel, filled with solid coke particles. Liquids trickle down in hearth from top and accumulate in voids between the coke particles which are assumed thermally saturated. A set of generic mass balance equations gives the amount of metal and slag intake in hearth. A small drainage (tap hole) is situated at the bottom of the hearth and flow rate of liquids from tap hole is computed taking in account the amount of both the phases accumulated their level in hearth, pressure from gases in the furnace and erosion behaviors of tap hole itself. Heat transfer equations provide the exchange of heat between various layers of liquid metal and slag, and heat loss to cooling system through refractories. Based on all that information a dynamic simulation is carried out which provides real time information of liquids accumulation in hearth before and during tapping, drainage rate and its variation, predicts critical event timings during tapping and expected tapping temperature of metal and slag on preset time intervals. The model is in use at JSPL, India BF-II and its output is regularly cross-checked with actual tapping data, which are in good agreement.

Keywords: blast furnace, hearth, deadman, hotmetal

Procedia PDF Downloads 186

Authors: B. S. Premalatha, Mereen Rose Babu, Vaishali Prabhu

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Background: Dysphagia must be assessed, either subjectively or objectively, in order to properly address the swallowing difficulty. Providing therapeutic care to patients with dysphagia via tele mode was one approach for providing clinical services during the COVID-19 epidemic. As a result, the teleassessment of dysphagia has increased in India. Aim: This study aimed to identify challenges faced by Indian SLPs while providing teleassessment to individuals with dysphagia during the outbreak of COVID-19 from 2020 to 2021. Method: After receiving approval from the institute's institutional review board and ethics committee, the current study was carried out. The study was cross-sectional in nature and lasted from 2020 to 2021. The study enrolled participants who met the inclusion and exclusion criteria of the study. It was decided to recruit roughly 246 people based on the sample size calculations. The research was done in three stages: questionnaire development and content validation, questionnaire administration. Five speech and hearing professionals' content verified the questionnaire for faults and clarity. Participants received questionnaires via various social media platforms such as e-mail and WhatsApp, which were written in Microsoft Word and then converted to Google Forms. SPSS software was used to examine the data. Results: In light of the obstacles that Indian SLPs encounter, the study's findings were examined. Only 135 people responded. During the COVID-19 lockdowns, 38% of participants said they did not deal with dysphagia patients. After the lockout, 70.4% of SLPs kept working with dysphagia patients, while 29.6% did not. From the beginning of the oromotor examination, the main problems in completing tele evaluation of dysphagia have been highlighted. Around 37.5% of SLPs said they don't undertake the OPME online because of difficulties doing the evaluation, such as the need for repeated instructions from patients and family members and trouble visualizing structures in various positions. The majority of SLPs' online assessments were inefficient and time-consuming. A bigger percentage of SLPs stated that they will not advocate tele evaluation in dysphagia to their colleagues. SLPs' use of dysphagia assessment has decreased as a result of the epidemic. When it came to the amount of food, the majority of people proposed a small amount. Apart from placing the patient for assessment and gaining less cooperation from the family, most SLPs found that Internet speed was a source of concern and a barrier. Hearing impairment and the presence of a tracheostomy in patients with dysphagia proved to be the most difficult conditions to treat online. For patients with NPO, the majority of SLPs did not advise tele-evaluation. In the anterior region of the oral cavity, oral meal residue was more visible. The majority of SLPs reported more anterior than posterior leakage. Even while the majority of SLPs could detect aspiration by coughing, many found it difficult to discern the gurgling tone of speech after swallowing. Conclusion: The current study sheds light on the difficulties that Indian SLPs experience when assessing dysphagia via tele mode, indicating that tele-assessment of dysphagia is still to gain importance in India.

Keywords: dysphagia, teleassessment, challenges, Indian SLP

Procedia PDF Downloads 138

Authors: Amir Gharavi, Mohamed Hassan, Amjad Shah

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

Keywords: unconventional, resource, hydraulic, fracturing

Procedia PDF Downloads 298

Authors: Medine Demir, Volker John

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Fluid equations in a rotating frame of reference have a broad class of important applications in meteorology and oceanography, especially in the large-scale flows considered in ocean and atmosphere, as well as many physical and industrial applications. The Coriolis and the centripetal forces, resulting from the rotation of the earth, play a crucial role in such systems. For such applications it may be required to solve the system in complex three-dimensional geometries. In recent years, the Navier--Stokes equations in a rotating frame have been investigated in a number of papers using the classical inf-sup stable mixed methods, like Taylor-Hood pairs, to contribute to the analysis and the accurate and efficient numerical simulation. Numerical analysis reveals that these classical methods introduce a pressure-dependent contribution in the velocity error bounds that is proportional to some inverse power of the viscosity. Hence, these methods are optimally convergent but small velocity errors might not be achieved for complicated pressures and small viscosity coefficients. Several approaches have been proposed for improving the pressure-robustness of pairs of finite element spaces. In this contribution, a pressure-robust space discretization of the incompressible Navier--Stokes equations in a rotating frame of reference is considered. The discretization employs divergence-free, $H^1$-conforming mixed finite element methods like Scott--Vogelius pairs. However, this approach might come with a modification of the meshes, like the use of barycentric-refined grids in case of Scott--Vogelius pairs. However, this strategy requires the finite element code to have control on the mesh generator which is not realistic in many engineering applications and might also be in conflict with the solver for the linear system. An error estimate for the velocity is derived that tracks the dependency of the error bound on the coefficients of the problem, in particular on the angular velocity. Numerical examples illustrate the theoretical results. The idea of pressure-robust method could be cast on different types of flow problems which would be considered as future studies. As another future research direction, to avoid a modification of the mesh, one may use a very simple parameter-dependent modification of the Scott-Vogelius element, the pressure-wired Stokes element, such that the inf-sup constant is independent of nearly-singular vertices.

Keywords: navier-stokes equations in a rotating frame of refence, coriolis force, pressure-robust error estimate, scott-vogelius pairs of finite element spaces

Procedia PDF Downloads 67

Authors: Fangliang Chen, Yihe Huang, Tejav Deganyar, Anselm Boehm, Hamid Batoul

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With growing population density and further urbanization, the average noise level in cities is increasing. Excessive noise is not only annoying but also leads to a negative impact on human health. To deal with the increasing city noise, environmental regulations bring up higher standards on acoustic comfort in buildings by mitigating the noise transmission from building envelope exterior to interior. Framed window, door and façade systems are the leading choice for modern fenestration construction, which provides demonstrated quality of weathering reliability, environmental efficiency, and installation ease. The overall sound insulation of such systems depends both on glasses and frames, where glass usually covers the majority of the exposed surfaces, thus it is the main source of sound energy transmission. While frames in modern façade systems become slimmer for aesthetic appearance, which contribute to a minimal percentage of exposed surfaces. Nevertheless, frames might provide substantial transmission paths for sound travels through because of much less mass crossing the path, thus becoming more critical in limiting the acoustic performance of the whole system. There are various methodologies and numerical programs that can accurately predict the acoustic performance of either glasses or frames. However, due to the vast variance of size and dimension between frame and glass in the same system, there is no satisfactory theoretical approach or affordable simulation tool in current practice to access the over acoustic performance of a whole façade system. For this reason, laboratory test turns out to be the only reliable source. However, laboratory test is very time consuming and high costly, moreover different lab might provide slightly different test results because of varieties of test chambers, sample mounting, and test operations, which significantly constrains the early phase design of framed façade systems. To address this dilemma, this study provides an effective analytical methodology to predict the acoustic performance of framed façade systems, based on vast amount of acoustic test results on glass, frame and the whole façade system consist of both. Further test results validate the current model is able to accurately predict the overall sound transmission loss of a framed system as long as the acoustic behavior of the frame is available. Though the presented methodology is mainly developed from façade systems with aluminum frames, it can be easily extended to systems with frames of other materials such as steel, PVC or wood.

Keywords: city noise, building facades, sound mitigation, sound transmission loss, framed façade system

Procedia PDF Downloads 63

Authors: Alexander Buhr, Klaus Ehrenfried

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Trackside induced airflow velocities, also known as slipstream velocities, are an important criterion for the design of high-speed trains. The maximum permitted values are given by the Technical Specifications for Interoperability (TSI) and have to be checked in the approval process. For train manufactures it is of great interest to know in advance, how new train geometries would perform in TSI tests. The Reynolds number in moving model experiments is lower compared to full-scale. Especially the limited model length leads to a thinner boundary layer at the rear end. The hypothesis is that the boundary layer rolls up to characteristic flow structures in the train wake, in which the maximum flow velocities can be observed. The idea is to enlarge the boundary layer using roughness elements at the train model head so that the ratio between the boundary layer thickness and the car width at the rear end is comparable to a full-scale train. This may lead to similar flow structures in the wake and better prediction accuracy for TSI tests. In this case, the design of the roughness elements is limited by the moving model rig. Small rectangular roughness shapes are used to get a sufficient effect on the boundary layer, while the elements are robust enough to withstand the high accelerating and decelerating forces during the test runs. For this investigation, High-Speed Particle Image Velocimetry (HS-PIV) measurements on an ICE3 train model have been realized in the moving model rig of the DLR in Göttingen, the so called tunnel simulation facility Göttingen (TSG). The flow velocities within the boundary layer are analysed in a plain parallel to the ground. The height of the plane corresponds to a test position in the EN standard (TSI). Three different shapes of roughness elements are tested. The boundary layer thickness and displacement thickness as well as the momentum thickness and the form factor are calculated along the train model. Conditional sampling is used to analyse the size and dynamics of the flow structures at the time of maximum velocity in the train wake behind the train. As expected, larger roughness elements increase the boundary layer thickness and lead to larger flow velocities in the boundary layer and in the wake flow structures. The boundary layer thickness, displacement thickness and momentum thickness are increased by using larger roughness especially when applied in the height close to the measuring plane. The roughness elements also cause high fluctuations in the form factors of the boundary layer. Behind the roughness elements, the form factors rapidly are approaching toward constant values. This indicates that the boundary layer, while growing slowly along the second half of the train model, has reached a state of equilibrium.

Keywords: boundary layer, high-speed PIV, ICE3, moving train model, roughness elements

Procedia PDF Downloads 307

Authors: Maryam Al Mheiri, Khaled Al Awadi

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Urban population is continuously increasing worldwide and the speed at which cities urbanize creates major challenges, particularly in terms of creating sustainable urban environments. Rapid urbanization often leads to negative environmental impacts and changes in the urban microclimates. Moreover, when rapid urbanization is paired with limited landscape elements, the effects on human health due to the increased pollution, and thermal comfort due to Urban Heat Island effects are increased. Urban Heat Island (UHI) describes the increase of urban temperatures in urban areas in comparison to its rural surroundings, and, as we discuss in this paper, it impacts on pedestrian comfort, reducing the number of walking trips and public space use. It is thus very necessary to investigate the quality of outdoor built environments in order to improve the quality of life incites. The main objective of this paper is to address the morphology of Emirati neighborhoods, setting a quantitative baseline by which to assess and compare spatial characteristics and microclimate performance of existing typologies in Abu Dhabi. This morphological mapping and analysis will help to understand the built landscape of Emirati neighborhoods in this city, whose form has changed and evolved across different periods. This will eventually help to model the use of different design strategies, such as landscaping, to mitigate UHI effects and enhance outdoor urban comfort. Further, the impact of different native plants types and native species in reducing UHI effects and enhancing outdoor urban comfort, allowing for the assessment of the impact of increasing landscaped areas in these neighborhoods. This study uses ENVI-met, an analytical, three-dimensional, high-resolution microclimate modeling software. This micro-scale urban climate model will be used to evaluate existing conditions and generate scenarios in different residential areas, with different vegetation surfaces and landscaping, and examine their impact on surface temperatures during summer and autumn. In parallel to these simulations, field measurement will be included to calibrate the Envi-met model. This research therefore takes an experimental approach, using simulation software, and a case study strategy for the evaluation of a sample of residential neighborhoods. A comparison of the results of these scenarios constitute a first step towards making recommendations about what constitutes sustainable landscapes for Abu Dhabi neighborhoods.

Keywords: landscape, microclimate, native plants, sustainable neighborhoods, thermal comfort, urban heat island

Procedia PDF Downloads 311

Authors: Badryah Alshehri, Kevin Gormley, Gillian Prue, Karen McCutcheon

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In a disaster event, sharing patient information between the pre-hospital Emergency Medical Services (EMS) and Emergency Department (ED) hospitals is a complex process during which important information may be altered or lost due to poor communication. The aim of this study was to critically discuss the current evidence base in relation to communication between pre- EMS hospital and ED hospital professionals by the use of Information and Communication Systems (ICT). This study followed the systematic approach; six electronic databases were searched: CINAHL, Medline, Embase, PubMed, Web of Science, and IEEE Xplore Digital Library were comprehensively searched in January 2018 and a second search was completed in April 2020 to capture more recent publications. The study selection process was undertaken independently by the study authors. Both qualitative and quantitative studies were chosen that focused on factors that are positively or negatively associated with coordinated communication between pre-hospital EMS and ED teams in a disaster event. These studies were assessed for quality, and the data were analyzed according to the key screening themes which emerged from the literature search. Twenty-two studies were included. Eleven studies employed quantitative methods, seven studies used qualitative methods, and four studies used mixed methods. Four themes emerged on communication between EMTs (pre-hospital EMS and ED staff) in a disaster event using the ICT. (1) Disaster preparedness plans and coordination. This theme reported that disaster plans are in place in hospitals, and in some cases, there are interagency agreements with pre-hospital and relevant stakeholders. However, the findings showed that the disaster plans highlighted in these studies lacked information regarding coordinated communications within and between the pre-hospital and hospital. (2) Communication systems used in the disaster. This theme highlighted that although various communication systems are used between and within hospitals and pre-hospitals, technical issues have influenced communication between teams during disasters. (3) Integrated information management systems. This theme suggested the need for an integrated health information system that can help pre-hospital and hospital staff to record patient data and ensure the data is shared. (4) Disaster training and drills. While some studies analyzed disaster drills and training, the majority of these studies were focused on hospital departments other than EMTs. These studies suggest the need for simulation disaster training and drills, including EMTs. This review demonstrates that considerable gaps remain in the understanding of the communication between the EMS and ED hospital staff in relation to response in disasters. The review shows that although different types of ICTs are used, various issues remain which affect coordinated communication among the relevant professionals.

Keywords: emergency medical teams, communication, information and communication technologies, disaster

Procedia PDF Downloads 127

Authors: Pierobon Enrico, Missiaggia Marta, Castelluzzo Michele, Tommasino Francesco, Ricci Leonardo, Scifoni Emanuele, Vincezo Monaco, Boscardin Maurizio, La Tessa Chiara

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Clinical outcomes collected over the past three decades have suggested that ion therapy has the potential to be a treatment modality superior to conventional radiation for several types of cancer, including recurrences, as well as for other diseases. Although the results have been encouraging, numerous treatment uncertainties remain a major obstacle to the full exploitation of particle radiotherapy. To overcome therapy uncertainties optimizing treatment outcome, the best possible radiation quality description is of paramount importance linking radiation physical dose to biological effects. Microdosimetry was developed as a tool to improve the description of radiation quality. By recording the energy deposition at the micrometric scale (the typical size of a cell nucleus), this approach takes into account the non-deterministic nature of atomic and nuclear processes and creates a direct link between the dose deposited by radiation and the biological effect induced. Microdosimeters measure the spectrum of lineal energy y, defined as the energy deposition in the detector divided by most probable track length travelled by radiation. The latter is provided by the so-called “Mean Chord Length” (MCL) approximation, and it is related to the detector geometry. To improve the characterization of the radiation field quality, we define a new quantity replacing the MCL with the actual particle track length inside the microdosimeter. In order to measure this new quantity, we propose a two-stage detector consisting of a commercial Tissue Equivalent Proportional Counter (TEPC) and 4 layers of Low Gain Avalanche Detectors (LGADs) strips. The TEPC detector records the energy deposition in a region equivalent to 2 um of tissue, while the LGADs are very suitable for particle tracking because of the thickness thinnable down to tens of micrometers and fast response to ionizing radiation. The concept of HDM has been investigated and validated with Monte Carlo simulations. Currently, a dedicated readout is under development. This two stages detector will require two different systems to join complementary information for each event: energy deposition in the TEPC and respective track length recorded by LGADs tracker. This challenge is being addressed by implementing SoC (System on Chip) technology, relying on Field Programmable Gated Arrays (FPGAs) based on the Zynq architecture. TEPC readout consists of three different signal amplification legs and is carried out thanks to 3 ADCs mounted on a FPGA board. LGADs activated strip signal is processed thanks to dedicated chips, and finally, the activated strip is stored relying again on FPGA-based solutions. In this work, we will provide a detailed description of HDM geometry and the SoC solutions that we are implementing for the readout.

Keywords: particle tracking, ion therapy, low gain avalanche diode, tissue equivalent proportional counter, microdosimetry

Procedia PDF Downloads 176

Authors: Francesca Schiavello

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This work aims to create a hybrid algorithm, combining Quantum Approximate Optimization Algorithm (QAOA) with an Evolutionary Algorithm (EA) in the place of traditional gradient based optimization processes. QAOA’s were first introduced in 2014, where, at the time, their algorithm performed better than the traditional best known classical algorithm for Max-cut graphs. Whilst classical algorithms have improved since then and have returned to being faster and more efficient, this was a huge milestone for quantum computing, and their work is often used as a benchmarking tool and a foundational tool to explore variants of QAOA’s. This, alongside with other famous algorithms like Grover’s or Shor’s, highlights to the world the potential that quantum computing holds. It also presents the reality of a real quantum advantage where, if the hardware continues to improve, this could constitute a revolutionary era. Given that the hardware is not there yet, many scientists are working on the software side of things in the hopes of future progress. Some of the major limitations holding back quantum computing are the quality of qubits and the noisy interference they generate in creating solutions, the barren plateaus that effectively hinder the optimization search in the latent space, and the availability of number of qubits limiting the scale of the problem that can be solved. These three issues are intertwined and are part of the motivation for using EAs in this work. Firstly, EAs are not based on gradient or linear optimization methods for the search in the latent space, and because of their freedom from gradients, they should suffer less from barren plateaus. Secondly, given that this algorithm performs a search in the solution space through a population of solutions, it can also be parallelized to speed up the search and optimization problem. The evaluation of the cost function, like in many other algorithms, is notoriously slow, and the ability to parallelize it can drastically improve the competitiveness of QAOA’s with respect to purely classical algorithms. Thirdly, because of the nature and structure of EA’s, solutions can be carried forward in time, making them more robust to noise and uncertainty. Preliminary results show that the EA algorithm attached to QAOA can perform on par with the traditional QAOA with a Cobyla optimizer, which is a linear based method, and in some instances, it can even create a better Max-Cut. Whilst the final objective of the work is to create an algorithm that can consistently beat the original QAOA, or its variants, due to either speedups or quality of the solution, this initial result is promising and show the potential of EAs in this field. Further tests need to be performed on an array of different graphs with the parallelization aspect of the work commencing in October 2023 and tests on real hardware scheduled for early 2024.

Keywords: evolutionary algorithm, max cut, parallel simulation, quantum optimization

Procedia PDF Downloads 60

Authors: Xu Qian

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This abstract examines the concept of resilience in adolescents from both adolescent medicine and child psychology perspectives. It discusses the role of healthcare providers in fostering resilience among adolescents, encompassing physical, psychological, and social aspects. The paper highlights evidence-based interventions and practical strategies for promoting resilience in this population. Introduction: Resilience plays a crucial role in the healthy development of adolescents, enabling them to navigate through the challenges of this transitional period. This abstract explores the concept of resilience from the perspectives of adolescent medicine and child psychology, shedding light on the collective efforts of healthcare providers in fostering resilience. By integrating the principles and practices of these two disciplines, this abstract emphasizes the multidimensional nature of resilience and its significance in the overall well-being of adolescents. Methods: A comprehensive literature review was conducted, encompassing research articles, empirical studies, and expert opinions from both adolescent medicine and child psychology fields. The search included databases such as PubMed, PsycINFO, and Google Scholar, focusing on publications from the past decade. The review aimed to identify evidence-based interventions and practical strategies employed by healthcare providers to promote resilience among adolescents. Results: The review revealed several key findings regarding the promotion of resilience in adolescents. Firstly, resilience is a dynamic process influenced by individual characteristics, environmental factors, and the interaction between the two. Secondly, healthcare providers play a critical role in fostering resilience by addressing the physical, psychological, and social needs of adolescents. This entails comprehensive healthcare services that integrate medical care, mental health support, and social interventions. Thirdly, evidence-based interventions such as cognitive-behavioral therapy, social skills training, and positive youth development programs have shown promising outcomes in enhancing resilience. Discussion: The integration of adolescent medicine and child psychology perspectives provides a comprehensive framework for promoting resilience in adolescents. By acknowledging the interplay between physical health, psychological well-being, and social functioning, healthcare providers can tailor interventions to address the specific needs and challenges faced by adolescents. Collaborative efforts between medical professionals, psychologists, educators, and families are vital in creating a supportive environment that fosters resilience. Additionally, the findings highlight the importance of early identification and intervention, emphasizing the need for routine screening and assessment to identify adolescents at risk and provide timely support. Conclusion: Promoting resilience in adolescents requires a holistic approach that integrates adolescent medicine and child psychology perspectives. By recognizing the multifaceted nature of resilience, healthcare providers can implement evidence-based interventions and practical strategies to enhance the well-being of adolescents. The collaboration between healthcare professionals from different disciplines, alongside the involvement of families and communities, is crucial for creating a resilient support system. By investing in the promotion of resilience during adolescence, we can empower young individuals to overcome adversity and thrive in their journey toward adulthood.

Keywords: psychology, clinical psychology, child psychology, adolescent psychology, adolescent

Procedia PDF Downloads 79

Authors: Kevin De Castro Cogle, Mirian Kubo, Maria Anastasiadi, Fady Mohareb, Claire Rossi

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Background: The bioaccessibility of bioactive compounds is a critical determinant of the nutritional quality of various food products. Despite its importance, there is a limited number of comprehensive studies aimed at assessing how the composition of a food matrix influences the bioaccessibility of a compound of interest. This knowledge gap has prompted a growing need to investigate the intricate relationship between food matrix formulations and the bioaccessibility of bioactive compounds. One such class of bioactive compounds that has attracted considerable attention is curcuminoids. These naturally occurring phytochemicals, extracted from the roots of Curcuma longa, have gained popularity owing to their purported health benefits and also well known for their poor bioaccessibility Project aim: The primary objective of this research project is to systematically assess the influence of matrix composition on the bioaccessibility of curcuminoids. Additionally, this study aimed to develop a series of predictive models for bioaccessibility, providing valuable insights for optimising the formula for functional foods and provide more descriptive nutritional information to potential consumers. Methods: Food formulations enriched with curcuminoids were subjected to in vitro digestion simulation, and their bioaccessibility was characterized with chromatographic and spectrophotometric techniques. The resulting data served as the foundation for the development of predictive models capable of estimating bioaccessibility based on specific physicochemical properties of the food matrices. Results: One striking finding of this study was the strong correlation observed between the concentration of macronutrients within the food formulations and the bioaccessibility of curcuminoids. In fact, macronutrient content emerged as a very informative explanatory variable of bioaccessibility and was used, alongside other variables, as predictors in a Bayesian hierarchical model that predicted curcuminoid bioaccessibility accurately (optimisation performance of 0.97 R2) for the majority of cross-validated test formulations (LOOCV of 0.92 R2). These preliminary results open the door to further exploration, enabling researchers to investigate a broader spectrum of food matrix types and additional properties that may influence bioaccessibility. Conclusions: This research sheds light on the intricate interplay between food matrix composition and the bioaccessibility of curcuminoids. This study lays a foundation for future investigations, offering a promising avenue for advancing our understanding of bioactive compound bioaccessibility and its implications for the food industry and informed consumer choices.

Keywords: bioactive bioaccessibility, food formulation, food matrix, machine learning, probabilistic modelling

Procedia PDF Downloads 68

Authors: Pampita Chakraborty, Sukumar Mukherjee

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This study was done to determine the bacteriological profile and antibiotic resistance of the isolates and to find out the potential risk factors for infection with multidrug-resistant organisms. Diabetic foot ulcer is a major medical, social, economic problem and a leading cause of morbidity and mortality, especially in the developing countries like India. 25 percent of all diabetic patients develop a foot ulcer at some point in their lives which is highly susceptible to infections and that spreads rapidly, leading to overwhelming tissue destruction and subsequent amputation. Infection with multidrug resistant organisms (MDRO) may increase the cost of management and may cause additional morbidity and mortality. Proper management of these infections requires appropriate antibiotic selection based on culture and antimicrobial susceptibility testing. Early diagnosis of microbial infections is aimed to institute the appropriate antibacterial therapy initiative to avoid further complications. A total of 200 Type 2 Diabetic Mellitus patients with infection were admitted at GD Hospital and Diabetes Institute, Kolkata. 60 of them who developed ulcer during the year 2013 were included in this study. A detailed clinical history and physical examination were carried out for every subject. Specimens for microbiological studies were obtained from ulcer region. Gram-negative bacilli were tested for extended spectrum Beta-lactamase (ESBL) production by double disc diffusion method. Staphylococcal isolates were tested for susceptibility to oxacillin by screen agar method and disc diffusion. Potential risk factors for MDRO-positive samples were explored. Gram-negative aerobes were most frequently isolated, followed by gram-positive aerobes. Males were predominant in the study and majority of the patients were in the age group of 41-60 years. The presence of neuropathy was observed in 80% cases followed by peripheral vascular disease (73%). Proteus spp. (22) was the most common pathogen isolated, followed by E.coli (17). Staphylococcus aureus was predominant amongst the gram-positive isolates. S.aureus showed a high rate of resistance to antibiotic tested (63.6%). Other gram-positive isolates were found to be highly resistant to erythromycin, tetracycline and ciprofloxacin, 40% each. All isolates were found to be sensitive to Vancomycin and Linezolid. ESBL production was noted in Proteus spp and E.coli. Approximately 70 % of the patients were positive for MDRO. MDRO-infected patients had poor glycemic control (HbA1c 11± 2). Infection with MDROs is common in diabetic foot ulcers and is associated with risk factors like inadequate glycemic control, the presence of neuropathy, osteomyelitis, ulcer size and increased the requirement for surgical treatment. There is a need for continuous surveillance of resistant bacteria to provide the basis for empirical therapy and reduce the risk of complications.

Keywords: diabetic foot ulcer, bacterial infection, multidrug-resistant organism, extended spectrum beta-lactamase

Procedia PDF Downloads 337

Authors: K. A.Veselova, N. V.Gromova, I. N.Antonova, I. N. Kalakutskii

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There are many diseases and incidents that may result facial defects and deformities: cancer, trauma, burns, congenital anomalies, and autoimmune diseases. In some cases, patient may acquire atypically extensive facial defect, including more than one anatomical region or, by contrast, atypically small defect (e.g. partial auricular defect). The anaplastology gives us opportunity to help patient with facial disfigurement in cases when plastic surgery is contraindicated. Using of implant retention for facial prosthesis is strongly recommended because improves both aesthetic and functional results and makes using of the prosthesis more comfortable. Prostheticly oriented fixture position is extremely important for aesthetic and functional long-term result; however, the optimal site for fixture placement is not clear in cases with atypical configuration of facial defect. The objective of this report is to demonstrate challenges in fixture position determination we have faced with and offer the solution. In this report, four cases of implant-supported facial prosthesis are described. Extra-oral implants with four millimeter length were used in all cases. The decision regarding the quantity of surgical stages was based on anamnesis of disease. Facial prostheses were manufactured according to conventional technique. Clinical and technological difficulties and mistakes are described, and prostheticly oriented approach for determination of fixture position is demonstrated. The case with atypically large combined orbital and nasal defect resulting after arteriovenous malformation is described: the correct positioning of artificial eye was impossible due to wrong position of the fixture (with suprastructure) located in medial aspect of supraorbital rim. The suprastructure was unfixed and this fixture wasn`t used for retention in order to achieve appropriate artificial eye placement and better aesthetic result. In other case with small partial auricular defect (only helix and antihelix were absent) caused by squamoized cell carcinoma T1N0M0 surgical template was used to avoid the difficulties. To achieve the prostheticly oriented fixture position in case of extremely small defect the template was made on preliminary cast using vacuum thermoforming method. Two radiopaque markers were incorporated into template in preferable for fixture placement positions taking into account future prosthesis configuration. The template was put on remaining ear and cone-beam CT was performed to insure, that the amount of bone is enough for implant insertion in preferable position. Before the surgery radiopaque markers were extracted and template was holed for guide drill. Fabrication of implant-retained facial prostheses gives us opportunity to improve aesthetics, retention and patients’ quality of life. But every inaccuracy in planning leads to challenges on surgery and prosthetic stages. Moreover, in cases with atypically small or extended facial defects prostheticly oriented approach for determination of fixture position is strongly required. The approach including surgical template fabrication is effective, easy and cheap way to avoid mistakes and unpredictable result.

Keywords: anaplastology, facial prosthesis, implant-retained facial prosthesis., maxillofacil prosthese

Procedia PDF Downloads 115

Authors: Neha Adsul, Rohit Shah

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Background: The global history of nursing is exclusively a history of deep contradictions as it seeks to negotiate inclusion in an already gendered world. Although a powerful 'clinical gaze exists, nurses have toiled to re-negotiate and subvert the 'medical gaze' by practicing the 'therapeutic gaze' to tether back 'care into nursing practice.' This helps address the duality of the 'body' and 'mind' wherein the patient is not just limited to being an object of medical inquiry. Nevertheless, there has been a consistent effort to fit 'nursing' into being an art or an emerging science over the years. Especially with advances in hospital-based techno-centric medical practices, the boundaries between technology and nursing practices are becoming more blurred as the technical process becomes synonymous with nursing, eroding the essence of nursing care. Aim: This paper examines the history of nursing and offers insights into how gendered relations and the ideological belief of 'nursing as gendered work' have propagated to the subjugation of the nursing profession. It further aims to provide insights into the patriarchally imbibed techno-centrism that negates the gendered caregiving which lies at the crux of a nurse's work. Method: A literature search was carried out using Google Scholar, Web of Science and PubMed databases. Search words included: technology and nursing, medical technology and nursing, history of nursing, sociology and nursing and nursing care. The history of nursing is presented in a discussion that weaves together the historical events of the 'Birth of the Clinic' and the shift from 'bed-side medicine' to 'hospital-based medicine' that legitimizes exploitation of the bodies of patients to the 'medical gaze while the emergence of nursing as acquiescent to instrumental, technical, positivist and dominant views of medicine. The resultant power asymmetries, wherein in contemporary nursing, the constant struggle of nurses to juggle between being the physicians "operational right arm" to harboring that subjective understanding of the patients to refrain from de-humanizing nursing-care. Findings: The nursing profession suffers from being rendered invisible due to gendered relations having patrifocal societal roots. This perpetuates a notion rooted in the idea that emphasizes empiricism and has resulted in theoretical and epistemological fragmentation of the understanding of body and mind as separate entities. Nurses operate within this structure while constantly being at the brink of being pushed beyond the legitimate professional boundaries while being labeled as being 'unscientific' as the work does not always corroborate and align with the existing dominant positivist lines of inquiries. Conclusion: When understood in this broader context of how nursing as a practice has evolved over the years, it provides a particularly crucial testbed for understanding contemporary gender relations. Not because nurses like to live in a gendered work trap but because the gendered relations at work are written in a covert narcissistic patriarchal milieu that fails to recognize the value of intangible yet utmost necessary 'caring work in nursing. This research urges and calls for preserving and revering the humane aspect of nursing care alongside the emerging tech-savvy expectations from nursing work.

Keywords: nursing history, technocentric, power relations, scientific duality

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Authors: Ciara Pienaar, J. W. Odendaal, J. Joubert, J. C. Smit

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Radar cross section (RCS) of dielectric objects play an important role in many applications, such as low observability technology development, drone detection, and monitoring as well as coastal surveillance. Various materials are used to construct the targets of interest such as metal, wood, composite materials, radar absorbent materials, and other dielectrics. Since simulated datasets are increasingly being used to supplement infield measurements, as it is more cost effective and a larger variety of targets can be simulated, it is important to have a high level of confidence in the predicted results. Confidence can be attained through validation. Various computational electromagnetic (CEM) methods are capable of predicting the RCS of dielectric targets. This study will extend previous studies by validating full-wave and asymptotic RCS simulations of dielectric targets with measured data. The paper will provide measured RCS data of a number of canonical dielectric targets exhibiting different material properties. As stated previously, these measurements are used to validate numerous CEM methods. The dielectric properties are accurately characterized to reduce the uncertainties in the simulations. Finally, an analysis of the sensitivity of oblique and normal incidence scattering predictions to material characteristics is also presented. In this paper, the ability of several CEM methods, including method of moments (MoM), and physical optics (PO), to calculate the RCS of dielectrics were validated with measured data. A few dielectrics, exhibiting different material properties, were selected and several canonical targets, such as flat plates and cylinders, were manufactured. The RCS of these dielectric targets were measured in a compact range at the University of Pretoria, South Africa, over a frequency range of 2 to 18 GHz and a 360° azimuth angle sweep. This study also investigated the effect of slight variations in the material properties on the calculated RCS results, by varying the material properties within a realistic tolerance range and comparing the calculated RCS results. Interesting measured and simulated results have been obtained. Large discrepancies were observed between the different methods as well as the measured data. It was also observed that the accuracy of the RCS data of the dielectrics can be frequency and angle dependent. The simulated RCS for some of these materials also exhibit high sensitivity to variations in the material properties. Comparison graphs between the measured and simulation RCS datasets will be presented and the validation thereof will be discussed. Finally, the effect that small tolerances in the material properties have on the calculated RCS results will be shown. Thus the importance of accurate dielectric material properties for validation purposes will be discussed.

Keywords: asymptotic, CEM, dielectric scattering, full-wave, measurements, radar cross section, validation

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Authors: Victorita Radulescu

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

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

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Authors: A. Gonzalez Aguna, J. M. Santamaria Garcia, J. L. Gomez Gonzalez, R. Barchino Plata, M. Fernandez Batalla, S. Herrero Jaen

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Background: Computer Science is a field that transcends other disciplines of knowledge because it allows to support all kinds of physical and mental tasks. Health centres have a greater number and complexity of technological devices and the population consume and demand services derived from technology. Also, nursing education plans have included competencies related to and, even, courses about new technologies are offered to health professionals. However, nurses still limit their performance to the use and evaluation of products previously built. Objective: Develop a teaching-learning methodology for acquiring skills on designing applications for care. Methodology: Blended learning teaching with a group of graduate nurses through official training within a Master's Degree. The study sample was selected by intentional sampling without exclusion criteria. The study covers from 2015 to 2017. The teaching sessions included a four-hour face-to-face class and between one and three tutorials. The assessment was carried out by written test consisting of the preparation of an IEEE 830 Standard Specification document where the subject chosen by the student had to be a problem in the area of care. Results: The sample is made up of 30 students: 10 men and 20 women. Nine students had a degree in nursing, 20 diploma in nursing and one had a degree in Computer Engineering. Two students had a degree in nursing specialty through residence and two in equivalent recognition by exceptional way. Except for the engineer, no subject had previously received training in this regard. All the sample enrolled in the course received the classroom teaching session, had access to the teaching material through a virtual area and maintained at least one tutoring. The maximum of tutorials were three with an hour in total. Among the material available for consultation was an example of a document drawn up based on the IEEE Standard with an issue not related to care. The test to measure competence was completed by the whole group and evaluated by a multidisciplinary teaching team of two computer engineers and two nurses. Engineers evaluated the correctness of the characteristics of the document and the degree of comprehension in the elaboration of the problem and solution elaborated nurses assessed the relevance of the chosen problem statement, the foundation, originality and correctness of the proposed solution and the validity of the application for clinical practice in care. The results were of an average grade of 8.1 over 10 points, a range between 6 and 10. The selected topic barely coincided among the students. Examples of care areas selected are care plans, family and community health, delivery care, administration and even robotics for care. Conclusion: The applied methodology of learning-teaching for the design of technologies demonstrates the success in the training of nursing professionals. The role of expert is essential to create applications that satisfy the needs of end users. Nursing has the possibility, the competence and the duty to participate in the process of construction of technological tools that are going to impact in care of people, family and community.

Keywords: care, learning, nursing, technology

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Authors: S. Mehrab Amiri, Nasser Talebbeydokhti

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Modeling sediment transport processes by means of numerical approach often poses severe challenges. In this way, a number of techniques have been suggested to solve flow and sediment equations in decoupled, semi-coupled or fully coupled forms. Furthermore, in order to capture flow discontinuities, a number of techniques, like artificial viscosity and shock fitting, have been proposed for solving these equations which are mostly required careful calibration processes. In this research, a numerical scheme for solving shallow water and Exner equations in fully coupled form is presented. First-Order Centered scheme is applied for producing required numerical fluxes and the reconstruction process is carried out toward using Monotonic Upstream Scheme for Conservation Laws to achieve a high order scheme.  In order to satisfy C-property of the scheme in presence of bed topography, Surface Gradient Method is proposed. Combining the presented scheme with fourth order Runge-Kutta algorithm for time integration yields a competent numerical scheme. In addition, to handle non-prismatic channels problems, Cartesian Cut Cell Method is employed. A trained Multi-Layer Perceptron Artificial Neural Network which is of Feed Forward Back Propagation (FFBP) type estimates sediment flow discharge in the model rather than usual empirical formulas. Hydrodynamic part of the model is tested for showing its capability in simulation of flow discontinuities, transcritical flows, wetting/drying conditions and non-prismatic channel flows. In this end, dam-break flow onto a locally non-prismatic converging-diverging channel with initially dry bed conditions is modeled. The morphodynamic part of the model is verified simulating dam break on a dry movable bed and bed level variations in an alluvial junction. The results show that the model is capable in capturing the flow discontinuities, solving wetting/drying problems even in non-prismatic channels and presenting proper results for movable bed situations. It can also be deducted that applying Artificial Neural Network, instead of common empirical formulas for estimating sediment flow discharge, leads to more accurate results.

Keywords: artificial neural network, morphodynamic model, sediment continuity equation, shallow water equations

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