Search results for: hospital design

Authors: Umran Erciyes, Filiz Okumus

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The purpose of this study was the determination of factors which impact the pregnancy, birth experience and the opinions regarding the delivery type of the puerperants, after vaginal birth. This descriptive study includes 349 patients who gave births with normal birth in one of the hospital in İstanbul in May- November 2014. After birth, we interview with these women face to face. The descriptive information form and Perception of Birth Scale were used as data collection tool. SPSS (Statistical Package for the Social Sciences) was used for statistical analysis. The average age of patients was 27.13, and the average score was 76.93±20.22. The patients are primary school graduate, and they do not have a job. They expressed an income outcome equality. More than half of women did not get educated before birth. Among educated patients, few women got educated overcoming the pain during labor process. As the time spent in the hospital for the birth increases, the birth perception of mothers is affected negatively. %86.8 of participants gave assisted delivery. Spontaneous vaginal birth has positive effects on birth perception. Establishing a vascular access, induction of labor performing enema, restriction of orally intake and movement, fundal pressure, episiotomy, nor to perform skin to skin contact with the baby after birth has adverse effects on the birth perceptions.

Keywords: antenatal care, birth experience, perception of birth, vaginal birth

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Authors: P. Tej, P. Kněž, M. Blank

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The paper presents design and production of thin-walled U-profile footbridge made of UHPFRC. The main structure of the bridge is one prefabricated shell structure made of UHPFRC with dispersed steel fibers without any conventional reinforcement. The span of the bridge structure is 10 m and the clear width of 1.5 m. The thickness of the UHPFRC shell structure oscillated in an interval of 30-45 mm. Several calculations were made during the bridge design and compared with the experiments. For the purpose of verifying the calculations, a segment of 1.5 m was first produced, followed by the whole footbridge for testing. After the load tests were done, the design was optimized to cast the final footbridge.

Keywords: footbridge, non-linear analysis, shell structure, UHPFRC, Ultra-High Performance Fibre Reinforced Concrete

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Authors: Sarah Misplon, Wim Marneffe, Johan Helling, Jana Missiaen, Inge Decock, Dries Myny, Steve Lervant, Koen Vaneygen

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The aim of this study was twofold. First, we investigated whether the current funding from the national health insurance (NHI) of home hospitalization (HH) for oncological patients is sufficient in Belgium. Second, we compared patient’s experiences and preferences of HH to the standard of care (SOC). Two HH models were examined in three Belgian hospitals and three home nursing organizations. In a first HH model, the blood draw and monitoring prior to intravenous therapy were performed by a trained home nurse at the patient’s home the day before the visit to the day hospital. In a second HH model, the administration of two subcutaneous treatments was partly provided at home instead of in the hospital. Therefore, we conducted (1) a bottom-up micro-costing study to compare the costs and revenues for the providers (hospitals and home care organizations), and (2) a cross-sectional survey to compare patient’s experiences and preferences of the SOC group and the HH group. Our results show that HH patients prefer HH and none of them wanted to return to SOC, although the satisfaction of patients was not significantly different between the two categories. At the same time, we find that costs associated to HH are higher overall. Comparing revenues with costs, we conclude that the current funding from NHI of HH for oncological patients is insufficient.

Keywords: cost analysis, health insurance, preference, home hospitalization

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Authors: Wei Chen Chang, Ming Yu Hsiao

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The commodity takes one kind of mark, the designer how to construction and interpretation the user how to use the process and effectively convey message in design education has always been an important issue. Cultural-creative design refers to signifying cultural heritage for product design. In terms of Peirce’s Semiotic Triangle: signifying elements-object-interpretant, signifying elements are the outcomes of design, the object is cultural heritage, and the interpretant is the positioning and description of product design. How to elaborate the positioning, design, and development of a product is a narrative issue of the interpretant, and how to shape the signifying elements of a product by modifying and adapting styles is a rhetoric matter. This study investigated the rhetoric of elements signifying products to develop a rhetoric model with cultural style. Figures of speech are a rhetoric method in narrative. By adapting figures of speech to the interpretant, this study developed the rhetoric context of cultural context by narrative means. In this two-phase study, phase I defines figures of speech and phase II analyzes existing cultural-creative products in terms of figures of speech to develop a rhetoric of style model. We expect it can reference for the future development of Cultural-creative design.

Keywords: cultural-creative design, cultural-creative products, figures of speech, Peirce’s semiotic triangle, rhetoric of style model

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Authors: Surasak Kangkhao, Chaturong Louhapensang

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This research investigates design and cultural heritage interpretations by residential architecture design in World Heritage cities: Kamphaeng Phet, Thailand reflect on the essence of design based on local identity. The research consisted of three thematic foci. First, the studies examined the contextual background that led to the genesis of the building. Second, the investigations concentrated on how its design was developed and implemented. Third, these modes of problematisation lent a basis to argue that a quality of placeness was not confined exclusively to traditional or vernacular structures but could be found from the unconventional aesthetics of Residential Architecture as well.

Keywords: expressions, local identity, residential architecture, practice, world heritage site

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Authors: M. M. El-Awad

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This paper deals with the introduction of thermal-design optimisation to engineering students by using Microsoft's Excel as a modelling platform. Thermal-design optimisation is an iterative process which involves the evaluation of many thermo-physical properties that vary with temperature and/or pressure. Therefore, suitable modelling software, such as Engineering Equation Solver (EES) or Interactive Thermodynamics (IT), is usually used for this purpose. However, such proprietary applications may not be available to many educational institutions in developing countries. This paper presents a simple thermal-design case that demonstrates how the principles of thermo-fluids and economics can be jointly applied so as to find an optimum solution to a thermal-design problem. The paper describes the solution steps and provides all the equations needed to solve the case with Microsoft Excel. The paper also highlights the advantage of using VBA (Visual Basic for Applications) for developing user-defined functions when repetitive or complex calculations are met. VBA makes Excel a powerful, yet affordable, the computational platform for introducing various engineering principles.

Keywords: engineering education, thermal design, Excel, VBA, user-defined functions

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Authors: Pugazhenthan Thangaraju

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Background: Since the pandemic began, more than millions of people have become infected with COVID-19. Globally, researchers are working for safe and effective treatments for this disease. Remdesivir is a drug that has been approved for the treatment of COVID-19. Many aspects are still being considered that may influence the future use of remdesivir. Aim: To assess the safety and efficacy of Remdesivir in hospitalized adult patients diagnosed with moderate and severe COVID-19. Methods: It was a record-based retrospective cohort study conducted between April 1st, 2020 and June 30th, 2021 at the tertiary care teaching hospital All India Institutes of Medical Sciences (AIIMS), Raipur Results: There were a total of 10,559 medical records of COVID-19 patients of which 1034 records were included in this study. Overall, irrespective of the survival status, there was statistical significant difference observed between the WHO score at the time of admission and discharge. Clinical improvement among the survivors was found to be statistically significant. Conclusion: Remdesivir's potential efficacy against coronaviruses has so far been limited to in vitro studies and animal models. However, information about COVID-19 is rapidly expanding. Several clinical trials for the treatment of COVID-19 with remdesivir are now underway. However, the findings of this study support remdesivir as a promising agent in the fight against SARS-CoV-2.

Keywords: Remdesivir, COVID-19, SARS-CoV-2, antiviral, RNA-dependent RNA polymerase, viral pneumonia

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Authors: Gaoyuan Wang, Tian Chen

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China’s emission peak and carbon neutrality strategies lead to the transformation of development patterns and call for new green urban design thinking. This paper begins by revealing the evolution of green urban design thinking during the periods of carbon enlightenment, carbon dependency, and carbon decoupling from the perspective of the energy transition. Combined with the current energy situation, national strengths, and technological trends, the emergence of green urban design towards carbon neutrality becomes inevitable. Based on the preliminary analysis of its connotation, the characteristics of the new type of green urban design are generalized as low-carbon orientation, carbon-related objects, carbon-reduction means, and carbon-control patterns. Its theory is briefly clarified in terms of the human-earth synergism, quality-energy interconnection, and form-flow interpromotion. Then, its mechanism is analyzed combined with the core tasks of carbon neutrality, and the scope of design issues is defined, including carbon flow mapping, carbon source regulation, carbon sink construction, and carbon emission management. Finally, a multi-scale spatial response system is proposed across the region, city, cluster, and neighborhood level. The discussion aims to provide support for the innovation of green urban design theories and methods in the context of peak neutrality.

Keywords: carbon neutrality, green urban design, energy transition, theoretical exploration

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Authors: Manjunath A. P., Al-Ajmi G. M., Al Shukri M., Girija S

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Introduction: This study aimed to compare the ability of hysteroscopy and ultrasonography to diagnose uterine polyps. To correlate the ultrasonography and hystroscopic findings with various clinical factors and histopathology of uterine polyps. Methods: This is a retrospective study conducted at the Department of Obstetrics and Gynaecology at Sultan Qaboos University Hospital from 2014 to 2019. All women undergoing hysteroscopy for suspected uterine polyps were included. All relevant data were obtained from the electronic patient record and analysed using SPSS. Results: A total of 77 eligible women were analysed. The mean age of the patients was 40 years. The clinical risk factors; obesity, hypertension, and diabetes mellitus, showed no significant statistical association with the presence of uterine polyps (p-value>0.005). Although 20 women (52.6%) with uterine polyps had thickened endometrium (>11 mm), however, there is no statistical association (p-value>0.005). The sensitivity and specificity of ultrasonography in the detection of uterine polyp were 39% and 65%, respectively. Whereas for hysteroscopy, it was 89% and 20%, respectively. The prevalence of malignant and premalignant lesions were 1.85% and 7.4%, respectively. Conclusion: This study found that obesity, hypertension, and diabetes mellitus were not associated with the presence of uterine polyps. There was no association between thick endometrium and uterine polyps. The sensitivity is higher for hysteroscopy, whereas the specificity is higher for sonography in detecting uterine polyps. The prevalence of malignancy was very low in uterine polyps.

Keywords: endometrial polyps, hysteroscopy, ultrasonography, premalignant, malignant

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Authors: Tebeu Pierre Marie

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Introduction: WHO defines community participation as a process in which the local population, take responsibility in planning for their health, participates in the strategy’s development for implementation and accessibility to physical, moral and social well-being. For the purpose of dealing with health, the community participation is made through the organization called health Centre committee leader (HCCL/COSA) for Integrated health Center and District hospital committee leaser (HDCL/COGES) for District Hospital. Little is known about the effective participation of the community in health related activities in Ignié-Ngabé-Mayama health district. Objective: This study aimed at assessing the involvement of community in the health system running at the Ignié-Ngabé-Mayama health district. Methods: This was a qualitative cross-sectional study conducted in the Ignié-Ngabé-Mayama health district from 15 December 2020 to 30 April 2021. The study population consisted of 10 HCCL and one District hospital committee leaser (DHCL). Data were collected using a pretested questionnaire and validated by the investigating team. The variables of interest were; effective existence of HCCL/DHCL, their involvement HCCL/DHCL in health related activities, their financing management, planning of activities and leadership. Results: A total of 11 participants were interviewed, including 10 HCCL and 1 DHCL. The Sex-Ratio was 9/11; with primary level 6/11 and were mostly farmers 6/11. Analyzing the involvement of the HDCL/DHCL in health promotion and preventive activities; this was effective only for two of them (2/11). Analyzing the barriers for their involvement, the leaders reported the lack of financial support by the state, lack NGO support. Additionally, they reported to have been very active when there was Performance Based Founding Project in the District. Conclusion: Only two of the (HDCL/HCCL) out of 11 were really functioning. Reported barriers to their running were: lack of state/NGOs support and ending of PBF Project. There is a need to organize a tripartite forum including stats, NGOs and Community for boosting the community participation in health related activities in Ignié-Ngabé-Mayama health district.

Keywords: health district committee, health Centre committee, community participation, Brazzaville, Congo

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Authors: Patrik Johansson, Selina Mardh

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The present study proposes a usability test method, Atmosphere, to assess the fitness of components and interaction patterns of design systems. The method covers the user’s perception of the components of the system, the efficiency of the logic of the interaction patterns, perceived ease of use as well as the user’s understanding of the intended outcome of interactions. These aspects are assessed by combining measures of first impression, visual affordance and expectancy. The method was applied to a design system developed for the design of an electronic health record system. The study was conducted involving 15 healthcare personnel. It could be concluded that the Atmosphere method provides tangible data that enable human-computer interaction practitioners to analyze and categorize components and patterns based on perceived usability, success rate of identifying interactive components and success rate of understanding components and interaction patterns intended outcome.

Keywords: atomic design, atmosphere methodology, design system, expectancy testing, first impression testing, usability testing, visual affordance testing

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Authors: Takuya Inoue

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Applying affordance theory to the field of communication research has been more significant. This paper suggests that the act of design, including language, is defined as encouraging or restricting affordance of an object or event and make it perceivable for users, rather merely conveying information. From this point of view, 5 types of oral expressions in Kyoto dialect, as well as 4 types of exterior design such as sekimori-ishi (a barrier-stone in a teahouse garden) which are specific to traditions in Kyoto, are examined. We found that exterior designs have no physical power in itself, they work as ‘signifier’ to highlight cultural frames which heavily depend on exclusive culture among city-dwellers in Kyoto. At the same time, the expressions are implicit, even sometimes sarcastic, which are also supported by cultural frames. In conclusion, the existence of traditional design is motivated in informative ‘ecological frame.’

Keywords: affordance theory, communication, cultural design, Japanese culture, Kyoto dialect, signifier

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Authors: Damian Gordon, Paul Doyle, Anna Becevel, Júlia Vilafranca Molero, Cinta Gascon, Arianna Vitiello, Tina Baloh

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It has long been recognized that the creation of any teaching content can be enhanced if the development process follows a pre-defined approach, which is often referred to as an instructional design methodology. These methodologies typically define a number of stages, or phases, that an educator should undertake to help ensure the quality of the final teaching content that is developed. In this paper, we present an instructional design methodology that is focused specifically on the introduction of blended resources into a heretofore bricks-and-mortar course. To achieve this, research was undertaken concerning a range of models of instructional design, as well as literature covering some of the key challenges and “pain points” of blending. Following this, our model, the BL-5D model, is presented, which incorporates some key questions at each stage of this five-stage methodology to guide the development process. Finally, a discussion of some of the key themes and issues that have been uncovered in this work is presented, as well as a template for a blended learning case study that emerged from this approach.

Keywords: blended learning, challenges of blended learning, design methodologies, instructional design

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Authors: Adam L. Yanagihara, Yong Seok Park

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The goal of this paper is to converge upon a design of a brake system that could be used for a roller coaster found at an amusement park. It was necessary to find what could be deemed as a “comfortable” deceleration so that passengers do not feel as if they are suddenly jerked and pressed against the restraining harnesses. A human factors engineering approach was taken in order to determine this deceleration. Using a previous study that tested the deceleration of transit vehicles, it was found that a -0.45 G deceleration would be used as a design requirement to build this system around. An adjustable linear eddy current brake using permanent magnets would be the ideal system to use in order to meet this design requirement. Anthropometric data were then used to determine a realistic weight and length of the roller coaster that the brake was being designed for. The weight and length data were then factored into magnetic brake force equations. These equations were used to determine how the brake system and the brake run layout would be designed. A final design for the brake was determined and it was found that a total of 12 brakes would be needed with a maximum braking distance of 53.6 m in order to stop a roller coaster travelling at its top speed and loaded to maximum capacity. This design is derived from theoretical calculations, but is within the realm of feasibility.

Keywords: eddy current brake, engineering design, design synthesis, human factors engineering

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Authors: Minsun Kim, Ki-Sun Choi, Hyun-Jee Lee, Young-Chan You

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There is no reinforcement example for the renovation of the vertical and horizontal extension to existing building structures which is a shear wall type in apartment units in Korea. Among these existing structures, the structures which are shear wall type are rare overseas, while Korea has many shear wall apartment units. Recently, in Korea, a few researchers are trying to confirm the possibility of the vertical extension in existing building with shear walls. This study evaluates the possibility of the renovation by applying performance-based seismic design to existing buildings with shear walls in the analysis phase of the structure. In addition, force-based seismic design, used by general structural engineers in Korea, is carried out to compare the amount of reinforcement of walls, which is a main component of wall structure. As a result, we suggest that performance-based design obtains more economical advantages than force-based seismic design.

Keywords: design for extension, performance-based design, remodeling, shear wall frame, structural analysis

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Authors: Trinh Bui, A. Cappellieri

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The fashion industry has become one of the most polluting industries in the world. In this context, designers can contribute solutions to the problem by applying Design for Sustainability (DfS) criteria, which will enable to promote designing products and services toward Sustainability. Therefore, 'Slow Fashion' movement has been receiving the attention of researchers, designers, and customers who are sensitive to sustainable development. The purpose of this paper is to contribute to a better understanding of DfS in fashion. In particular, how can apply sustainable design principles to the fashion accessory in order to minimize the negative impact on the environment and society? The research method of this study is qualitative, utilising a multi-method case study approach. Grounded theory analysis was applied to analyse the data of the case studies collected and the results obtained. Also, research findings indicate that DfS applied to Fashion Accessory design processes might have great potential and win-win approaches toward a sustainable future. An important implication is that understanding the concepts and applying DfS to fashion accessory design processes can support designers to face challenges and seize opportunities. Furthermore, identify the key concept of sustainability and social responsibility could raise awareness on sustainable fashion for both producers and customers more effectively.

Keywords: design for sustainability, fashion accessory, sustainable fashion, sustainability

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Authors: M. A. Effati, M. R. Hojjati, M. Razmdideh

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Nowadays, engine developments have focused on internal combustion engine design call for increased engine power, reduced engine size and improved fuel economy, simultaneously. In this paper, a novel design for combustion engine is proposed. Two combustion chambers were designed in two sides of cylinder. Piston was designed in a way that two sides of piston would transfer heat energy due to combustion to linear motion. This motion would convert to rotary motion through the designed mechanism connected to connecting rod. Connecting rod operation was analyzed to evaluate applied stress in 3000, 4500 and 6000 rpm. Boundary conditions including generated pressure in each side of cylinder in these 3 situations was calculated.

Keywords: combustion engine, design, finite element method, modeling

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Authors: Boubacar Niang, Denis Raulin

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This paper presents the design of a dedicated board for learning and programming with ATMEL AVR new generation micro controller’s family. This board designed as a "shield" for the Arduino Uno allows us to focus on the design and programming of basic micro controller functionalities in high level language with a considerable time saving because of dealing with additional components is not required.

Keywords: Arduino, microcontroller, programming, language

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Authors: Sai Siddharth S., Prasanna Kumar G. M., Alagarsamy R.

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This research introduces an alternative approach to urban road maintenance by utilizing Blended Wing Body (BWB) design and Vertical Takeoff and Landing (VTOL) drones. The integration of this aerospace innovation, combining blended wing efficiency with VTOL maneuverability, aims to optimize fuel consumption and explore versatile applications in solving urban problems. A few problems are discussed along with optimization of the design and comparative study with other drone configurations.

Keywords: design optimization, CFD, CAD, VTOL, blended wing body

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Authors: A. Lardjam, R. Mazid, S. Y. Boudghene, A. Izarouken, Y. Dali, N. Djebli, H. Toumi

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Origanum glandulosum is an aromatic plant, common in Algeria and widely used by local people for its medicinal properties. The essential oil from this plant, which grows in the west of Algeria, was studied to evaluate and determine its antibacterial activity. The extraction of the essential oil was performed by water steam distillation; the yield obtained from the aerial parts (1.78 %) is interesting, its chromatographic profile revealed by TLC showed the presence of phenolic compounds thymol and carvacrol. The evaluation of the activity of the essential oil of Origanum glandulosum on bacterial strains of hospital origin, ATCC, MRB, and HRB, most implicated in nosocomial infections (Staphylococcus aureus ATCC 25923, Staphylococcus aureus ATCC 43300, Enterococcus faecalis ATCC 29212, Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 27853, Staphylococcus aureus resistant to meticillin, Enterococcus faecium, VA R and R TEC, Acinetobacter baumanii, IMP R and R CAZ, Klebsiella pneumonia carbapenemase-producing) by the method of aromatogramme and micro atmosphere, shows that the antibacterial potency of this oil is very high, expressed by significant inhibition diameters on all strains except Pseudomonas aeruginosa, and low MICs and is characterized by a bactericidal action.

Keywords: antibacterial activity, essential oil, HRB, MBR, nosocomial infections, origanum glandulosum

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Authors: Farhood Rismanchian, Seong Hyeon Park, Young Hoon Lee

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This paper proposes a method to optimize the layout of an emergency department (ED) based on real executions of care processes by considering several planning objectives simultaneously. Recently, demand for healthcare services has been dramatically increased. As the demand for healthcare services increases, so do the need for new healthcare buildings as well as the need for redesign and renovating existing ones. The importance of implementation of a standard set of engineering facilities planning and design techniques has been already proved in both manufacturing and service industry with many significant functional efficiencies. However, high complexity of care processes remains a major challenge to apply these methods in healthcare environments. Process mining techniques applied in this study to tackle the problem of complexity and to enhance care process analysis. Process related information such as clinical pathways extracted from the information system of an ED. A 0-1 goal programming approach is then proposed to find a single layout that simultaneously satisfies several goals. The proposed model solved by optimization software CPLEX 12. The solution reached using the proposed method has 42.2% improvement in terms of walking distance of normal patients and 47.6% improvement in walking distance of critical patients at minimum cost of relocation. It has been observed that lots of patients must unnecessarily walk long distances during their visit to the emergency department because of an inefficient design. A carefully designed layout can significantly decrease patient walking distance and related complications.

Keywords: healthcare operation management, goal programming, facility layout problem, process mining, clinical processes

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Authors: Wanlapa Kunsongkeit

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When a person gets sick, he or she goes to hospital for the treatment. In the case of severe illness, there might be no hope for some patients to recover. In this state, the patients will face anxiety and fear. These feelings make the patients suffer in mind until the time of death or called bad death. These feeling also directly effect to family members who are loved ones and significant persons of the patients. They can help the dying patients to have good death. From literature reviews, many studies focused on good death in patients and nurses. Little is known about good death in family member. Therefore, the qualitative research based on Heideggerian phenomenology aimed to describe good death as perceived by the critically ill patients’ family members. Five informants who were the critically ill patients’ family members at hospital in Chonburi were purposively selected. Data were collected by in-depth interview, observation and critical reflection during January, 2014 to March, 2014 . Cohen, Kahn and Steeves’s (2000) steps guided data analysis. Trustworthiness was maintained throughout the study following Lincoln and Guba’s guidelines. Four themes were emerged, which were no suffering, acceptance of imminent death, preparing for death, and being with the family. This findings provide deep understanding of good death as perceived by the critically ill patients’ family members. It can be basic information for nurses to provide good death nursing care and further explore for development of knowledge regarding good death nursing care.

Keywords: good death, family member, critically ill patient, phenomenology

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Authors: Azizah Che Omar

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Various studies have proposed factors of impulse purchase in different advertising mediums like website, mobile, traditional retail store and traditional television. However, to the best of researchers’ knowledge, none of the impulse purchase model is dedicated towards impulse purchase tendency for interactive TV (iTV) advertising. Therefore, the proposed model conceptual design model of interactive television advertising toward impulse purchase (iTVAdIP) was developed. The focus of this study is to evaluate the conceptual design model of iTVAdIP through expert review. As a result, the finding showed that majority of expert reviews agreed that the conceptual design model iTVAdIP is applicable to the development of interactive television advertising and it will increase the effectiveness of advertising. This study also shows the conceptual design model of iTVAdIP that has been reviewed.

Keywords: impulse purchase, interactive television advertising, persuasive

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Authors: Beate Niemann, Fabian Pramel

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The formerly industrially or militarily used Urban Waterfront is a potential area for urban development. Extensive interventions in the urban space come along with the development of these previously inaccessible areas in the city. The development of the Urban Waterfront in the European City is not subject to any recognizable urban paradigm. In this study, the development of the Urban Waterfront as a new urban space typology is analyzed by case studies of Urban Waterfront developments in European Cities. For humans, perceptible spatial conditions are categorized and it is identified whether the themed Urban Waterfront Developments are congruent or incongruent urban design interventions and which deviations the Urban Waterfront itself induce. As congruent urban design, a design is understood, which fits in the urban fabric regarding its similar spatial conditions to the surrounding. Incongruent urban design, however, shows significantly different conditions in its shape. Finally, the spatial relationship of the themed Urban Waterfront developments and their associated environment are compared in order to identify contrasts between new and old urban space. In this way, conclusions about urban design paradigms of the new urban space typology are tried to be drawn.

Keywords: composition, congruence, identity, paradigm, spatial condition, urban design, urban development, urban waterfront

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Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

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Authors: Natasha Botha, Gary Corderely, Helen M. Inglis

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With the move to cleaner energy applications the transport industry is working towards on-board hydrogen, or compressed natural gas-fuelled vehicles. A popular method for storage is to use composite overwrapped pressure vessels (COPV) because of their high strength to weight ratios. The proper design of these COPVs are according to international standards; this study aims to provide a preliminary design for a 350 Bar Type IV COPV (i.e. a polymer liner with a composite overwrap). Netting analysis, a popular analytical approach, is used as a first step to generate an initial design concept for the composite winding. This design is further improved upon by following the American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel standards, Section X: Fibre-reinforced composite pressure vessels. A design program based on these two approaches is developed using Python. A numerical model of a burst test simulation is developed based on the two approaches and compared. The results indicate that the netting analysis provides a good preliminary design, while the ASME-based design is more robust and accurate as it includes a better approximation of the material behaviour. Netting analysis is an easy method to follow when considering an initial concept design for the composite winding when not all the material characteristics are known. Once these characteristics have been fully defined with experimental testing, an ASME-based design should always be followed to ensure that all designs conform to international standards and practices. Future work entails more detailed numerical testing of the design for improvement, this will include the boss design. Once finalised prototype manufacturing and experimental testing will be conducted, and the results used to improve on the COPV design.

Keywords: composite overwrapped pressure vessel, netting analysis, design, American Society of Mechanical Engineers section x, fiber-reinforced, hydrogen storage

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Authors: Debabrata Das

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This paper explains how to design a regulation loop for a power supply circuit. It also discusses the need of a regulation loop and the improvement of a circuit with regulation loop. A sample design is used to demonstrate how to use PSpice to design feedback loop to control output voltage of a power supply and how to check if the power supply is stable or oscillatory. A sample design is made using a specific Integrated Circuit (IC) available in the PSpice library. A designer can experiment feedback loop design using Cadence Pspice tool. PSpice is easy to use, reliable, and convenient. To test a feedback loop, generally, engineers use trial and error method with the hardware which takes a lot of time and manpower. Moreover, it is expensive because component and Printed Circuit Board (PCB) may go bad. PSpice can be used by designers to test their loop designs without using hardware circuits. A designer can save time, cost, manpower and simulate his/her power supply circuit accurately before making a real hardware using this software package.

Keywords: power electronics, feedback loop, regulation, stability, pole, zero, oscillation

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Authors: Komal Fizza

Abstract:

All around the world in every field professionals are taking great support from their computers. Computer assisted strategies not only increase the efficiency of the professionals but also in case of healthcare they help in life-saving interventions. The background of this current research is aimed towards two things; first to find out if computer assisted strategies are useful for Pharmacist for not and secondly how much these assist a Pharmacist to do quality interventions. Shifa International Hospital is a 500 bedded hospital, and it is running Antimicrobial Stewardship, during their stewardship rounds pharmacists observed that a lot of wrong doses of antibiotics were coming at times those were being overlooked by the other pharmacist even. So, with the help of MIS team the patients were categorized into adult and peads depending upon their age. Minimum and maximum dose of every single antibiotic present in the pharmacy that could be dispensed to the patient was developed. These were linked to the order entry window. So whenever pharmacist would type any order and the dose would be below or above the therapeutic limit this would give an alert to the pharmacist. Whenever this message pop-up this was recorded at the back end along with the antibiotic name, pharmacist ID, date, and time. From 14th of January 2015 and till 14th of March 2015 the software stopped different users 350 times. Out of this 300 were found to be major errors which if reached to the patient could have harmed them to the greater extent. While 50 were due to typing errors and minor deviations. The pilot study showed that computer assisted strategies can be of great help to the pharmacist. They can improve the efficacy and quality of interventions.

Keywords: antibiotics, computer assisted strategies, pharmacist, stewardship

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Authors: Sheila R. Pai, N. K. Subbalakshmi, C. Vidya

Abstract:

Background: Accumulating evidence from prospective studies suggests an increased risk of type 2 diabetes associated with sleep deprivation and sleep disorders. Shift work by disrupting the circadian rhythm, could possibly cause metabolic disturbances. Objective: To investigate the influence of shift work on fasting blood glucose in hospital workers population. Materials and Methods: This was a cross-sectional study including 90 night shift workers (study group) and 90 day workers (controls) drawn from paramedical personnel. Night shift work was on a forward rotation basis, with an average of one night shift every 4 weeks. Each night shift rotation was for a period of 7 days, with a total of 8 hours of shift work per night. In the entire subjects body mass index (BMI) and fasting blood sugar (FBS) was measured. Statistical analysis included unpaired t test, Mann-Whitney ‘U’ test and Chi-square test. P value less than 0.05 was considered significant. Result: The study and control groups were comparable with regard to age, sex distribution and duration of employment. FBS was higher in study group compared to controls (p < 0.0001). There was no significant difference in BMI between control and study group. Conclusion: Shift work may adversely influence glucose metabolism.

Keywords: shift work, fasting blood sugar, sleep disturbances, diabetes

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Authors: Armando Cuspinera

Abstract:

Humans are nature itself, being with non-human species part of the same ecosystem, but the praxis reflects that not all relations are the same. In fields of design such as Biomimicry, Biodesign, and Biophilic design exist different approaches towards nature, nevertheless, anthropocentric principles such as domination, objectivization, or exploitation are defined in the same as ecocentric principles of inherent importance in life itself. Anthropocentrism has showed humanity with pollution of the earth, water, air, and the destruction of whole ecosystems from monocultures and rampant production of useless objects that life cannot outstand this unaware rhythm of life focused only for the human benefits. Even if by nature the biosphere is resilient, studies showed in the Paris Agreement explain that humanity will perish in an unconscious way of praxis. This is why is important to develop a differentiation between anthropocentric and ecocentricprinciples in the praxis of design, in order to enhance respect, valorization, and positive affectivity towards other life forms is necessary to analyze what principles are reproduced from each practice of design. It is only from the study of immaterial dimensions of design such as symbolism, epistemology, and ontology that the relation towards nature can be redesigned, and in order to do so, it must be studies from the dimensions of ontological design what principles –anthropocentric or ecocentric- through what the objects enhance or focus the perception humans have to its surrounding. The things we design also design us is the principle of ontological design, and in order to develop a way of ecological design in which is possible to consider other species as users, designers or collaborators is important to extend the studies and relation to other living forms from a transdisciplinary perspective of techniques, knowledge, practice, and disciplines in general. Materials, technologies, and any kind of knowledge have the principle of a tool: is not good nor bad, but is in the way of using it the possibilities that exist within them. The collaboration of disciplines and fields of study gives the opportunity to connect principles from other cultures such as Deep Ecology and Environmental Humanities in the development of methodologies of design that study nature, integrates their strategies to our own species, and considers life of other species as important as human life, and is only form the studies of ontological design that material and immaterial dimensions can be analyzed and imbued with structures that already exist in other fields.

Keywords: design, antropocentrism, ecocentrism, ontological design

Procedia PDF Downloads 144