Search results for: service cost and queue length cost
1538 The Implementation of an E-Government System in Developing Countries: A Case of Taita Taveta County, Kenya
Authors: Tabitha Mberi, Tirus Wanyoike, Joseph Sevilla
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The use of Information and Communication Technology (ICT) in Government is gradually becoming a major requirement to transform delivery of services to its stakeholders by improving quality of service and efficiency. In Kenya, the devolvement of government from local authorities to county governments has resulted in many counties adopting online revenue collection systems which can be easily accessed by its stakeholders. Strathmore Research and Consortium Centre (SRCC) implemented a revenue collection system in Taita Taveta, a County in coastal Kenya. It consisted of two systems that are integrated; an online system dubbed “CountyPro” for processing county services such as Business Permit applications, General Billing, Property Rates Payments and any other revenue streams from the county. The second part was a Point of Sale(PoS) system used by the county revenue collectors to charge for market fees and vehicle parking fees. This study assesses the success and challenges in adoption of the integrated system. Qualitative and quantitative data collection methods were used to collect data on the adoption of the system with the researcher using focus groups, interviews, and questionnaires to collect data from various users of the system An analysis was carried out and revealed that 87% of the county revenue officers who are situated in county offices describe the system as efficient and has made their work easier in terms of processing of transactions for customers.Keywords: e-government, counties, information technology, online system, point of sale
Procedia PDF Downloads 2461537 An Investigation of Performance Versus Security in Cognitive Radio Networks with Supporting Cloud Platforms
Authors: Kurniawan D. Irianto, Demetres D. Kouvatsos
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The growth of wireless devices affects the availability of limited frequencies or spectrum bands as it has been known that spectrum bands are a natural resource that cannot be added. Many studies about available spectrum have been done and it shows that licensed frequencies are idle most of the time. Cognitive radio is one of the solutions to solve those problems. Cognitive radio is a promising technology that allows the unlicensed users known as secondary users (SUs) to access licensed bands without making interference to licensed users or primary users (PUs). As cloud computing has become popular in recent years, cognitive radio networks (CRNs) can be integrated with cloud platform. One of the important issues in CRNs is security. It becomes a problem since CRNs use radio frequencies as a medium for transmitting and CRNs share the same issues with wireless communication systems. Another critical issue in CRNs is performance. Security has adverse effect to performance and there are trade-offs between them. The goal of this paper is to investigate the performance related to security trade-off in CRNs with supporting cloud platforms. Furthermore, Queuing Network Models with preemptive resume and preemptive repeat identical priority are applied in this project to measure the impact of security to performance in CRNs with or without cloud platform. The generalized exponential (GE) type distribution is used to reflect the bursty inter-arrival and service times at the servers. The results show that the best performance is obtained when security is disable and cloud platform is enable.Keywords: performance vs. security, cognitive radio networks, cloud platforms, GE-type distribution
Procedia PDF Downloads 3461536 Infant Care Practice in Hadiya Culture: Case Study of Harche Auyaya
Authors: Dawit Thomas
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Feeding and weaning practices vary from culture to culture and depend on different child-rearing values. The socio-cultural dimensions that influence the acceptable infant feeding practices are varied and complex. Understanding cultural differences in beliefs and practices relating to infant feeding is important to enhance designing programs for delivering successful psychological, social, physiological and economic well-being of mothers and infants. The main purpose of this study was exploring mothers infant feeding practices in the context of Hadiyya culture. After purposively selecting Harche Huyaya Uyaya Kebele eight infant feeding mothers were selected using snowball sampling technique. The study employed interviews and focus group discussion. The study found out early initiation and prolonged breastfeeding and early complementary feeding in some instances immediately after birth. In addition, infants were not forced to wean unless the mothers encounter pressing issues like pregnancy and health related problems. Furthermore, the main weaning techniques were putting unpleasant materials on the tip of nipples and sending infants to grandparents home. The study also found out gender difference in weaning, i.e., early initiation of weaning for girls. This can be indicative of gender-based bias on weaning practice. Finally, health extension workers, office of women and children affairs and Hadiyya Zone Tourism office should organize awareness raising programs to preserve vital infant feeding practices like prolonged breastfeeding and length of weaning. In addition, the offices should raise awareness among communities on negative side effects of sending infant to grandparents home that may weaken infant-mothers attachment and create favorable ground for the development of phobia.Keywords: feeding, infant, practices, weaning
Procedia PDF Downloads 3231535 A Numerical Model for Simulation of Blood Flow in Vascular Networks
Authors: Houman Tamaddon, Mehrdad Behnia, Masud Behnia
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An accurate study of blood flow is associated with an accurate vascular pattern and geometrical properties of the organ of interest. Due to the complexity of vascular networks and poor accessibility in vivo, it is challenging to reconstruct the entire vasculature of any organ experimentally. The objective of this study is to introduce an innovative approach for the reconstruction of a full vascular tree from available morphometric data. Our method consists of implementing morphometric data on those parts of the vascular tree that are smaller than the resolution of medical imaging methods. This technique reconstructs the entire arterial tree down to the capillaries. Vessels greater than 2 mm are obtained from direct volume and surface analysis using contrast enhanced computed tomography (CT). Vessels smaller than 2mm are reconstructed from available morphometric and distensibility data and rearranged by applying Murray’s Laws. Implementation of morphometric data to reconstruct the branching pattern and applying Murray’s Laws to every vessel bifurcation simultaneously, lead to an accurate vascular tree reconstruction. The reconstruction algorithm generates full arterial tree topography down to the first capillary bifurcation. Geometry of each order of the vascular tree is generated separately to minimize the construction and simulation time. The node-to-node connectivity along with the diameter and length of every vessel segment is established and order numbers, according to the diameter-defined Strahler system, are assigned. During the simulation, we used the averaged flow rate for each order to predict the pressure drop and once the pressure drop is predicted, the flow rate is corrected to match the computed pressure drop for each vessel. The final results for 3 cardiac cycles is presented and compared to the clinical data.Keywords: blood flow, morphometric data, vascular tree, Strahler ordering system
Procedia PDF Downloads 2711534 The High Quality Colored Wind Chimes by Anodization on Aluminum Alloy
Authors: Chia-Chih Wei, Yun-Qi Li, Ssu-Ying Chen, Hsuan-Jung Chen, Hsi-Wen Yang, Chih-Yuan Chen, Chien-Chon Chen
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In this paper we used high quality anodization technique to make colored wind chime with a nano-tube structure anodic film, which controls the length to diameter ratio of an aluminum rod and controls the oxide film structure on the surface of the aluminum rod by anodizing method. The research experiment used hard anodization to grow a controllable thickness of anodic film on aluminum alloy surface. The hard anodization film has high hardness, high insulation, high temperature resistance, good corrosion resistance, colors, and mass production properties can be further applied to transportation, electronic products, biomedical fields, or energy industry applications. This study also in-depth research and detailed discussion in the related process of aluminum alloy surface hard anodizing including pre-anodization, anodization, and post-anodization. The experiment parameters of anodization including using a mixed acid solution of sulfuric acid and oxalic acid as an anodization electrolyte, and control the temperature, time, current density, and final voltage to obtain the anodic film. In the experiments results, the properties of anodic film including thickness, hardness, insulation, and corrosion characteristics, microstructure of the anode film were measured and the hard anodization efficiency was calculated. Thereby obtaining different transmission speeds of sound in the aluminum rod and different audio sounds can be presented on the aluminum rod. Another feature of the present invention is the use of anodizing method dyeing method, laser engraving patterning and electrophoresis method to make colored aluminum wind chimes.Keywords: anodization, colored, high quality, wind chime, nano-tube
Procedia PDF Downloads 2431533 Psychosocial Risks and Occupational Health in a Mexican Small and Medium-Sized Enterprises
Authors: Magdalena Escamilla Quintal, Thelma Cetina Canto, Cecilia Aguilar Ortega
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Due to the importance that people represent for companies, the setting of a clear control of the risks that threaten the health and the material and financial resources of workers is essential. It is irrelevant if the company is a small and medium-sized enterprise (SME) or a large multinational, or if it is in the construction or service sector. The risk prevention importance is related to a constitutional and human right that all people have; working in a risk-free environment to prevent accidents or illnesses that may influence their quality of life and the tranquility of their family. Therefore, the objective of this study was to determine the level of psychosocial risks (physical and emotional) of the employees of an SME. The participants of this study were 186 employees of a productive sector SME; 151 men and 35 women, all with an average age of 31.77 years. Their seniority inside the SME was between one month and 19.91 years. Ninety-six workers were from the production area, 28 from the management area, as well as 25 from the sales area and 40 from the supplies area. Ninety-three workers were found in Uman, 78 in Playa del Carmen, 11 in Cancun and seven in Cd. del Carmen. We found a statistically significant relationship between the burnout variable and the engagement and psychosomatic complaints as well as between the variables of sex, burnout and psychosomatic complaints. We can conclude that, for benefit of the SME, that there are low levels of burnout and psychosomatic complaints, the women experience major levels of burnout and the men show major levels of psychosomatic complaints. The findings, contributions, limitations and future proposals will be analyzed.Keywords: psychosocial risks, SME, burnout, engagement, psychosomatic complaints
Procedia PDF Downloads 3651532 Impact of the Electricity Market Prices during the COVID-19 Pandemic on Energy Storage Operation
Authors: Marin Mandić, Elis Sutlović, Tonći Modrić, Luka Stanić
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With the restructuring and deregulation of the power system, storage owners, generation companies or private producers can offer their multiple services on various power markets and earn income in different types of markets, such as the day-ahead, real-time, ancillary services market, etc. During the COVID-19 pandemic, electricity prices, as well as ancillary services prices, increased significantly. The optimization of the energy storage operation was performed using a suitable model for simulating the operation of a pumped storage hydropower plant under market conditions. The objective function maximizes the income earned through energy arbitration, regulation-up, regulation-down and spinning reserve services. The optimization technique used for solving the objective function is mixed integer linear programming (MILP). In numerical examples, the pumped storage hydropower plant operation has been optimized considering the already achieved hourly electricity market prices from Nord Pool for the pre-pandemic (2019) and the pandemic (2020 and 2021) years. The impact of the electricity market prices during the COVID-19 pandemic on energy storage operation is shown through the analysis of income, operating hours, reserved capacity and consumed energy for each service. The results indicate the role of energy storage during a significant fluctuation in electricity and services prices.Keywords: electrical market prices, electricity market, energy storage optimization, mixed integer linear programming (MILP) optimization
Procedia PDF Downloads 1701531 The Subcellular Localisation of EhRRP6 and Its Involvement in Pre-Ribosomal RNA Processing in Growth-Stressed Entamoeba histolytica
Authors: S. S. Singh, A. Bhattacharya, S. Bhattacharya
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The eukaryotic exosome complex plays a pivotal role in RNA biogenesis, maturation, surveillance and differential expression of various RNAs in response to varying environmental signals. The exosome is composed of evolutionary conserved nine core subunits and the associated exonucleases Rrp6 and Rrp44. Rrp6p is crucial for the processing of rRNAs, other non-coding RNAs, regulation of polyA tail length and termination of transcription. Rrp6p, a 3’-5’ exonuclease is required for degradation of 5’-external transcribed spacer (ETS) released from the rRNA precursors during the early steps of pre-rRNA processing. In the parasitic protist Entamoeba histolytica in response to growth stress, there occurs the accumulation of unprocessed pre-rRNA and 5’ ETS sub fragment. To understand the processes leading to this accumulation, we looked for Rrp6 and the exosome subunits in E. histolytica, by in silico approaches. Of the nine core exosomal subunits, seven had high percentage of sequence similarity with the yeast and human. The EhRrp6 homolog contained exoribonuclease and HRDC domains like yeast but its N- terminus lacked the PMC2NT domain. EhRrp6 complemented the temperature sensitive phenotype of yeast rrp6Δ cells suggesting conservation of biological activity. We showed 3’-5’ exoribonuclease activity of EhRrp6p with in vitro-synthesized appropriate RNAs substrates. Like the yeast enzyme, EhRrp6p degraded unstructured RNA, but could degrade the stem-loops slowly. Furthermore, immunolocalization revealed that EhRrp6 was nuclear-localized in normal cells but was diminished from nucleus during serum starvation, which could explain the accumulation of 5’ETS during stress. Our study shows functional conservation of EhRrp6p in E.histolytica, an early-branching eukaryote, and will help to understand the evolution of exosomal components and their regulatory function.Keywords: entamoeba histolytica, exosome complex, rRNA processing, Rrp6
Procedia PDF Downloads 2001530 An Intelligent Search and Retrieval System for Mining Clinical Data Repositories Based on Computational Imaging Markers and Genomic Expression Signatures for Investigative Research and Decision Support
Authors: David J. Foran, Nhan Do, Samuel Ajjarapu, Wenjin Chen, Tahsin Kurc, Joel H. Saltz
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The large-scale data and computational requirements of investigators throughout the clinical and research communities demand an informatics infrastructure that supports both existing and new investigative and translational projects in a robust, secure environment. In some subspecialties of medicine and research, the capacity to generate data has outpaced the methods and technology used to aggregate, organize, access, and reliably retrieve this information. Leading health care centers now recognize the utility of establishing an enterprise-wide, clinical data warehouse. The primary benefits that can be realized through such efforts include cost savings, efficient tracking of outcomes, advanced clinical decision support, improved prognostic accuracy, and more reliable clinical trials matching. The overarching objective of the work presented here is the development and implementation of a flexible Intelligent Retrieval and Interrogation System (IRIS) that exploits the combined use of computational imaging, genomics, and data-mining capabilities to facilitate clinical assessments and translational research in oncology. The proposed System includes a multi-modal, Clinical & Research Data Warehouse (CRDW) that is tightly integrated with a suite of computational and machine-learning tools to provide insight into the underlying tumor characteristics that are not be apparent by human inspection alone. A key distinguishing feature of the System is a configurable Extract, Transform and Load (ETL) interface that enables it to adapt to different clinical and research data environments. This project is motivated by the growing emphasis on establishing Learning Health Systems in which cyclical hypothesis generation and evidence evaluation become integral to improving the quality of patient care. To facilitate iterative prototyping and optimization of the algorithms and workflows for the System, the team has already implemented a fully functional Warehouse that can reliably aggregate information originating from multiple data sources including EHR’s, Clinical Trial Management Systems, Tumor Registries, Biospecimen Repositories, Radiology PAC systems, Digital Pathology archives, Unstructured Clinical Documents, and Next Generation Sequencing services. The System enables physicians to systematically mine and review the molecular, genomic, image-based, and correlated clinical information about patient tumors individually or as part of large cohorts to identify patterns that may influence treatment decisions and outcomes. The CRDW core system has facilitated peer-reviewed publications and funded projects, including an NIH-sponsored collaboration to enhance the cancer registries in Georgia, Kentucky, New Jersey, and New York, with machine-learning based classifications and quantitative pathomics, feature sets. The CRDW has also resulted in a collaboration with the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC) at the U.S. Department of Veterans Affairs to develop algorithms and workflows to automate the analysis of lung adenocarcinoma. Those studies showed that combining computational nuclear signatures with traditional WHO criteria through the use of deep convolutional neural networks (CNNs) led to improved discrimination among tumor growth patterns. The team has also leveraged the Warehouse to support studies to investigate the potential of utilizing a combination of genomic and computational imaging signatures to characterize prostate cancer. The results of those studies show that integrating image biomarkers with genomic pathway scores is more strongly correlated with disease recurrence than using standard clinical markers.Keywords: clinical data warehouse, decision support, data-mining, intelligent databases, machine-learning.
Procedia PDF Downloads 1261529 Woodcast Is Ecologically Sound and Tolerated by Majority of Patients
Authors: R. Hassan, J. Duncombe, E. Darke, A. Dias, K. Anderson, R. G. Middleton
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Background: NHS England has set itself the task of delivering a “Net Zero” National Health service by 2040. It is incumbent upon all health care practioners to work towards this goal. Orthopaedic surgeons are no exception. Distal radial fractures are the most common fractures sustained by the adult population. However, studiesare shortcoming on individual patient experience. The aim of this study was to assess the patient’ssatisfaction and outcomes with woodcast used in the conservative management of distal radius fractures. Methods: For all patients managed with woodcast in our unit, we undertook a structured questionnairethat included the Patient Rated Wrist Evaluation (PRWE) score, The EQ-5D-5L score, and the pain numerical score at the time of injury and six weeks after. Results: 30 patients were initially managed with woodcast.80% of patients tolerated woodcast for the full duration of their treatment. Of these, 20% didn’t tolerate woodcast and had their casts removed within 48 hours. Of the remaining, 79.1% were satisfied about woodcast comfort, 66% were very satisfied about woodcast weight, 70% were satisfied with temperature and sweatiness, 62.5% were very satisfied about the smell/odour, and 75% were satisfied about the level of support woodcast provided. During their treatment, 83.3% of patients rated their pain as five or less. Conclusion: For those who completed their treatment in woodcast, none required any further intervention or utilised the open appointment because of ongoing wrist problems. In conclusion, when woodcast is tolerated, patients’ satisfaction and outcome levels were good. However, we acknowledged 20% of patients in our series were not able to tolerate woodacst, Therefore, we suggest a comparison between the widely used synthetic plaster of Pariscasting and woodcast to come in order.Keywords: distal radius fractures, ecological cast, sustainability, woodcast
Procedia PDF Downloads 841528 Solid Waste Pollution and the Importance of Environmental Planning in Managing and Preserving the Public Environment in Benghazi City and Its Surrounding Areas
Authors: Abdelsalam Omran Gebril
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Pollution and solid waste are the most important environmental problems plaguing the city of Benghazi as well as other cities and towns in Libya. These problems are caused by the lack of environmental planning and sound environmental management. Environmental planning is very important at present for the development of projects that preserve the environment, therefore, the planning process should be prioritized over the management process. Pollution caused by poor planning and environmental management exists not only in Benghazi but also in all other Libyan cities. This study was conducted through various field visits to several neighborhoods and areas within Benghazi as well as its neighboring regions. Follow-ups in these areas were conducted from March 2013 to October 2013 and documented by photographs. The existing methods of waste collection and means of transportation were investigated. Interviews were conducted with relevant authorities, including the Environment Public Authority in Benghazi and the Public Service Company of Benghazi. The objective of this study is to determine the causes of solid waste pollution in Benghazi City and its surrounding areas. Results show that solid waste pollution in Benghazi and its surrounding areas is the result of poor planning and environmental management, population growth, and the lack of hardware and equipment for the collection and transport of waste from the city to the landfill site. One of the most important recommendations in this study is the development of a complete and comprehensive plan that includes environmental planning and environmental management to reduce solid waste pollution.Keywords: solid waste, pollution, environmental planning, management, Benghazi, Libya
Procedia PDF Downloads 3121527 Teratogenic Effect of Bisphenol A in Development of Balb/C Mouse
Authors: Nazihe Sedighi, Mohsen Nokhbatolphoghaei
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Bisphenol A (BPA) is a monomer used in the manufacture of polycarbonate plastics. Due to having properties such as transparency, heat and impact resistance, it is used widely in medicine, sorts, electronic components, and food containers. It is also used in the production of resins which is applied for lining cans. BPA releases from resins and polycarbonate when it is heated or continuously used the containers from which BPA can enter the body. There are several reports indicating the presence of BPA in the placenta, amniotic fluid, and the embryo itself. While researchers investigated the teratogenic effect of BPA on embryos, very limited work has been done on the effects of BPA when applied from early stages of development. In this study, The teratogenic effect of BPA was investigated at earliest preimplantation (day zero) through day 15.5 of the development of Balb/C mouse embryos. After ensuring the pregnancy via observing vaginal plug, Pregnant mice were divided into five groups. For the three experimental groups, the amount of 500, 750, and 1000 mg/kg/d Bisphenol A was given orally according to body weight. The sham group that was treated with sesame oil, which was used as vehicle and control group remained intact. On day 18.5 of gestation, embryos were removed from the uterus. Randomly half of the embryo were fixed in Bouin for tissue analysis. The other half were prepared for skeletal system staining using Alizarin Red and alcian blue dies. The results showed that the embryonic weight and the crown-rump length of embryos decreased significantly (P < 0.05) in all experimental groups compared to the control group and the sham. In this study, skeletal abnormalities such as delay in ossification of skull and limbs as well as the deviation in the backbone were seen. This research suggests that pregnant mothers need to be aware of possible teratogenic effects of BPA at any stage of pregnancy especially from early to mid stages. In this case, pregnant mothers may need to stop using any manufacture of polycarbonate plastics, as a container for food or drinking.Keywords: bisphenol A, development, polycarbonate plastic, skeletal system, teratogenicity
Procedia PDF Downloads 2921526 mm-Wave Wearable Edge Computing Module Hosted by Printed Ridge Gap Waveguide Structures: A Physical Layer Study
Authors: Matthew Kostawich, Mohammed Elmorsy, Mohamed Sayed Sifat, Shoukry Shams, Mahmoud Elsaadany
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6G communication systems represent the nominal future extension of current wireless technology, where its impact is extended to touch upon all human activities, including medical, security, and entertainment applications. As a result, human needs are allocated among the highest priority aspects of the system design and requirements. 6G communications is expected to replace all the current video conferencing with interactive virtual reality meetings involving high data-rate transmission merged with massive distributed computing resources. In addition, the current expansion of IoT applications must be mitigated with significant network changes to provide a reasonable Quality of Service (QoS). This directly implies a high demand for Human-Computer Interaction (HCI) through mobile computing modules in future wireless communication systems. This article proposes the utilization of a Printed Ridge Gap Waveguide (PRGW) to host the wearable nodes. To the best of our knowledge, we propose for the first time a physical layer analysis within the context of a complete architecture. A thorough study is provided on the impact of the distortion of the guiding structure on the overall system performance. The proposed structure shows small latency and small losses, highlighting its compatibility with future applications.Keywords: ridge gap waveguide, edge computing module, 6G, multimedia IoT applications
Procedia PDF Downloads 701525 Assessment of the Illustrated Language Activities of the Portage Guide to Early Education
Authors: Ofelia A. Damag
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The study was focused on the development and assessment of the illustrated language activities of the 1996 Edition of the Portage Guide to Early Education. It determined the extent of appropriateness, applicability, time efficiency and aesthetics of the illustrated language activities to be used as instructional material not only by teachers, but parents and caregivers as well. The eclectic research design was applied in this study using qualitative and quantitative methods. To determine the applicability and time efficiency of the study, a try out was done. Since the eclectic research design was used, it made use of a researcher-made survey questionnaire and focus group discussion. Analysis of the data was done through weighted mean and ANOVA. The respondents of the study were representatives of Special Education (SPED) teachers, caregivers and parents of a special-needs child, particularly with difficulties in learning basic language skills. The results of the study show that a large number of respondents are SPED teachers and caregivers and are mostly college graduates. Many of them have earned units towards Master’s studies. Moreover, a majority of the respondents have not attended seminars or in-service training in early intervention for them to be more competent in the area of specialization. It is concluded that the illustrated language activities under review in this study are appropriate, applicable, time efficient and aesthetic for use as a tool in teaching. The recommendations are focused on the advocacy for SPED teachers, caregivers and parents of special-needs children to be more consistent in the implementation of the new instructional materials as an aid in an intervention program.Keywords: illustrated language activities, inclusion, portage guide to early education, special educational needs
Procedia PDF Downloads 1571524 Effect of Sulfur on the High-Temperature Oxidation of DIN1.4091
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Centrifugal casting is a metal casting method that uses forces make by centripetal acceleration to distribute molten material in mold. Centrifugal cast parts manufactured in industry contain gas pipes and water supply lines, moreover rings, turbocharger, bushings, brake drums. Turbochargers were exposed to exhaust temperatures of 900-1050°C require a material for the corrosion resistance that will withstand such high component temperatures during the entire service life of the vehicle. Hence, the study of corrosion resistance for turbocharger is important for practical application. DIN1.4091 steels were used widely. The DIN1.4091 steels whose compositions were Fe-34.4Cr-14.5Ni-2.5Mo-0.4W-0.4Mn-0.5Si-(0.009 or 0.35)S (wt.%) were centrifugally cast, and oxidized at 900°C for 50-200 h in order to find the effect of sulfur on the high-temperature oxidation of Fe-34.4Cr-14.5Ni-2.5Mo-0.4W-0.4Mn-0.5Si-(0.009 or 0.35)S (wt.%) alloys. These alloys formed oxide scales that consisted primarily of Cr₂O₃ as the major oxide and Cr₂MnO₄ as the minor one through preferential oxidation of Cr and Mn. Cr formed a thin CrOx oxide film on the surface to prevent further oxidation, and when it is added more than 20%, the sulphide decreased corrosion rate. The high affinity of Mn with S, led to the formation of scattered MnS inclusions, particularly in the 0.35S-containing cast alloy. Sulfur was harmful to the oxidation resistance because it deteriorated the scale/alloy adherence so as to accelerate the adherence and compactness of the formed scales. Acknowledgement: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (2016R1A2B1013169).Keywords: centrifugal casting, turbocharger, sulfur, oxidation, Fe-34.4Cr-14.5Ni alloy
Procedia PDF Downloads 1971523 Selection of Lead Mobilizing Bacteria from Contaminated Soils and Their Potential in Promoting Plant Growth through Plant Growth Promoting Activity
Authors: Maria Manzoor, Iram Gul, Muhammad Arshad
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Bacterial strains were isolated from contaminated soil collected from Rawalpindi and Islamabad. The strains were investigated for lead resistance and their effect on Pb solubility and PGPR activity. Incubation experiments were carried for inoculated and unoculated soil containing different levels of Pb. Results revealed that few stains (BTM-4, BTM-11, BTM-14) were able to tolerate Pb up to 600 mg L-1, whereas five strains (BTM-3, BTM-6, BTM-10, BTM-21 and BTM-24) showed significant increase in solubility of Pb when compared to all other strains and control. The CaCl2 extractable Pb was increased by 13.6, 6.8, 4.4 and 2.4 folds compared to un-inoculated control soil at increased soil Pb concentration (500, 1000, 1500 and 200 mg kg-1, respectively). The selected bacterial strains (11) were further investigated for plant growth promotion activity through PGPR assays including. Germination and root elongation assays were also conducted under elevated metal concentration in controlled conditions to elucidate the effects of microbial strains upon plant growth and development. The results showed that all the strains tested in this study, produced significantly varying concentrations of IAA, siderophores and gibberellic acid along with ability to phosphorus solubilization index (PSI). The results of germination and root elongation assay further confirmed the beneficial role of the microbial strains in elevating metal stress through PGPR activity. Among all tested strains, BTM-10 significantly improved plant growth. 1.3 and 2.7 folds increase in root and shoot length was observed when compared to control. Which may be attributed to presence of important plant growth promoting enzymes (IAA 74.6 μg/ml; GA 19.23 μg/ml; Sidrophore units 49% and PSI 1.3 cm). The outcome of this study indicates that these Pb tolerant and solubilizing strains may have the potential for plant growth promotion under metal stress and can be used as mediator when coupled with heavy metal hyperaccumulator plants for phytoremediation of Pb contaminated soil.Keywords: Pb resistant bacteria, Pb mobilizing bacteria, Phytoextraction of Pb, PGPR activity of bacteria
Procedia PDF Downloads 2171522 Introduction of Digital Radiology to Improve the Timeliness in Availability of Radiological Diagnostic Images for Trauma Care
Authors: Anuruddha Jagoda, Samiddhi Samarakoon, Anil Jasinghe
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In an emergency department ‘where every second count for patient’s management’ timely availability of X- rays play a vital role in early diagnosis and management of patients. Trauma care centers rely heavily on timely radiologic imaging for patient care and radiology plays a crucial role in the emergency department (ED) operations. A research study was carried out to assess timeliness of availability of X-rays and total turnaround time at the Accident Service of National Hospital of Sri Lanka which is the premier trauma center in the country. Digital Radiology system was implemented as an intervention to improve the timeliness of availability of X-rays. Post-implementation assessment was carried out to assess the effectiveness of the intervention. Reduction in all three aspects of waiting times namely waiting for initial examination by doctors, waiting until X –ray is performed and waiting for image availability was observed after implementation of the intervention. However, the most significant improvement was seen in waiting time for image availability and reduction in time for image availability had indirect impact on reducing waiting time for initial examination by doctors and waiting until X –ray is performed. The most significant reduction in time for image availability was observed when performing 4-5 X rays with DR system. The least improvement in timeliness was seen in patients who are categorized as critical.Keywords: emergency department, digital radilogy, timeliness, trauma care
Procedia PDF Downloads 2641521 Analysis of Accessibility of Tourism Transportation in Banyuwangi
Authors: Lilla Anjani, Ervina Ahyudanari
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Tourism is one of the contributors to regional economic income. Banyuwangi has made rapid developments related to the tourism sector, especially since 2010. There are 25 tourist visit locations that can become tourist destinations. Banyuwangi has tourism transportation to support the ease of reaching tourist places. This transportation operates with six routes, namely the final destination of Ijen Crater, Glenmore, Bajangan, Bangsring, Red Island, and Pine Forest. Despite having tourism transportation, tourists tend to choose to use a private car or rent a car because there is no access to tourist places using public transportation. Tourism transportation is also one form of sustainable tourism development in the future, such as the Sustainable Development Goals. The Banyuwangi government has a special program for tourism development that is supported by all sectors in Banyuwangi. To support the development of tourism in Banyuwangi, it is necessary to analyze existing tourism transportation as well as suggestions regarding new routes to reach all tourism locations in Banyuwangi Regency. The analysis reviewed in this study is an analysis of accessibility, distance, and time to the tourism location. There are 30 tourism destination points from 39 ODTW references from the transportation service, and the tourism office of Banyuwangi Regency Banyuwangi tourism objects can be divided into six zones based on travel time and distance. The highest accessibility value for Zone A is 51.96, and the lowest is 11.989. The highest accessibility value for Zone B is 33.4269, and the lowest is 21.737. The highest accessibility value for Zone C is 33,407, and the lowest is 14,848. The highest accessibility value for Zone D is 58,967, and the lowest is 14,742. The highest accessibility value for Zone E is 56,401, and the lowest is 14.1. The highest accessibility value for Zone F is 176.14, and the lowest is 44.1. There are two tourist transportation routes with six sessions every day. The resulting new route is in the form of grouping based on locations that can be reached in one particular area.Keywords: accessibility, tourism clustering, Banyuwangi tourism, sustainable development goals
Procedia PDF Downloads 891520 Effectiveness of Using Multiple Non-pharmacological Interventions to Prevent Delirium in the Hospitalized Elderly
Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu
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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium
Procedia PDF Downloads 771519 Toxicological Effects of Heavy Metals; Copper, Lead and Chromium on Brain and Liver Tissue of Grass Carp (Ctenopharyngodon idella)
Authors: Ahsan Khan, Nazish Shah, Muhammad Salman
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The present study deals with the toxicological effects of copper, lead and chromium on brain and liver tissues of grass carp (Ctenopharyngodon idella). The average length of experimental fish was 8.5 ± 5.5 cm and weighed 9.5 ± 6.5 g. Grass carp was exposed to lethal concentration (LC₁₅) of copper, lead and chromium for 24, 48, 72 and 96 hours respectively. (LC₁₅) for copper was 1.5, 1.4, 1.2 and 1mgL⁻¹. Similarly, LC₁₅ of lead was 250, 235, 225 and 216mgL⁻¹ while (LC₁₅) for chromium was 25.5, 22.5, 20 and 18mgL⁻¹ respectively. During the time of exposure against various doses of heavy metals the grass carp showed some behavioral changes. In the initial stages of experiment, the rapid movements and gulping of air were observed. Several times the fish tried to jump to scat from the toxic median. In addition, the accumulation of heavy metals in different tissues of grass carp particularly in liver and brain tissues were observed. Lead was highly accumulated in brain tissue after the exposure of fish for 24 and 48 hours, while highly accumulated in liver tissues after the exposure of fish for 72 and 96 hours. Chromium was highly accumulated in the liver tissues after the exposure of fish for 24 hours while its accumulation was found highly in the brain tissues after the exposure of fish for 48, 72 and 96 hours. Similarly, accumulation of copper concentration was found highly in brain tissues after the exposure of 48 and 96 hours while its accumulation was high in liver tissues after the exposure of 24 and 72 hours. Comparatively maximum accumulation of lead was found in brain and liver tissues of grass carp followed by chromium and copper. Furthermore, accumulation of these metals caused many abnormalities like gliosis, destruction of cell, change in cell shape and shrinkage of cells in brain tissue while in liver tissues aggregation in hepatocytes, widen space between cells and also destruction of cell was observed. These experiments and observations can be useful to monitor the aquatic pollution and quality of aquatic environment system.Keywords: brain, grass carp, liver, lethal concentration, toxicity
Procedia PDF Downloads 1551518 Rd-PLS Regression: From the Analysis of Two Blocks of Variables to Path Modeling
Authors: E. Tchandao Mangamana, V. Cariou, E. Vigneau, R. Glele Kakai, E. M. Qannari
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A new definition of a latent variable associated with a dataset makes it possible to propose variants of the PLS2 regression and the multi-block PLS (MB-PLS). We shall refer to these variants as Rd-PLS regression and Rd-MB-PLS respectively because they are inspired by both Redundancy analysis and PLS regression. Usually, a latent variable t associated with a dataset Z is defined as a linear combination of the variables of Z with the constraint that the length of the loading weights vector equals 1. Formally, t=Zw with ‖w‖=1. Denoting by Z' the transpose of Z, we define herein, a latent variable by t=ZZ’q with the constraint that the auxiliary variable q has a norm equal to 1. This new definition of a latent variable entails that, as previously, t is a linear combination of the variables in Z and, in addition, the loading vector w=Z’q is constrained to be a linear combination of the rows of Z. More importantly, t could be interpreted as a kind of projection of the auxiliary variable q onto the space generated by the variables in Z, since it is collinear to the first PLS1 component of q onto Z. Consider the situation in which we aim to predict a dataset Y from another dataset X. These two datasets relate to the same individuals and are assumed to be centered. Let us consider a latent variable u=YY’q to which we associate the variable t= XX’YY’q. Rd-PLS consists in seeking q (and therefore u and t) so that the covariance between t and u is maximum. The solution to this problem is straightforward and consists in setting q to the eigenvector of YY’XX’YY’ associated with the largest eigenvalue. For the determination of higher order components, we deflate X and Y with respect to the latent variable t. Extending Rd-PLS to the context of multi-block data is relatively easy. Starting from a latent variable u=YY’q, we consider its ‘projection’ on the space generated by the variables of each block Xk (k=1, ..., K) namely, tk= XkXk'YY’q. Thereafter, Rd-MB-PLS seeks q in order to maximize the average of the covariances of u with tk (k=1, ..., K). The solution to this problem is given by q, eigenvector of YY’XX’YY’, where X is the dataset obtained by horizontally merging datasets Xk (k=1, ..., K). For the determination of latent variables of order higher than 1, we use a deflation of Y and Xk with respect to the variable t= XX’YY’q. In the same vein, extending Rd-MB-PLS to the path modeling setting is straightforward. Methods are illustrated on the basis of case studies and performance of Rd-PLS and Rd-MB-PLS in terms of prediction is compared to that of PLS2 and MB-PLS.Keywords: multiblock data analysis, partial least squares regression, path modeling, redundancy analysis
Procedia PDF Downloads 1461517 Simultaneous Measurement of Displacement and Roll Angle of Object
Authors: R. Furutani, K. Ishii
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Laser interferometers are now widely used for length and displacement measurement. In conventional methods, the optical path difference between two mirrors, one of which is a reference mirror and the other is a target mirror, is measured, as in Michelson interferometry, or two target mirrors are set up and the optical path difference between the two targets is measured, as in differential interferometry. In these interferometers, the two laser beams pass through different optical elements so that the measurement result is affected by the vibration and other effects in the optical paths. In addition, it is difficult to measure the roll angle around the optical axis. The proposed interferometer simultaneously measures both the translational motion along the optical axis and the roll motion around it by combining the retroreflective principle of the ball lens (BL) and the polarization. This interferometer detects the interferogram by the two beams traveling along the identical optical path from the beam source to BL. This principle is expected to reduce external influences by using the interferogram between the two lasers in an identical optical path. The proposed interferometer uses a BL so that the reflected light from the lens travels on the identical optical path as the incident light. After reaching the aperture of the He-Ne laser oscillator, the reflected light is reflected by a mirror with a very high reflectivity installed in the aperture and is irradiated back toward the BL. Both the first laser beam that enters the BL and the second laser beam that enters the BL after the round trip interferes with each other, enabling the measurement of displacement along the optical axis. In addition, for the measurement of the roll motion, a quarter-wave plate is installed on the optical path to change the polarization state of the laser. The polarization states of the first laser beam and second laser beam are different by the roll angle of the target. As a result, this system can measure the displacement and the roll angle of BL simultaneously. It was verified by the simulation and the experiment that the proposed optical system could measure the displacement and the roll angle simultaneously.Keywords: common path interferometer, displacement measurement, laser interferometer, simultaneous measurement, roll angle measurement
Procedia PDF Downloads 891516 Determinants of Free Independent Traveler Tourist Expenditures in Israel: Quantile Regression Model
Authors: Shlomit Hon-Snir, Sharon Teitler-Regev, Anabel Lifszyc Friedlander
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Tourism, one of the world's largest and fastest growing industries, exerts a major economic influence. The number of international tourists is growing every year, and the relative portion of independent (FIT) tourists is growing as well. The characteristics of independent tourists differ from those of tourists who travel in organized trips. The purpose of the research is to identify the factors that affect the individual tourist's expenses in Israel: total expenses, expenses per day, expenses per tourist, expenses per day per tourist, accommodation expenses, dining expenses and transportation expenses. Most of the research analyzed the total expenses using OLS regression. The determinants influencing expenses were divided into four groups: budget constraints, socio-demographic data, psychological characteristics and travel-related characteristics. Since the effect of each variable may change over different levels of total expenses the quantile regression (QR) theory will be applied. The current research will use data collected by the Israeli Ministry of Tourism in 2015 from individual independent tourists at the end of their visit to Israel. Preliminary results show that: At lower levels of expense, only income has a (positive) effect on total expenses, while at higher levels of expense, both income and length of stay have (positive) effects. -The effect of income on total expenses is higher for higher levels of expenses than for lower level of expenses. -The number of sites visited during the trip has a (negative) effect on tourist accommodation expenses only for tourists with a high level of total expenses. Due to the increasing share of independent tourism in Israel and around the world and due to the importance of tourism to Israel, it is very important to understand the factors that influence the expenses and behavior of independent tourists. Understanding the factors that affect independent tourists' expenses in Israel can help Israeli policymakers in their promotional efforts to attract tourism to Israel.Keywords: independent tourist, quantile regression theory, tourism expenses, tourism
Procedia PDF Downloads 2731515 A Preliminary Literature Review of Digital Transformation Case Studies
Authors: Vesna Bosilj Vukšić, Lucija Ivančić, Dalia Suša Vugec
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While struggling to succeed in today’s complex market environment and provide better customer experience and services, enterprises encompass digital transformation as a means for reaching competitiveness and foster value creation. A digital transformation process consists of information technology implementation projects, as well as organizational factors such as top management support, digital transformation strategy, and organizational changes. However, to the best of our knowledge, there is little evidence about digital transformation endeavors in organizations and how they perceive it – is it only about digital technologies adoption or a true organizational shift is needed? In order to address this issue and as the first step in our research project, a literature review is conducted. The analysis included case study papers from Scopus and Web of Science databases. The following attributes are considered for classification and analysis of papers: time component; country of case origin; case industry and; digital transformation concept comprehension, i.e. focus. Research showed that organizations – public, as well as private ones, are aware of change necessity and employ digital transformation projects. Also, the changes concerning digital transformation affect both manufacturing and service-based industries. Furthermore, we discovered that organizations understand that besides technologies implementation, organizational changes must also be adopted. However, with only 29 relevant papers identified, research positioned digital transformation as an unexplored and emerging phenomenon in information systems research. The scarcity of evidence-based papers calls for further examination of this topic on cases from practice.Keywords: digital strategy, digital technologies, digital transformation, literature review
Procedia PDF Downloads 2171514 Seismic Performance of Concrete Moment Resisting Frames in Western Canada
Authors: Ali Naghshineh, Ashutosh Bagchi
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Performance-based seismic design concepts are increasingly being adopted in various jurisdictions. While the National Building Code of Canada (NBCC) is not fully performance-based, it provides some features of a performance-based code, such as displacement control and objective-based solutions. Performance evaluation is an important part of a performance-based design. In this paper, the seismic performance of a set of code-designed 4, 8 and 12 story moment resisting concrete frames located in Victoria, BC, in the western part of Canada at different hazard levels namely, SLE (Service Level Event), DLE (Design Level Event) and MCE (Maximum Considered Event) has been studied. The seismic performance of these buildings has been evaluated based on FEMA 356 and ATC 72 procedures, and the nonlinear time history analysis. Pushover analysis has been used to investigate the different performance levels of these buildings and adjust their design based on the corresponding target displacements. Since pushover analysis ignores the higher mode effects, nonlinear dynamic time history using a set of ground motion records has been performed. Different types of ground motion records, such as crustal and subduction earthquake records have been used for the dynamic analysis to determine their effects. Results obtained from push over analysis on inter-story drift, displacement, shear and overturning moment are compared to those from the dynamic analysis.Keywords: seismic performance., performance-based design, concrete moment resisting frame, crustal earthquakes, subduction earthquakes
Procedia PDF Downloads 2631513 Characteristics of the Wake behind a Heated Cylinder in Relatively High Reynolds Number
Authors: Morteza Khashehchi, Kamel Hooman
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Thermal effects on the dynamics and stability of the flow past a circular cylinder operating in the mixed convection regime is studied experimentally for Reynolds number (ReD) between 1000 and 4000, and different cylinder wall temperatures (Tw) between 25 and 75°C by means of Particle Image Velocimetry (PIV). The experiments were conducted in a horizontal wind tunnel with the heated cylinder placed horizontally. With such assumptions, the direction of the thermally induced buoyancy force acting on the fluid surrounding the heated cylinder would be perpendicular to the flow direction. In each experiment, to acquire 3000 PIV image pairs, the temperature and Reynolds number of the approach flow were held constant. By adjusting different temperatures in different Reynolds numbers, the corresponding Richardson number (RiD = Gr/Re^2) was varied between 0:0 (unheated) and 10, resulting in a change in the heat transfer process from forced convection to mixed convection. With increasing temperature of the wall cylinder, significant modifications of the wake flow pattern and wake vortex shedding process were clearly revealed. For cylinder at low wall temperature, the size of the wake and the vortex shedding process are found to be quite similar to those of an unheated cylinder. With high wall temperature, however, the high temperature gradient in the wake shear layer creates a type of vorticity with opposite sign to that of the shear layer vorticity. This temperature gradient vorticity weakens the strength of the shear layer vorticity, causing delay in reaching the recreation point. In addition to the wake characteristics, the shedding frequency for the heated cylinder is determined for all aforementioned cases. It is found that, as the cylinder wall is heated, the organization of the vortex shedding is altered and the relative position of the first detached vortices with respect to the second one is changed. This movement of the first detached vortex toward the second one increases the frequency of the shedding process. It is also found that the wake closure length decreases with increasing the Richardson number.Keywords: heated cylinder, PIV, wake, Reynolds number
Procedia PDF Downloads 3881512 Research on Autonomous Controllability of BeiDou Navigation Satellite System Based on Knowledge Transformation
Authors: Hang Ju, Changmin Zhu
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The development level of the BeiDou Navigation Satellite System (BDS) can strongly reflect national defense strength as an important spatial information infrastructure. BDS can be not only used for military purposes, such as intelligence gathering, nuclear explosion monitoring, emergency communications, but also for location services, transportation, mapping, precision agriculture. In order to ensure the national defense security and the wide application of BDS in civil and military areas, BDS must be autonomous and controllable. As a complex system of knowledge-intensive, knowledge transformation runs through the whole process of research and development, production, operation, and maintenance of BDS. Based on the perspective of knowledge transformation, this paper expounds on the meaning of socialization, externalization, combination, and internalization of knowledge transformation, and the coupling relationship of autonomy and control on the basis of analyzing the status quo and problems of the autonomy and control of BDS. The autonomous and controllable framework of BDS based on knowledge transformation is constructed from six dimensions of management capability, R&D capability, technical capability, manufacturing capability, service support capability, and application capability. It can provide support for the smooth implementation of information security policy, provide a reference for the autonomy and control of the upstream and downstream industrial chains in Beidou, and provide a reference for the autonomous and controllable research of aerospace components, military measurement test equipment, and other related industries.Keywords: knowledge transformation, BeiDou Navigation Satellite System, autonomy and control, framework
Procedia PDF Downloads 1831511 Evidence of Natural Selection Footprints among Some African Chicken Breeds and Village Ecotypes
Authors: Ahmed Elbeltagy, Francesca Bertolini, Damarius Fleming, Angelica Van Goor, Chris Ashwell, Carl Schmidt, Donald Kugonza, Susan Lamont, Max Rothschild
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The major factor in shaping genomic variation of the African indigenous rural chicken is likely natural selection drives the development genetic footprints in the chicken genomes. To investigate such a hypothesis of a selection footprint, a total of 292 birds were randomly sampled from three indigenous ecotypes from East Africa (Uganda, Rwanda) and North Africa (Egypt) and two registered Egyptian breeds (Fayoumi and Dandarawi), and from the synthetic Kuroiler breed. Samples were genotyped using the Affymetrix 600K Axiom® Array. A total of 526,652 SNPs were utilized in the downstream analysis after quality control measures. The intra-population runs of homozygosity (ROH) that were consensuses in > 50% of individuals of an ecotype or > 75% of a breed were studied. To identify inter-population differentiation due to genetic structure, FST was calculated for North- vs. East- African populations in addition to population-pairwise combinations for overlapping windows (500Kb with an overlap of 250Kb). A total of 28,563 ROH were determined and were classified into three length categories. ROH and Fst detected sweeps were identified on several autosomes. Several genes in these regions are likely to be related to adaptation to local environmental stresses that include high altitude, diseases resistance, poor nutrition, oxidative and heat stresses and were linked to gene ontology terms (GO) related to immune response, oxygen consumption and heme binding, carbohydrate metabolism, oxidation-reduction, and behavior. Results indicated a possible effect of natural selection forces on shaping genomic structure for adaptation to local environmental stresses.Keywords: African Chicken, runs of homozygosity, FST, selection footprints
Procedia PDF Downloads 3121510 An Intelligent Scheme Switching for MIMO Systems Using Fuzzy Logic Technique
Authors: Robert O. Abolade, Olumide O. Ajayi, Zacheaus K. Adeyemo, Solomon A. Adeniran
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Link adaptation is an important strategy for achieving robust wireless multimedia communications based on quality of service (QoS) demand. Scheme switching in multiple-input multiple-output (MIMO) systems is an aspect of link adaptation, and it involves selecting among different MIMO transmission schemes or modes so as to adapt to the varying radio channel conditions for the purpose of achieving QoS delivery. However, finding the most appropriate switching method in MIMO links is still a challenge as existing methods are either computationally complex or not always accurate. This paper presents an intelligent switching method for the MIMO system consisting of two schemes - transmit diversity (TD) and spatial multiplexing (SM) - using fuzzy logic technique. In this method, two channel quality indicators (CQI) namely average received signal-to-noise ratio (RSNR) and received signal strength indicator (RSSI) are measured and are passed as inputs to the fuzzy logic system which then gives a decision – an inference. The switching decision of the fuzzy logic system is fed back to the transmitter to switch between the TD and SM schemes. Simulation results show that the proposed fuzzy logic – based switching technique outperforms conventional static switching technique in terms of bit error rate and spectral efficiency.Keywords: channel quality indicator, fuzzy logic, link adaptation, MIMO, spatial multiplexing, transmit diversity
Procedia PDF Downloads 1511509 Closed Incision Negative Pressure Therapy Dressing as an Approach to Manage Closed Sternal Incisions in High-Risk Cardiac Patients: A Multi-Centre Study in the UK
Authors: Rona Lee Suelo-Calanao, Mahmoud Loubani
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Objective: Sternal wound infection (SWI) following cardiac operation has a significant impact on patient morbidity and mortality. It also contributes to longer hospital stays and increased treatment costs. SWI management is mainly focused on treatment rather than prevention. This study looks at the effect of closed incision negative pressure therapy (ciNPT) dressing to help reduce the incidence of superficial SWI in high-risk patients after cardiac surgery. The ciNPT dressing was evaluated at 3 cardiac hospitals in the United Kingdom". Methods: All patients who had cardiac surgery from 2013 to 2021 were included in the study. The patients were classed as high risk if they have two or more of the recognised risk factors: obesity, age above 80 years old, diabetes, and chronic obstructive pulmonary disease. Patients receiving standard dressing (SD) and patients using ciNPT were propensity matched, and the Fisher’s exact test (two-tailed) and unpaired T-test were used to analyse categorical and continuous data, respectively. Results: There were 766 matched cases in each group. Total SWI incidences are lower in the ciNPT group compared to the SD group (43 (5.6%) vs 119 (15.5%), P=0.0001). There are fewer deep sternal wound infections (14(1.8%) vs. 31(4.04%), p=0.0149) and fewer superficial infections (29(3.7%) vs. 88 (11.4%), p=0.0001) in the ciNPT group compared to the SD group. However, the ciNPT group showed a longer average length of stay (11.23 ± 13 days versus 9.66 ± 10 days; p=0.0083) and higher mean logistic EuroSCORE (11.143 ± 13 versus 8.094 ± 11; p=0.0001). Conclusion: Utilization of ciNPT as an approach to help reduce the incidence of superficial and deep SWI may be effective in high-risk patients requiring cardiac surgery.Keywords: closed incision negative pressure therapy, surgical wound infection, cardiac surgery complication, high risk cardiac patients
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