Search results for: maternity care model

Authors: Prima Gusti Yanti, Fairul Zabadi

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The purpose of the study is to find out relation of moral massage with the authority ang globalization in proverb. Proverb is one of the many forms of cultural identity of the Indonesian/Malay people fulled with moral values. The values contained within those proverbs are beneficial not only to the society, but also to those who held power amidst on this era of globalization. The method being used is qualitative research by using content analysis which is done by describing and uncovering the forms and meanings of proverbs used within Indonesia Minangkabau society. Sources for this study’s data were extracted from a Minangkabau native speaker in the subdistrict of Tanah Abang, Jakarta. Said sources were retrieved through a series of interviews with the Minangkabau native speaker, whose speech is still adorned with idiomatic expressions. The research findings show that there existed 30 proverbs or idiomatic expressions in the Minangkabau language that are often used by its indigenous people. The thirty data contain moral values that are closely interwoven with the matter of power and globalization. Analytical results show that there are fourteen moral values contained within proverbs reflect a firm connection between rule and power in globalization; such as: responsible, brave, togetherness and consensus,tolerance, politeness, thorough and meticulous,honest and keeping promise, ingenious and learning, care, self-correction, be fair, alert, arbitrary, self-awareness. Structurally, proverbs possess an unchangeably formal construction; symbolically, proverbs possess meanings that are clearly decided through ethnographic communicative factors along with situational and cultural contexts. Values contained within proverbs may be used as a guide in social management, be it between fellow men, men between nature, or even men between their Creator. Therefore, the meanings and values contained within the morals of proverbs could also be utilized as a counsel for those who rule and in charge of power in order to stem the tides of globalization that had already spread into sectoral, territorial and educational continuums.

Keywords: continuum, globalization, identity, proverb, rule-power

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Authors: Khairani Binti Supyan, Fatimah Khalid, Mas Rina Mustaffa, Azreen Bin Azman, Amirul Azuani Romle

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Perennial plant classification plays a significant role in various agricultural and environmental applications, assisting in plant identification, disease detection, and biodiversity monitoring. Nevertheless, attaining high accuracy in perennial plant image classification remains challenging due to the complex variations in plant appearance, the diverse range of environmental conditions under which images are captured, and the inherent variability in image quality stemming from various factors such as lighting conditions, camera settings, and focus. This paper proposes an adaptation approach to optimize perennial plant image classification by fine-tuning the pre-trained DNNs model. This paper explores the efficacy of fine-tuning prevalent architectures, namely VGG16, ResNet50, and InceptionV3, leveraging transfer learning to tailor the models to the specific characteristics of perennial plant datasets. A subset of the MYLPHerbs dataset consisted of 6 perennial plant species of 13481 images under various environmental conditions that were used in the experiments. Different strategies for fine-tuning, including adjusting learning rates, training set sizes, data augmentation, and architectural modifications, were investigated. The experimental outcomes underscore the effectiveness of fine-tuning deep neural networks for perennial plant image classification, with ResNet50 showcasing the highest accuracy of 99.78%. Despite ResNet50's superior performance, both VGG16 and InceptionV3 achieved commendable accuracy of 99.67% and 99.37%, respectively. The overall outcomes reaffirm the robustness of the fine-tuning approach across different deep neural network architectures, offering insights into strategies for optimizing model performance in the domain of perennial plant image classification.

Keywords: perennial plants, image classification, deep neural networks, fine-tuning, transfer learning, VGG16, ResNet50, InceptionV3

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Authors: Nawt Almutairi, Ramzi El-Haddadeh

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With the extensive increase in the number of online shops, loyalty becomes the most purpose for e-retailers by which they can maintain their exit customers and regular income instead of spending large deal of money to target new segmentation. To obtain customers’ loyalty e-marketers should firstly satisfy customers by providing a high quality of services that could fulfil their demand. They have to satisfy them to trust the web-site then increase their intention to re-visit it. This study intends to investigate to what extend the elements of e-service quality presented in the literature affect customers’ satisfaction and how these influences contribute to customers’ trust and loyalty. Three dimensions of service quality are estimated. The first element is web-site interactivity, which is perceived the quality of interactive support and the accessible communications-tool. The second aspect is security/privacy, which is perceived the quality of controlling security and privacy while transaction over the web-site. The third element is web-design that perceived a pleasant user interface with visual appealing. These elements present positive effects on shoppers’ satisfaction. Thus, To examine the proposed constructs of this research, some measurements scale-items adapted from similar prior studies. Survey data collected online from Saudi customers (n=106) were utilized to test the research hypotheses. After that, the hypotheses were analyzed by using a variety of regression tools. The analytical results of this study propose that perceived quality of interactivity and security/privacy affects customers’ satisfaction. As well as trust seems to be a substantial construct that highly affects loyalty in online shopping. This study provides a developed model to obtain a simple understanding of the series of customers’ loyalty in online shopping. One construct presenting in the research model is web-design appears to be not important antecedent of satisfaction (the path to loyalty) in online shopping.

Keywords: e-service, satisfaction, trust, loyalty

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Authors: B. Groß, P. Fronia, P. Nyhuis

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In addition to the production, which is already frequently optimized, improving the distribution logistics also opens up tremendous potential for increasing an enterprise’s competitiveness. Here too though, numerous interactions need to be taken into account, enterprises thus need to be able to identify and weigh between different potentials for economically efficient optimizations. In order to be able to assess potentials, enterprises require a suitable method. This paper first briefly presents the need for this research before introducing the procedure that will be used to develop an appropriate method that not only considers interactions but is also quickly and easily implemented.

Keywords: distribution logistics, evaluation of potential, methods, model

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Authors: Magdalena Barbara Kaziuk, Waldemar Kosiba

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Introduction: Despite the development of technologies and improvements in the interior of dialysis stations, dialysis remains an unpleasant procedure, difficult to accept by the patients (who undergo it 2 to 3 times a week, a single treatment lasting several hours). Haemodialysis is one of the renal replacement therapies, in Poland most commonly used in patients with chronic or acute kidney failure. Purpose: An attempt was made to evaluate the quality of life in haemodialysed patients using the WHOQOL-BREF questionnaire. Material and methods: The study covered 422 patients (200 women and 222 men, aged 60.5 ± 12.9 years) undergoing dialysis at three selected stations in Poland. The patients were divided into 2 groups, depending on the duration of their dialysis treatment. The evaluation was conducted with the WHOQOL-BREF questionnaire containing 26 questions analysing 4 areas of life, as well as the perception of the quality of life and health self-assessment. A 5-point scale is used to answer them. The maximum score in each area is 20 points. The results in individual areas have a positive direction. Results: In patients undergoing dialysis for more than 3 years, a reduction in the quality of life was found in the physical area and in their environment versus a group of patients undergoing dialysis for less than 3 years, where a reduced quality of life was found in the areas of social relations and mental well-being (p < 0.05). A significant correlation (p < 0.01) between the two groups was found in self-perceived general health, while no significant differences were observed in the general perception of the quality of life (p > 0.05). Conclusions: The study confirmed that in patients undergoing dialysis for more than three years, the quality of life is especially reduced in their environment (access to and quality of healthcare, financial resources, and mental and physical safety). The assessment of the quality of life should form a part of the therapeutic process, in which the role of the patient in chronic renal care should be emphasised, reflected in the quality of services provided by dialysis stations.

Keywords: haemodialysis, perception of quality of life, quality of services provided, dialysis station

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Authors: T. Heikkinen, J. Oksman, T. Bragge, A. Nurmi, O. Kontkanen, T. Ahtoniemi

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Motor impairment is an inherent phenotypic feature of several chronic neurodegenerative diseases, and pharmacological therapies aimed to counterbalance the motor disability have a great market potential. Animal models of chronic neurodegenerative diseases display a number deteriorating motor phenotype during the disease progression. There is a wide array of behavioral tools to evaluate motor functions in rodents. However, currently existing methods to study motor functions in rodents are often limited to evaluate gross motor functions only at advanced stages of the disease phenotype. The most commonly applied traditional motor assays used in CNS rodent models, lack the sensitivity to capture fine motor impairments or improvements. Fine motor skill characterization in rodents provides a more sensitive tool to capture more subtle motor dysfunctions and therapeutic effects. Importantly, similar approach, kinematic movement analysis, is also used in clinic, and applied both in diagnosis and determination of therapeutic response to pharmacological interventions. The aim of this study was to apply kinematic gait analysis, a novel and automated high precision movement analysis system, to characterize phenotypic deficits in three different chronic neurodegenerative animal models, a transgenic mouse model (SOD1 G93A) for amyotrophic lateral sclerosis (ALS), and R6/2 and Q175KI mouse models for Huntington’s disease (HD). The readouts from walking behavior included gait properties with kinematic data, and body movement trajectories including analysis of various points of interest such as movement and position of landmarks in the torso, tail and joints. Mice (transgenic and wild-type) from each model were analyzed for the fine motor kinematic properties at young ages, prior to the age when gross motor deficits are clearly pronounced. Fine motor kinematic Evaluation was continued in the same animals until clear motor dysfunction with conventional motor assays was evident. Time course analysis revealed clear fine motor skill impairments in each transgenic model earlier than what is seen with conventional gross motor tests. Motor changes were quantitatively analyzed for up to ~80 parameters, and the largest data sets of HD models were further processed with principal component analysis (PCA) to transform the pool of individual parameters into a smaller and focused set of mutually uncorrelated gait parameters showing strong genotype difference. Kinematic fine motor analysis of transgenic animal models described in this presentation show that this method isa sensitive, objective and fully automated tool that allows earlier and more sensitive detection of progressive neuromuscular and CNS disease phenotypes. As a result of the analysis a comprehensive set of fine motor parameters for each model is created, and these parameters provide better understanding of the disease progression and enhanced sensitivity of this assay for therapeutic testing compared to classical motor behavior tests. In SOD1 G93A, R6/2, and Q175KI mice, the alterations in gait were evident already several weeks earlier than with traditional gross motor assays. Kinematic testing can be applied to a wider set of motor readouts beyond gait in order to study whole body movement patterns such as with relation to joints and various body parts longitudinally, providing a sophisticated and translatable method for disseminating motor components in rodent disease models and evaluating therapeutic interventions.

Keywords: Gait analysis, kinematic, motor impairment, inherent feature

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Authors: Nishantha Giguruwa

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This research investigates the transformative potential of smart container farming, building upon the successful cultivation of Japanese mushrooms at Sakai Farms in Aichi Prefecture, Japan, under the strategic collaboration with the Daikei Group. Inspired by this success, the study focuses on establishing an advanced urban strawberry farming laboratory with the aim of understanding strawberry farming technologies, fostering collaboration, and strategizing marketing approaches for both local and global markets. Positioned within the business framework of Sakai Farms and the Daikei Group, the study underscores the sustainability and forward-looking solutions offered by smart container farming in agriculture. The global significance of strawberries is emphasized, acknowledging their economic and cultural importance. The detailed examination of strawberry farming intricacies informs the technological framework developed for smart containers, implemented at Sakai Farms. Integral to this research is the incorporation of controlled bee pollination, a groundbreaking addition to the smart container farming model. The study anticipates future trends, outlining avenues for continuing exploration, stakeholder collaborations, policy considerations, and expansion strategies. Notably, the author expresses a strategic intent to approach the global market, leveraging the foreign student/faculty base at Ritsumeikan Asia Pacific University, where the author is affiliated. This unique approach aims to disseminate the research findings globally, contributing to the broader landscape of agricultural innovation. The integration of controlled bee pollination within this innovative framework not only enhances sustainability but also marks a significant stride in the evolution of urban agriculture, aligning with global agricultural trends.

Keywords: smart container farming, urban agriculture, strawberry farming technologies, controlled bee pollination, agricultural innovation

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Authors: Hema Lattupalli

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Introduction: A bony bridge extends from the lateral mass of the atlas to postero medial margin of vertebral artery groove, termed as a posterior bridge of atlas or posterior ponticulus. The foramen formed by the bridge is called as arcuate foramen or retroarticulare superior. Another bony bridge sometimes extends laterally from lateral mass to posterior root of transverse foramen forming and additional groove for vertebral artery, above and behind foramen transversarium called Lateral bridge or ponticulus lateralis. When both posterior and lateral are present together it is called as Posterolateral ponticuli. Aim and Objectives: The aim of the present study is to detect the presence of such Bridge or Ponticuli called as Lateral, Posterior and Posterolateral reported by earlier investigators in atlas vertebrae. Material and Methods: The study was done on 100 Atlas vertebrae from the Department of Anatomy Narayana Medical College Nellore, and also from SVIMS Tirupati was collected over a period of 2 years. The parameters that were studied include the presence of ponticuli, complete and incomplete and right and left side ponticuli. They were observed for all these parameters and the results were documented and photographed. Results: Ponticuli were observed in 25 (25%) of atlas vertebrae. Posterior ponticuli were found in 16 (16%), Lateral in 01 (01%) and Posterolateral in 08(08%) of the atlas vertebrae. Complete ponticuli were present in 09 (09%) and incomplete ponticuli in 16 (16%) of the atlas vertebrae. Bilateral ponticuli were seen in 10 (10%) and unilateral ponticuli were seen in 15 (15%) of the atlas vertebrae. Right side ponticuli were seen in 04 (04%) and Left side ponticuli in 05 (05%) of the atlas vertebrae respectively. Interpretation and Conclusion: In the present study posterior complete ponticuli were said to be more than the lateral complete ponticuli. The presence of Bilateral Incomplete Posterior ponticuli is higher and also Atlantic ponticuli. The present study is to say that knowledge of normal anatomy and variations in the atlas vertebra is very much essential to the neurosurgeons giving a message that utmost care is needed to perform surgeries related to craniovertebral regions. This is additional information to the Anatomists, Neurosurgeons and Radiologist. This adds an extra page to the literature.

Keywords: atlas vertebra, ponticuli, posterior arch, arcuate foramen

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Authors: Ebenezer O. Ige, Funmilayo H. Oyelami, Joshua Olutayo-Irheren, Joseph T. Okunlola

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Hyperthermia therapy is an adjuvant procedure during which perfused body tissues is subjected to elevated range of temperature in bid to achieve improved drug potency and efficacy of cancer treatment. While a selected class of hyperthermia techniques is shouldered on the thermal radiations derived from single-sourced electro-radiation measures, there are deliberations on conjugating dual radiation field sources in an attempt to improve the delivery of therapy procedure. This paper numerically explores the thermal effectiveness of combined infrared hyperemia having nanoparticle recirculation in the vicinity of imposed magnetic field on subcutaneous strata of a model lesion as ablation scheme. An elaborate Spectral relaxation method (SRM) was formulated to handle equation of coupled momentum and thermal equilibrium in the blood-perfused tissue domain of a spongy fibrous tissue. Thermal diffusion regimes in the presence of external magnetic field imposition were described leveraging on the renowned Roseland diffusion approximation to delineate the impact of radiative flux within the computational domain. The contribution of tissue sponginess was examined using mechanics of pore-scale porosity over a selected of clinical informed scenarios. Our observations showed for a substantial depth of spongy lesion, magnetic field architecture constitute the control regimes of hemodynamics in the blood-tissue interface while facilitating thermal transport across the depth of the model lesion. This parameter-indicator could be utilized to control the dispensing of hyperthermia treatment in intravenous perfused tissue.

Keywords: spectra relaxation scheme, thermal equilibrium, Roseland diffusion approximation, hyperthermia therapy

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Authors: Annika Kjallman Alm, Ove Hellzen, Malin Rising-Holmstrom

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Worldwide, the number of people who are living with dementia is increasing because of an aging population, which leads to increased financial and social costs, including reduced quality of life for people with dementia and their care partners. Most people who have dementia reside in the community. Aging in place could be described as having the health and social supports and services you need to live safely and independently in your home or your society for as long as you wish and are able. People with dementia are not different than people without dementia where they want to remain at home, if possible, with a sense of familiarity and engagement in typical everyday activities. So how do persons with dementia or cognitive decline see their possibilities to be socially involved and experience support? The aim of this study was to explore persons with cognitive decline's sense of involvement and support living in the ordinary dwelling. The study was approved by the Ethical Review Authority in Sweden prior to the interviews. Interviews were conducted with 20 persons living at home, either alone or in a relationship. The persons had perceived cognitive decline; some were under investigation or already had a diagnose of early dementia. Thematic analysis was used to identify, analyze, and report patterns within the data. Researchers extracted three main themes through participants’ interviews: a) Importance of social involvement with family and friends. b) Hindrances for social involvement. c) Struggling mentally with a new life situation. Results found that going to activity centers, staying involved, and meeting friends and family enhanced the sense of involvement and support. There were also hindrances to a sense of involvement and support as they struggled with the diagnose and the changes in daily life, such as physical problems, mental problems, or economic issues. The mental struggle of accepting the cognitive decline and the changes in daily life it brought was also an issue for some of the participants. A multidimensional support should be provided by the community to enable persons with cognitive decline to stay involved in family and community in the comfort of their own homes.

Keywords: aging in place, cognitive decline, dementia, sense of involvement

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Authors: Q. Giraud, J. Gonçalvès, B. Paris

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Remediation of dense non-aqueous phase liquids (DNAPLs) represents a challenging issue because of their persistent behaviour in the environment. This pilot-scale study investigates, by means of in situ experiments and numerical modelling, the feasibility of the pulsed pumping process of a large amount of a DNAPL in an alluvial aquifer. The main compound of the DNAPL is hexachlorobutadiene, an emerging organic pollutant. A low-permeability keyed enclosure was built at the location of the DNAPL source zone in order to isolate a finite undisturbed volume of soil, and a 3-month pulsed pumping process was applied inside the enclosure to exclusively extract the DNAPL. The water/DNAPL interface elevation at both the pumping and observation wells and the cumulated pumped volume of DNAPL were also recorded. A total volume of about 20m³ of purely DNAPL was recovered since no water was extracted during the process. The three-dimensional and multiphase flow simulator TMVOC was used, and a conceptual model was elaborated and generated with the pre/post-processing tool mView. Numerical model consisted of 10 layers of variable thickness and 5060 grid cells. Numerical simulations reproduce the pulsed pumping process and show an excellent match between simulated, and field data of DNAPL cumulated pumped volume and a reasonable agreement between modelled and observed data for the evolution of the water/DNAPL interface elevations at the two wells. This study offers a new perspective in remediation since DNAPL pumping system optimisation may be performed where a large amount of DNAPL is encountered.

Keywords: dense non-aqueous phase liquid (DNAPL), hexachlorobutadiene, in situ pulsed pumping, multiphase flow, numerical modelling, porous media

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Authors: Tae-Hoon Kim, Kwon-Ha Yoon, Hong Young Jun, Ki-Jong Kim, Young Hwan Lee, Myeung Su Lee, Keum Ha Choi, Ki Jung Yun, Eun Young Cho, Yong-Yeon Jeong, Chung-Hwan Jun

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Purpose: To assess the changes of hepatic metabolite for differentiation between non-alcoholic steatohepatitis (NASH) and simple steatosis on proton magnetic resonance spectroscopy (1H-MRS) in both humans and animal model. Methods: The local institutional review board approved this study and subjects gave written informed consent. 1H-MRS measurements were performed on a localized voxel of the liver using a point-resolved spectroscopy (PRESS) sequence and hepatic metabolites of alanine (Ala), lactate/triglyceride (Lac/TG), and TG were analyzed in NASH, simple steatosis and control groups. The group difference was tested with the ANOVA and Tukey’s post-hoc tests, and diagnostic accuracy was tested by calculating the area under the receiver operating characteristics (ROC) curve. The associations between metabolic concentration and pathologic grades or non-alcoholic fatty liver disease(NAFLD) activity scores were assessed by the Pearson’s correlation. Results: Patient with NASH showed the elevated Ala(p<0.001), Lac/TG(p < 0.001), TG(p < 0.05) concentration when compared with patients who had simple steatosis and healthy controls. The NASH patients were higher levels in Ala(mean±SEM, 52.5±8.3 vs 2.0±0.9; p < 0.001), Lac/TG(824.0±168.2 vs 394.1±89.8; p < 0.05) than simple steatosis. The area under the ROC curve to distinguish NASH from simple steatosis was 1.00 (95% confidence interval; 1.00, 1.00) with Ala and 0.782 (95% confidence interval; 0.61, 0.96) with Lac/TG. The Ala and Lac/TG levels were well correlated with steatosis grade, lobular inflammation, and NAFLD activity scores. The metabolic changes in human were reproducible to a mice model induced by streptozotocin injection and a high-fat diet. Conclusion: 1H-MRS would be useful for differentiation of patients with NASH and simple hepatic steatosis.

Keywords: non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, 1H MR spectroscopy, hepatic metabolites

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Authors: Mabel Usunobun Olanipekun, Henry Ogbemudia Omoregbee

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Anomalies such as water pipeline and hydraulic or petrochemical pipeline network leakages and bursts have significant implications for economic conditions and the environment. In order to ensure pipeline systems are reliable, they must be efficiently controlled. Wireless Sensor Networks (WSNs) have become a powerful network with critical infrastructure monitoring systems for water, oil and gas pipelines. The loss of water, oil and gas is inevitable and is strongly linked to financial costs and environmental problems, and its avoidance often leads to saving of economic resources. Substantial repair costs and the loss of precious natural resources are part of the financial impact of leaking pipes. Pipeline systems experts have implemented various methodologies in recent decades to identify and locate leakages in water, oil and gas supply networks. These methodologies include, among others, the use of acoustic sensors, measurements, abrupt statistical analysis etc. The issue of leak quantification is to estimate, given some observations about that network, the size and location of one or more leaks in a water pipeline network. In detecting background leakage, however, there is a greater uncertainty in using these methodologies since their output is not so reliable. In this work, we are presenting a scalable concept and simulation where a pressure-driven model (PDM) was used to determine water pipeline leakage in a system network. These pressure data were collected with the use of acoustic sensors located at various node points after a predetermined distance apart. We were able to determine with the use of correlation difference to determine the leakage point locally introduced at a predetermined point between two consecutive nodes, causing a substantial pressure difference between in a pipeline network. After de-noising the signal from the sensors at the nodes, we successfully obtained the exact point where we introduced the local leakage using the correlation difference model we developed.

Keywords: leakage detection, acoustic signals, pipeline network, correlation, wireless sensor networks (WSNs)

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Authors: Keltoum Bouherine, Olivier Leroy

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The present work is dedicated to study a three–dimensional (3D) self-consistent fluid simulation of microwave discharges of argon plasma in PECVD reactor. The model solves the Maxwell’s equations, continuity equations for charged species and the electron energy balance equation, coupled with Poisson’s equation, and Navier-Stokes equations by finite element method, using COMSOL Multiphysics software. In this study, the simulations yield the profiles of plasma components as well as the charge densities and electron temperature, the electric field, the gas velocity, and gas temperature. The results show that the microwave plasma reactor is outside of local thermodynamic equilibrium.The present work is dedicated to study a three–dimensional (3D) self-consistent fluid simulation of microwave discharges of argon plasma in PECVD reactor. The model solves the Maxwell’s equations, continuity equations for charged species and the electron energy balance equation, coupled with Poisson’s equation, and Navier-Stokes equations by finite element method, using COMSOL Multiphysics software. In this study, the simulations yield the profiles of plasma components as well as the charge densities and electron temperature, the electric field, the gas velocity, and gas temperature. The results show that the microwave plasma reactor is outside of local thermodynamic equilibrium.

Keywords: electron density, electric field, microwave plasma reactor, gas velocity, non-equilibrium plasma

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Authors: Yuet Wah Echo Yeung

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Working with people from minority ethnic groups, refugees and asylum seeking communities who have limited proficiency in the language of the host country often presents a major challenge for social workers. Because of language differences, social workers need to work with interpreters to ensure accurate information is collected for their assessment and intervention. Drawing from social learning theory, this paper discusses how role play was used as an experiential learning exercise in a training session to help social work students develop skills when working with interpreters. Social learning theory posits that learning is a cognitive process that takes place in a social context when people observe, imitate and model others’ behaviours. The roleplay also helped students understand the role of the interpreter and the challenges they may face when they rely on interpreters to communicate with service users and their family. The first part of the session involved role play. A tutor played the role of social worker and deliberately behaved in an unprofessional manner and used inappropriate body language when working alongside the interpreter during a home visit. The purpose of the roleplay is not to provide a positive role model for students to ‘imitate’ social worker’s behaviours. Rather it aims to active and provoke internal thinking process and encourages students to critically consider the impacts of poor practice on relationship building and the intervention process. Having critically reflected on the implications for poor practice, students were then asked to play the role of social worker and demonstrate what good practice should look like. At the end of the session, students remarked that they learnt a lot by observing the good and bad example; it showed them what not to do. The exercise served to remind students how practitioners can easily slip into bad habits and of the importance of respect for the cultural difference when working with people from different cultural backgrounds.

Keywords: role play, social learning theory, social work practice, working with interpreters

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Authors: Ivan Poza Martínez

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The international energy landscape has been significantly affected by the Covid-19 pandemic and te conflict in Ukraine. The Vaca Muerta sedimentary formation in Argentina´s Neuquén province has become a crucial area for energy production, specifically in the shale gas ad shale oil sectors. The massive investment required for theexploitation of this reserve make it essential to understand te determinants of the investment in the upstream sector at both local ad international levels. The aim of this study is to identify the qualitative and quantitative determinants of investment in Vaca Muerta. The research methodolody employs both quantiative ( econometrics ) and qualitative approaches. A linear regression model is used to analyze the impact in non-conventional hydrocarbons. The study highlights that, in addition to quantitative factors, qualitative variables, particularly the design of a regulatory framework, significantly influence the level of the investment in Vaca Muerta. The analysis reveals the importance of attracting both domestic and foreign capital investment. This research contributes to understanding the factors influencing investment inthe Vaca Muerta regioncomapred to other published studies. It emphasizes to role of qualitative varibles, such as regulatory frameworks, in the development of the shale gas and oil sectors. The study uses a combination ofquantitative data , such a investment figures, and qualitative data, such a regulatory frameworks. The data is collected from various rpeorts and industry publications. The linear regression model is used to analyze the relationship between the variables and the investment in Vaca Muerta. The research addresses the question of what factors drive investment in the Vaca Muerta region, both from a quantitative and qualitative perspective. The study concludes that a combination of quantitative and qualitative factors, including the design of a regulatory framework, plays a significant role in attracting investment in Vaca Muerta. It highlights the importance of these determinants in the developmentof the local energy sector and the potential economic benefits for Argentina and the Southern Cone region.

Keywords: vaca muerta, FDI, shale gas, shale oil, YPF

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Authors: Redhouane Ghernaout, Amira Fredj, Boualem Remini

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Suspended sediment transport is a serious problem worldwide, but it is much more worrying in certain regions of the world, as is the case in the Maghreb and more particularly in Algeria. It continues to take disturbing proportions in Northern Algeria due to the variability of rains in time and in space and constant deterioration of vegetation. Its prediction is essential in order to identify its intensity and define the necessary actions for its reduction. The purpose of this study is to analyze the concentration data of suspended sediment measured at Wadi El-Abtal Hydrometric Station. It also aims to find and highlight regressive power relationships, which can explain the suspended solid flow by the measured liquid flow. The study strives to find models of artificial neural networks linking the flow, month and precipitation parameters with solid flow. The obtained results show that the power function of the solid transport rating curve and the models of artificial neural networks are appropriate methods for analysing and estimating suspended sediment transport in Wadi Mina at Wadi El-Abtal Hydrometric Station. They made it possible to identify in a fairly conclusive manner the model of neural networks with four input parameters: the liquid flow Q, the month and the daily precipitation measured at the representative stations (Frenda 013002 and Ain El-Hadid 013004 ) of the watershed. The model thus obtained makes it possible to estimate the daily solid flows (interpolate and extrapolate) even beyond the period of observation of solid flows (1985/86 to 1999/00), given the availability of the average daily liquid flows and daily precipitation since 1953/1954.

Keywords: suspended sediment, concentration, regression, liquid flow, solid flow, artificial neural network, modeling, mina, algeria

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Authors: Etienne Gaborit, Dorothy Durnford, Daniel Deacu, Marco Carrera, Nathalie Gauthier, Camille Garnaud, Vincent Fortin

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A new experimental streamflow forecasting system was recently implemented at the Environment and Climate Change Canada’s (ECCC) Canadian Centre for Meteorological and Environmental Prediction (CCMEP). It relies on CaLDAS (Canadian Land Data Assimilation System) for the assimilation of surface variables, and on a surface prediction system that feeds a routing component. The surface energy and water budgets are simulated with the SVS (Soil, Vegetation, and Snow) Land-Surface Scheme (LSS) at 2.5-km grid spacing over Canada. The routing component is based on the Watroute routing scheme at 1-km grid spacing for the Great Lakes and Nelson River watersheds. The system is run in two distinct phases: an analysis part and a forecast part. During the analysis part, CaLDAS outputs are used to force the routing system, which performs streamflow assimilation. In forecast mode, the surface component is forced with the Canadian GEM atmospheric forecasts and is initialized with a CaLDAS analysis. Streamflow performances of this new system are presented over 2019. Performances are compared to the current ECCC’s operational streamflow forecasting system, which is different from the new experimental system in many aspects. These new streamflow forecasts are also compared to persistence. Overall, the new streamflow forecasting system presents promising results, highlighting the need for an elaborated assimilation phase before performing the forecasts. However, the system is still experimental and is continuously being improved. Some major recent improvements are presented here and include, for example, the assimilation of snow cover data from remote sensing, a backward propagation of assimilated flow observations, a new numerical scheme for the routing component, and a new reservoir model.

Keywords: assimilation system, distributed physical model, offline hydro-meteorological chain, short-term streamflow forecasts

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Authors: Ankur Chaudhuri, Sibani Sen Chakraborty

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In human, glutaminyl cyclase activity is highly abundant in neuronal and secretory tissues and is preferentially restricted to hypothalamus and pituitary. The N-terminal modification of β-amyloids (Aβs) peptides by the generation of a pyro-glutamyl (pGlu) modified Aβs (pE-Aβs) is an important process in the initiation of the formation of neurotoxic plaques in Alzheimer’s disease (AD). This process is catalyzed by glutaminyl cyclase (QC). The expression of QC is characteristically up-regulated in the early stage of AD, and the hallmark of the inhibition of QC is the prevention of the formation of pE-Aβs and plaques. A computer-aided drug design (CADD) process was employed to give an idea for the designing of potentially active compounds to understand the inhibitory potency against human glutaminyl cyclase (QC). This work elaborates the ligand-based and structure-based pharmacophore exploration of glutaminyl cyclase (QC) by using the known inhibitors. Three dimensional (3D) quantitative structure-activity relationship (QSAR) methods were applied to 154 compounds with known IC50 values. All the inhibitors were divided into two sets, training-set, and test-sets. Generally, training-set was used to build the quantitative pharmacophore model based on the principle of structural diversity, whereas the test-set was employed to evaluate the predictive ability of the pharmacophore hypotheses. A chemical feature-based pharmacophore model was generated from the known 92 training-set compounds by HypoGen module implemented in Discovery Studio 2017 R2 software package. The best hypothesis was selected (Hypo1) based upon the highest correlation coefficient (0.8906), lowest total cost (463.72), and the lowest root mean square deviation (2.24Å) values. The highest correlation coefficient value indicates greater predictive activity of the hypothesis, whereas the lower root mean square deviation signifies a small deviation of experimental activity from the predicted one. The best pharmacophore model (Hypo1) of the candidate inhibitors predicted comprised four features: two hydrogen bond acceptor, one hydrogen bond donor, and one hydrophobic feature. The Hypo1 was validated by several parameters such as test set activity prediction, cost analysis, Fischer's randomization test, leave-one-out method, and heat map of ligand profiler. The predicted features were then used for virtual screening of potential compounds from NCI, ASINEX, Maybridge and Chembridge databases. More than seven million compounds were used for this purpose. The hit compounds were filtered by drug-likeness and pharmacokinetics properties. The selective hits were docked to the high-resolution three-dimensional structure of the target protein glutaminyl cyclase (PDB ID: 2AFU/2AFW) to filter these hits further. To validate the molecular docking results, the most active compound from the dataset was selected as a reference molecule. From the density functional theory (DFT) study, ten molecules were selected based on their highest HOMO (highest occupied molecular orbitals) energy and the lowest bandgap values. Molecular dynamics simulations with explicit solvation systems of the final ten hit compounds revealed that a large number of non-covalent interactions were formed with the binding site of the human glutaminyl cyclase. It was suggested that the hit compounds reported in this study could help in future designing of potent inhibitors as leads against human glutaminyl cyclase.

Keywords: glutaminyl cyclase, hit lead, pharmacophore model, simulation

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Authors: Mattea Carmen Castrovilli, Antonella Cartoni

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Electrospray ionisation (ESI), a well-established technique widely used to produce ion beams of biomolecules in mass spectrometry (ESI-MS), can be used for ambient soft landing of enzymes on a specific substrate. In this work, we show how the ambient electrospray deposition (ESD) technique can be successfully exploited for manufacturing a promising, green-friendly electrochemical amperometric laccase-based biosensor with unprecedented reuse and storage performance. These biosensors have been manufactured by spraying a laccase solution of 2μg/μL at 20% of methanol on a commercial carbon screen printed electrode (C-SPE) using a custom ESD set-up. The laccase-based ESD biosensor has been tested against catechol compounds in the linear range 2-100 μM, with a limit of detection of 1.7 μM, without interference from cadmium, chrome, arsenic, and zinc and without any memory effects, but showing a matrix effect in lake and well water. The ESD biosensor shows enhanced performances compared to the ones fabricated with other immobilization methods, like drop-casting. Indeed, it retains 100% activity up to two months of storage at ambient conditions without any special care and working stability up to 63 measurements on the same electrode just prepared and 20 on a one-year-old electrode subjected to redeposition together with a 100% resistance to use of the same electrode in subsequent days. The ESD method is a one-step, environmentally friendly method that allows the deposition of the bio-recognition layer without using any additional chemicals. The promising results in terms of storage and working stability also obtained with the more fragile lactate oxidase enzyme suggest these improvements should be attributed to the ESD technique rather than to the bioreceptor, highlighting how the ESD could be useful in reducing pollution from disposable devices. Acknowledgment: The understanding at the molecular level of this promising biosensor by using different spectroscopies, microscopies and analytical techniques is the subject of our PRIN 2022 project ESILARANTE.

Keywords: reuse, storage performance, immobilization, electrospray deposition, biosensor, laccase, catechol detection, green chemistry

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Authors: Malgorzata Krysiak, Anna Wegrzyn, Maciej Garstka, Radoslaw Mazur

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Under constantly fluctuating environmental conditions, the thylakoid membrane protein network evolved the ability to dynamically respond to changing biotic and abiotic factors. One of the most important protective mechanism is rearrangement of the chlorophyll-protein (CP) complexes, induced by protein phosphorylation. In a temperate climate, low temperature is one of the abiotic stresses that heavily affect plant growth and productivity. The aim of this study was to determine the role of LHCII antenna complex phosphorylation in the dark-chilling response. The study included an experimental model based on dark-chilling at 4 °C of detached chilling sensitive (CS) runner bean (Phaseolus coccineus L.) and chilling tolerant (CT) garden pea (Pisum sativum L.) leaves. This model is well described in the literature as used for the analysis of chilling impact without any additional effects caused by light. We examined changes in thylakoid membrane protein phosphorylation, interactions between phosphorylated LHCII (P-LHCII) and CP complexes, and their impact on the dynamics of photosystem II (PSII) under dark-chilling conditions. Our results showed that the dark-chilling treatment of CS bean leaves induced a substantial increase of phosphorylation of LHCII proteins, as well as changes in CP complexes composition and their interaction with P-LHCII. The PSII photochemical efficiency measurements showed that in bean, PSII is overloaded with light energy, which is not compensated by CP complexes rearrangements. On the contrary, no significant changes in PSII photochemical efficiency, phosphorylation pattern and CP complexes interactions were observed in CT pea. In conclusion, our results indicate that different responses of the LHCII phosphorylation to chilling stress take place in CT and CS plants, and that kinetics of LHCII phosphorylation and interactions of P-LHCII with photosynthetic complexes may be crucial to chilling stress response. Acknowledgments: presented work was financed by the National Science Centre, Poland grant No.: 2016/23/D/NZ3/01276

Keywords: LHCII, phosphorylation, chilling stress, pea, runner bean

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Authors: Hesti Ghassani, Tessa Septiadi

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In the world we live on today, young generation highly influences the future of a nation. We have to concern that the condition of the country in 20 years later depending by the character of young adults these days. Therefore, it is important that we have to support and control the teenagers especially in one of developing countries in which I live in: Indonesia. Indonesia is a home to 240 million people. It diverse in languages, cultures, as well as attitudes. The differences among each individual lead us to think that there is something we have to take care of. It is necessary to pay attention to the nutrition consumed by the nation. We initiate to control the food consumed by young generation as early as a primary students. Nutrition affects the immune of the body, neuron system, and, most importantly brain. One of the nutrition that has to be fulfilled is milk. However, most of the population in Indonesia isn’t aware of the importance of consuming milk as their daily basis. We’ve formed an innovation called the Brilliant Candy which is affordable and rich in nutrition. So that is why the paper made by literature study to solve the problem with effective ways using available resources, practice and cheap. Brilliant Candy consists of Centella asiatica extract mixed with Soy milk. Centella asiatica contains of alkaloid which give the energy to brain and circulate oxygen. Based on the research of Sathya and Ganga, Centella asiatica can increase the intelligence. Indeed, Centella asiatica can relieve stress, and help us in staying focus. Soy milk is a kind of milk which come from extracted soybean. Soybean is rich in flafonoid. It has various advantages for our body. Which can also support child nutrition consumed. Soybean boosts immune system, helps digestive system, and in terms of food, soy bean exists as a source of nutrition. A method to get extraction of Centella asiatica is namely maserasi using ethanol. While making soybean milk with got the pollen of soybean. Both materials get mixed processed into hard candy with congelation of.

Keywords: Indonesia, Centella asiatica, Soy milk, alkaloid, flafonoid

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Authors: K. R. Sreenivas, Shaurya Kaushal

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After sunset, under calm & clear-sky nocturnal conditions, the air layer near the surface containing aerosols cools through radiative processes to the upper atmosphere. Due to this cooling, surface air-layer temperature can fall 2-6 degrees C lower than the ground-surface temperature. This unstable convection layer, on the top, is capped by a stable inversion-boundary layer. Radiative divergence, along with the convection within the surface layer, governs the vertical transport of heat and moisture. Micro-physics in this layer have implications for the occurrence and growth of the fog layer. This particular configuration, featuring a convective mixed layer beneath a stably stratified inversion layer, exemplifies a classic case of penetrative convection. In this study, we conduct numerical simulations of the penetrative convection phenomenon within the nocturnal atmospheric surface layer and elucidate its relevance to the dynamics of fog layers. We employ field and laboratory measurements of aerosol number density to model the strength of the radiative cooling. Our analysis encompasses horizontally averaged, vertical profiles of temperature, density, and heat flux. The energetic incursion of the air from the mixed layer into the stable inversion layer across the interface results in entrainment and the growth of the mixed layer, modeling of which is the key focus of our investigation. In our research, we ascertain the appropriate length scale to employ in the Richardson number correlation, which allows us to estimate the entrainment rate and model the growth of the mixed layer. Our analysis of the mixed layer and the entrainment zone reveals a close alignment with previously reported laboratory experiments on penetrative convection. Additionally, we demonstrate how aerosol number density influences the growth or decay of the mixed layer. Furthermore, our study suggests that the presence of fog near the ground surface can induce extensive vertical mixing, a phenomenon observed in field experiments.

Keywords: inversion layer, penetrative convection, radiative cooling, fog occurrence

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Authors: Md. Asif Ullah, M. A. R. Sarkar

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This paper illustrates 2-D and 3-D simulations of sub-channels of a Pressurized Water Reactor (PWR) having hexagonal array of fuel rods. At a steady state, the temperature of outer surface of the cladding of fuel rod is kept about 1200°C. The temperature of this isothermal surface is taken as boundary condition for simulation. Water with temperature of 290°C is given as a coolant inlet to the primary water circuit which is pressurized upto 157 bar. Turbulent flow of pressurized water is used for heat removal. In 2-D model, temperature, velocity, pressure and Nusselt number distributions are simulated in a vertical sectional plane through the sub-channels of a hexagonal fuel rod assembly. Temperature, Nusselt number and Y-component of convective heat flux along a line in this plane near the end of fuel rods are plotted for different Reynold’s number. A comparison between X-component and Y-component of convective heat flux in this vertical plane is analyzed. Hexagonal fuel rod assembly has three types of sub-channels according to geometrical shape whose boundary conditions are different too. In 3-D model, temperature, velocity, pressure, Nusselt number, total heat flux magnitude distributions for all the three sub-channels are studied for a suitable Reynold’s number. A horizontal sectional plane is taken from each of the three sub-channels to study temperature, velocity, pressure, Nusselt number and convective heat flux distribution in it. Greater values of temperature, Nusselt number and Y-component of convective heat flux are found for greater Reynold’s number. X-component of convective heat flux is found to be non-zero near the bottom of fuel rod and zero near the end of fuel rod. This indicates that the convective heat transfer occurs totally along the direction of flow near the outlet. As, length to radius ratio of sub-channels is very high, simulation for a short length of the sub-channels are done for graphical interface advantage. For the simulations, Turbulent Flow (K-Є ) module and Heat Transfer in Fluids (ht) module of COMSOL MULTIPHYSICS 5.0 are used.

Keywords: sub-channels, Reynold’s number, Nusselt number, convective heat transfer

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Authors: Carolina Payares-Asprino

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Dual-phase duplex stainless steel comprised of ferrite and austenite has shown high strength and corrosion resistance in many aggressive environments. Joining duplex alloys is challenging due to several embrittling precipitates and metallurgical changes during the welding process. The welding parameters strongly influence the quality of a weld joint. Therefore, it is necessary to quantify the weld bead’s integral properties as a function of welding parameters, especially when part of the weld bead is removed through a machining process due to aesthetic reasons or to couple the elements in the in-service structure. The present study uses the existing stress-strain model to predict the stress-strain curves for duplex stainless-steel welds under different welding conditions. Having mathematical expressions that predict the shape of the stress-strain curve is advantageous since it reduces the experimental work in obtaining the tensile test. In analysis and design, such stress-strain modeling simplifies the time of operations by being integrated into calculation tools, such as the finite element program codes. The elastic zone and the plastic zone of the curve can be defined by specific parameters, generating expressions that simulate the curve with great precision. There are empirical equations that describe the stress-strain curves. However, they only refer to the stress-strain curve for the stainless steel, but not when the material is under the welding process. It is a significant contribution to the applications of duplex stainless steel welds. For this study, a 3x3 matrix with a low, medium, and high level for each of the welding parameters were applied, giving a total of 27 weld bead plates. Two tensile specimens were manufactured from each welded plate, resulting in 54 tensile specimens for testing. When evaluating the four models used to predict the stress-strain curve in the welded specimens, only one model (Rasmussen) presented a good correlation in predicting the strain stress curve.

Keywords: duplex stainless steels, modeling, stress-stress curve, tensile test, welding

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Authors: G. Judakova, M. Bause

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The ability to model and simulate numerically natural gas flow in pipelines has become of high importance for the design of pipeline systems. The understanding of the formation of hydrate particles and their dynamical behavior is of particular interest, since these processes govern the operation properties of the systems and are responsible for system failures by clogging of the pipelines under certain conditions. Mathematically, natural gas flow can be described by multiphase flow models. Using the two-fluid modeling approach, the gas phase is modeled by the compressible Euler equations and the particle phase is modeled by the pressureless Euler equations. The numerical simulation of compressible multiphase flows is an important research topic. It is well known that for nonlinear fluxes, even for smooth initial data, discontinuities in the solution are likely to occur in finite time. They are called shock waves or contact discontinuities. For hyperbolic and singularly perturbed parabolic equations the standard application of the Galerkin finite element method (FEM) leads to spurious oscillations (e.g. Gibb's phenomenon). In our approach, we use stabilized FEM, the streamline upwind Petrov-Galerkin (SUPG) method, where artificial diffusion acting only in the direction of the streamlines and using a special treatment of the boundary conditions in inviscid convective terms, is added. Numerical experiments show that the numerical solution obtained and stabilized by SUPG captures discontinuities or steep gradients of the exact solution in layers. However, within this layer the approximate solution may still exhibit overshoots or undershoots. To suitably reduce these artifacts we add a discontinuity capturing or shock capturing term. The performance properties of our numerical scheme are illustrated for two-phase flow problem.

Keywords: two-phase flow, gas-particle mixture, inviscid two-fluid model, euler equation, finite element method, streamline upwind petrov-galerkin, shock capturing

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Authors: Riccardo Patriarca, Giulio Di Gravio, Francesco Costantino, Massimo Tronci

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An accurate inventory management policy acquires a crucial role in the several high-availability sectors. In these sectors, due to the high-cost of spares and backorders, an (S-1, S) replenishment policy is necessary for high-availability items. The policy enables the shipment of a substitute efficient item anytime the inventory size decreases by one. This policy can be modelled following the Multi-Echelon Technique for Recoverable Item Control (METRIC). The METRIC is a system-based technique that allows defining the optimum stock level in a multi-echelon network, adopting measures in line with the decision-maker’s perspective. The METRIC defines an availability-cost function with inventory costs and required service levels, using as inputs data about the demand trend, the supplying and maintenance characteristics of the network and the budget/availability constraints. The traditional METRIC relies on the hypothesis that a Poisson distribution well represents the demand distribution in case of items with a low failure rate. However, in this research, we will explore the effects of using a Poisson distribution to model the demand of low failure rate items characterized by an irregular demand trend. This characteristic of a demand is not included in the traditional METRIC formulation leading to the need of revising its traditional formulation. Using the CV (Coefficient of Variation) and ADI (Average inter-Demand Interval) classification, we will define the inherent flaws of Poisson-based METRIC for irregular demand items, defining an innovative ad hoc distribution which can better fit the irregular demands. This distribution will allow defining proper stock levels to reduce stocking and backorder costs due to the high irregularities in the demand trend. A case study in the aviation domain will clarify the benefits of this innovative METRIC approach.

Keywords: METRIC, inventory management, irregular demand, spare parts

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Authors: R. Gwynn, P. Panwalkar, K. Veravalli , M. Tofighi, R. Clement, A. Mofidi

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The aim of this study was to access the impact of Covid-19 and lockdown on the incidence, injury pattern, and treatment of tibial plateau fractures in a combined rural and urban population in wales. Methods: Retrospective study was performed to identify tibial plateau fractures in 15-month period of Covid-19 lockdown 15-month period immediately before lockdown. Patient demographics, injury mechanism, injury severity (based on Schatzker classification), and associated injuries, treatment methods, and outcome of fractures in the Covid-19 period was studied. Results: The incidence oftibial plateau fracture was 9 per 100000 during Covid-19, and 8.5 per 100000, and both were similar to previous studies. The average age was 52, and female to male ratio was 1:1 in both control and study group. High energy injury was seen in only 20% of the patients and 35% in the control groups (2=12, p<0025). 14% of the covid-19 population sustained other injuries as opposed 16% in the control group(2=0.09, p>0.95). Lower severity isolated lateral condyle fracturesinjury (Schatzker 1-3) were seen in 40% of fractures this was 60% in the control populations. Higher bicondylar and shaft fractures (Schatzker 5-6) were seen in 60% of the Covid-19 group and 35% in the control groups(2=7.8, p<0.02). Treatment mode was not impacted by Covid-19. The complication rate was low in spite of higher number of complex fractures and the impact of covid-19 pandemic. Conclusion: The associated injuries were similar in spite of a significantly lower mechanism of injury. There were unexpectedly worst tibial plateau fracture based Schatzker classification in the Covid-19 period as compared to the control groups. This was especially relevant for medial condyle and shaft fractures. This was postulated to be caused by reduction in bone density caused by lack of vitamin D and reduction in activity. The treatment mode and outcome was not impacted by the impact of Covid-19 on care for tibial plateau fractures.

Keywords: Covid-19, knee, tibial plateau fracture, trauma

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Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Dóris F. Rabelo

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Some patients with COVID-19 disease and difficult airway characteristics undergo to endotracheal intubation (ETI) procedure. The tracheal introducer, known as the bougie guide, can aid ETI in patients with difficult airway pattern. Realistic simulation (RS) is a methodology utilized for healthcare professionals training. To improve skills in using the bougie guide of physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was carried out. Simulated scenario included the Nasco Lifeform realistic simulator for ETI and a bougie guide introducer. Training was a capacitation program organized by the Health Department of Bahia State. Objective: To report effects in participants´ self-confidence perception for using bougie guide after a RS based training. Methods: Descriptive study, secondary data extracted from questionnaires. Priority workplace and previous knowledge about bougie were reported on a preparticipation formulary. Participants also completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding to self-confidence in using bougie guide. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's exact test. Results: From May to June 2020 a total of 36 physicians participated of training, 25 (69%) from primary care setting, 32 (89%) with no previous knowledge about the bougie guide utilization. For those who had previous knowledge about bougie pre-training self-confidence median was 6,5, and 2 for participants who had not. In overall there was an increase in self-confidence median for bougie utilization. Median (variation) before and after training was 2.5 (1-7) vs. 8 (4-10) (p <0.0001). Among those who had no previous knowledge about bougie (n = 32) an increase in self-confidence greater than 3 points for bougie utilization was reported by 31 vs. 1 participants (p = 0.71). Conclusions: Most of participants had no previous knowledge about using the bougie guide. RS training contributed to self-confidence increase for using bougie for ETI procedure. RS methodology can contribute for training in using the bougie guide for ETI procedure during COVID-19 outbreak.

Keywords: bougie, confidence, COVID-19, endotracheal intubation, realistic simulation

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Authors: S. M. C. Kelly, A. Hargreaves, S. Hargreaves

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Introduction: The Can’t intubate, Can’t ventilate emergency scenario is one which has been shown to be managed badly in the past. Reasons identified included gaps in knowledge of the procedure and the emergency equipment used. We aimed to show an increase in confidence amongst anesthetists and operating department practitioners in the technique following a short tea trolley style teaching intervention. Methods: We carried out the teaching on a one-to-one basis. Two Anaesthetists visited each operating theatre during normal working days. One carried out the teaching session and one took over the intra‐operative care of the patient, releasing the listed anaesthetist for a short teaching session. The teaching was delivered to mixture of students and healthcare professionals, both anaesthetists and anaesthetic practitioners. The equipment includes a trolley, an airway manikin, size 10 scalpel, bougie and size 6.0 tracheal tube. The educator discussed the equipment, performed a demonstration and observed the participants performing the procedure. We asked each person to fill out a pre and post teaching questionnaire, stating their confidence with the procedure. Results: The teaching was delivered to 63 participants in total, which included 21 consultant anaesthetists, 23 trainee doctors and 19 anaesthetic practitioners. The teaching sessions lasted on average 9 minutes (range 5– 15 minutes). All participants reported an increase in confidence in both the equipment and technique in front of neck access. Anaesthetic practitioners reported the greatest increase in confidence (53%), with trainee anaesthetists reporting 27% increase and consultant anaesthetists 22%. Overall, confidence in the performance of emergency front of neck access increased by 31% after the teaching session. Discussion: Short ‘Trolley style’ teaching improves confidence in the equipment and technique used for the emergency front of neck access. This is true for students and for consultant anaesthetists. This teaching style is quick with minimal running costs and is relevant for all anesthetic departments.

Keywords: airway teaching, can't intubate can't ventilate, cricothyroidotomy, front-of-neck

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