Search results for: point of care testing (POCT)

Authors: Lesley Northrop, Justin DeGrazia, Jessica Greenwood

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ASPIRA Labs now offers an en-suit and ready-to-implement technology transfer solution to enable labs and hospitals that lack the resources to build it themselves to offer in-house genetic testing. This unique platform employs a patented Molecular Inversion Probe (MIP) technology that combines the specificity of a hybrid capture protocol with the ease of an amplicon-based protocol and utilizes an advanced bioinformatics analysis pipeline based on machine learning. To demonstrate its efficacy, two independent genetic tests were validated on this technology transfer platform: expanded carrier screening (ECS) and hereditary cancer testing (HC). The analytical performance of ECS and HC was validated separately in a blinded manner for calling three different types of variants: SNVs, short indels (typically, <50 bp), and large indels/CNVs defined as multi-exonic del/dup events. The reference set was constructed using samples from Coriell Institute, an external clinical genetic testing laboratory, Maine Molecular Quality Controls Inc. (MMQCI), SeraCare and GIAB Consortium. Overall, the analytical performance showed a sensitivity and specificity of >99.4% for both ECS and HC in detecting SNVs. For indels, both tests reported specificity of 100%, and ECS demonstrated a sensitivity of 100%, whereas HC exhibited a sensitivity of 96.5%. The bioinformatics pipeline also correctly called all reference CNV events resulting in a sensitivity of 100% for both tests. No additional calls were made in the HC panel, leading to a perfect performance (specificity and F-measure of 100%). In the carrier panel, however, three additional positive calls were made outside the reference set. Two of these calls were confirmed using an orthogonal method and were re-classified as true positives leaving only one false positive. The pipeline also correctly identified all challenging carrier statuses, such as positive cases for spinal muscular atrophy and alpha-thalassemia, resulting in 100% sensitivity. After confirmation of additional positive calls via long-range PCR and MLPA, specificity for such cases was estimated at 99%. These performance metrics demonstrate that this tech-transfer solution can be confidently internalized by clinical labs and hospitals to offer mainstream ECS and HC as part of their test catalog, substantially increasing access to quality germline genetic testing for labs of all sizes and resources levels.

Keywords: clinical genetics, genetic testing, molecular genetics, technology transfer

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Authors: Michele L. Tilstra, Tiffany J. Peets

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Interprofessional collaboration in behavioral healthcare education is increasingly recognized for its value in training students to address diverse client needs. While interprofessional education (IPE) is well-documented in occupational therapy education to address physical health, limited research exists on collaboration with counselors to address mental health concerns and the psychosocial needs of individuals receiving care. Counseling education literature primarily examines the collaboration of counseling students with psychiatrists, psychologists, social workers, and marriage and family therapists. This pretest/posttest survey research study explored changes in attitudes toward interprofessional teams among 56 Master of Occupational Therapy (MOT) (n = 42) and Counseling and Human Development (CHD) (n = 14) students participating in the Counselors and Occupational Therapists Professionally Engaged in the Community (COPE) program. The COPE program was designed to strengthen the behavioral health workforce in high-need and high-demand areas. Students accepted into the COPE program were divided into small MOT/CHD groups to complete multiple interprofessional multicultural learning modules using videos, case studies, and online discussion board posts. The online modules encouraged reflection on various behavioral healthcare roles, benefits of team-based care, cultural humility, current mental health challenges, personal biases, power imbalances, and advocacy for underserved populations. Using the Student Perceptions of Interprofessional Clinical Education- Revision 2 (SPICE-R2) scale, students completed pretest and posttest surveys using a 5-point Likert scale (Strongly Agree = 5 to Strongly Disagree = 1) to evaluate their attitudes toward interprofessional teamwork and collaboration. The SPICE-R2 measured three different factors: interprofessional teamwork and team-based practice (Team), roles/responsibilities for collaborative practice (Roles), and patient outcomes from collaborative practice (Outcomes). The mean total scores for all students improved from 4.25 (pretest) to 4.43 (posttest), Team from 4.66 to 4.58, Roles from 3.88 to 4.30, and Outcomes from 4.08 to 4.36. A paired t-test analysis for the total mean scores resulted in a t-statistic of 2.54, which exceeded both one-tail and two-tail critical values, indicating statistical significance (p = .001). When the factors of the SPICE-R2 were analyzed separately, only the Roles (t Stat=4.08, p =.0001) and Outcomes (t Stat=3.13, p = .002) were statistically significant. The item ‘I understand the roles of other health professionals’ showed the most improvement from a mean score for all students of 3.76 (pretest) to 4.46 (posttest). The significant improvement in students' attitudes toward interprofessional teams suggests that the unique integration of OT and CHD students in the COPE program effectively develops a better understanding of the collaborative roles necessary for holistic client care. These results support the importance of IPE through structured, engaging interprofessional experiences. These experiences are essential for enhancing students' readiness for collaborative practice and align with accreditation standards requiring interprofessional education in OT and CHD programs to prepare practitioners for team-based care. The findings contribute to the growing body of evidence supporting the integration of IPE in behavioral healthcare curricula to improve holistic client care and encourage students to engage in collaborative practice across healthcare settings.

Keywords: behavioral healthcare, counseling education, interprofessional education, mental health education, occupational therapy education

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Authors: Rasouli Divkalaee Zeinab, Kalteh Safa, Roudbari Aliakbar

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Introduction: Medical waste can lead to the generation and transmission of many infectious and contagious diseases due to the presence of pathogenic agents, thereby necessitating the need for special management to collect, decontaminate, and finally dispose of such products. This study aimed to design a centralized health care (medical) waste management program for the cities of Semnan, Mahdishahr, and Shahmirzad. Methods: This descriptive-analytical study was conducted for six months in the cities of Semnan, Mahdishahr, and Shahmirzad. In this study, the quantitative and qualitative characteristics of the generated wastes were determined by taking samples from all medical waste production centers. Then, the equipment, devices, and machines required for separate collection of the waste from the production centers and for their subsequent decontamination were estimated. Next, the investment costs, current costs, and working capital required for collection, decontamination, and final disposal of the wastes were determined. Finally, the payment for proper waste management of each category of medical waste-producing centers was determined. Results: 1021 kilograms of medical waste are produced daily in the cities of Semnan, Mahdishahr, and Shahmirzad. It was estimated that a 1000-liter autoclave, a machine for collecting medical waste, four 60-liter bins, four 120-liter bins, and four 1200-liter bins were required for implementing the study plan. Also, the estimated total annual medical waste management costs for Semnan City were determined (23,283,903,720 Iranian Rials). Conclusion: The study results showed that establishing a proper management system for medical wastes generated in the three studied cities will cost between 334,280 and 1,253,715 Iranian Rials in fees for the medical centers. The findings of this study provided comprehensive data regarding medical wastes from the generation point to the landfill site, which is vital for the government and the private sector.

Keywords: clinics, decontamination, management, medical waste

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Authors: Linda Blümel, Bettina Bert, Jan Brosda, Heidrun Fink, Melanie Hamann

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Age-related cognitive decline can eventually lead to dementia, the most common mental illness in elderly people and an immense challenge for patients, their families and caregivers. Cholinesterase inhibitors constitute the most commonly used antidementia prescription medication. The standardized Ginkgo biloba leaf extract EGb 761® is approved for treating age-associated cognitive impairment and has been shown to improve the quality of life in patients suffering from mild dementia. A clinical trial with 96 Alzheimer´s disease patients indicated that the combined treatment with donepezil and EGb 761® had fewer side effects than donepezil alone. In an animal model of cognitive aging, we compared the effect of combined treatment with EGb 761® or donepezil monotherapy and vehicle. We compared the effect of chronic treatment (15 days of pretreatment) with donepezil (1.5 mg/kg p. o.), EGb 761® (100 mg/kg p. o.), or the combination of the two drugs, or vehicle in 18 – 20 month old male OFA rats. Learning and memory performance were assessed by Morris water maze testing, motor behavior in an open field paradigm. In addition to chronic treatment, the substances were administered orally 30 minutes before testing. Compared to the first day and to the control group, only the combination group showed a significant reduction in latency to reach the hidden platform on the second day of testing. Moreover, from the second day of testing onwards, the donepezil, the EGb 761® and the combination group required less time to reach the hidden platform compared to the first day. The control group did not reach the same latency reduction until day three. There were no effects on motor behavior. These results suggest a superiority of the combined treatment of donepezil with EGb 761® compared to monotherapy.

Keywords: age-related cognitive decline, dementia, ginkgo biloba leaf extract EGb 761®, learning and memory, old rats

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Authors: M. Mohsin Munir, Taimoor Ahmad, Javed Munir, Usman Rashid

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Determination of maximum elevation of a flowing fluid due to sudden rejection of load in a hydropower facility is of great interest to hydraulic engineers to ensure safety of the hydraulic structures. Several mathematical models exist that employ one-dimensional modeling for the determination of surge but none of these perfectly simulate real-time circumstances. The paper envisages investigation of surge inception and propagation for a Low Head Hydropower project using Computational Fluid Dynamics (CFD) analysis on FLOW-3D software package. The fluid dynamic model utilizes its analysis for surge by employing Reynolds’ Averaged Navier-Stokes Equations (RANSE). The CFD model is designed for a case study at Taunsa hydropower Project in Pakistan. Various scenarios have run through the model keeping in view upstream boundary conditions. The prototype results were then compared with the results of physical model testing for the same scenarios. The results of the numerical model proved quite accurate coherence with the physical model testing and offers insight into phenomenon which are not apparent in physical model and shall be adopted in future for the similar low head projects limiting delays and cost incurred in the physical model testing.

Keywords: surge, FLOW-3D, numerical model, Taunsa, RANSE

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Authors: Yixun Shi

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Many interior point methods for convex programming solve an (n+m)x(n+m)linear system in each iteration. Many implementations solve this system in each iteration by considering an equivalent mXm system (4) as listed in the paper, and thus the job is reduced into solving the system (4). However, the system(4) has to be solved exactly since otherwise the error would be entirely passed onto the last m equations of the original system. Often the Cholesky factorization is computed to obtain the exact solution of (4). One Cholesky factorization is to be done in every iteration, resulting in higher computational costs. In this paper, two iterative methods for solving linear systems using vector division are combined together and embedded into interior point methods. Instead of computing one Cholesky factorization in each iteration, it requires only one Cholesky factorization in the entire procedure, thus significantly reduces the amount of computation needed for solving the problem. Based on that, a hybrid algorithm for solving convex programming problems is proposed.

Keywords: convex programming, interior point method, linear systems, vector division

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Authors: Heba Salama, Barry Gibson, Jennifer Burr

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Introduction: It is often argued that better oral health leads to better wellbeing, and the goal of dental care is to improve wellbeing. Notwithstanding, to our best knowledge, there is a lack of evidence to support the relationship between oral health and wellbeing. Aim: The scoping review aims to examine current definitions of health and wellbeing as well as map the evidence to examine the relationship between oral health and wellbeing. Methods: The scoping review followed the Preferred Reporting Items for Systematic Reviews Extension for Scoping Review (PRISMA-ScR). A two-phase search strategy was followed because of the unmanageable number of hits returned. The first phase was to identify how well-being was conceptualised in oral health literacy, and the second phase was to search for extracted keywords. The extracted keywords were searched in four databases: PubMed, CINAHL, PsycINFO, and Web of Science. To limit the number of studies to a manageable amount, the search was limited to the open-access studies that have been published in the last five years (from 2018 to 2022). Results: Only eight studies (0.1%) of the 5455 results met the review inclusion criteria. Most of the included studies defined wellbeing based on the hedonic theory. And the Satisfaction with Life Scale is the most used. Although the research results are inconsistent, it has generally been shown that there is a weak or no association between oral health and wellbeing. Interpretation: The review revealed a very important point about how oral health literature uses loose definitions that have significant implications for empirical research. That results in misleading evidence-based conclusions. According to the review results, improving oral health is not a key factor in improving wellbeing. It appears that investing in oral health care to improve wellbeing is not a top priority to tell policymakers about. This does not imply that there should be no investment in oral health care to improve oral health. That could have an indirect link to wellbeing by eliminating the potential oral health-related barriers to quality of life that could represent the foundation of wellbeing. Limitation: Only the most recent five years (2018–2022), peer-reviewed English-language literature, and four electronic databases were included in the search. These restrictions were put in place to keep the volume of literature at a manageable level. This suggests that some significant studies might have been omitted. Furthermore, the study used a definition of wellbeing that is currently being evolved and might not everyone agrees with it. Conclusion: Whilst it is a ubiquitous argument that oral health is related to wellbeing, and this seems logical, there is little empirical evidence to support this claim. This question, therefore, requires much more detailed consideration. Funding: This project was funded by the Ministry of Higher Education and Scientific Research in Libya and Tripoli University.

Keywords: oral health, wellbeing, satisfaction, emotion, quality of life, oral health related quality of life

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Authors: J. Alcisto, M. Papakyriakou, J. Guerra, A. Dominguez, M. Miller, J. Foyos, E. Jones, N. Ula, M. Hahn, L. Zeng, Y. Li, O. S. Es-Said

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Current methods of testing for hydrogen charging are slow and time consuming. The objective of this paper was to determine if hydrogen charging can be detected quantitatively through the use of Charpy Impact (CI) testing. CI is a much faster and simpler process than current methods for detecting hydrogen charging. Steel plates were Electro Discharge Machined (EDM) into ninety-six 4340 steel CI samples and forty-eight tensile bars. All the samples were heat treated at 900°C to austentite and then rapidly quenched in water to form martensite. The samples were tempered at eight different target strengths/target temperatures (145, 160, 170, 180, 190, 205, 220, to 250KSI, thousands of pounds per square inch)/(1100, 1013, 956, 898, 840, 754, 667, 494 degrees Celsius). After a tedious process of grinding and machining v-notches to the Charpy samples, they were divided into four groups. One group was kept as received baseline for comparison while the other three groups were sent to Alcoa (Fasteners) Inc. in Torrance to be cadmium coated. The three groups were coated with three thicknesses (2, 3 and 5 mils). That means that the samples were charged with ascending hydrogen levels. The samples were CI tested and tensile tested, and the data was tabulated and compared to the baseline group of uncharged samples of the same material. The results of this study were successful and indicated that CI testing was able to quantitatively detect hydrogen charging.

Keywords: Charpy impact toughness, hydrogen charging, 4340 steel, Electro Discharge Machined (EDM)

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Authors: Michael Josef Schwerer

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Background: Analyzing any aircraft accident is mandatory based on the regulations of the International Civil Aviation Organization and the respective country’s criminal prosecution authorities. Legal medicine investigations are unavoidable when fatalities involve the flight crew or when doubts arise concerning the pilot’s aeromedical health status before the event. As a result of frequently tremendous blunt and sharp force trauma along with the impact of the aircraft to the ground, consecutive blast or fire exposition of the occupants or putrefaction of the dead bodies in cases of delayed recovery, relevant findings can be masked or destroyed and therefor being inaccessible in standard pathology practice comprising just forensic autopsy and histopathology. Such cases are of considerable risk of remaining unsolved without legal consequences for those responsible. Further, no lessons can be drawn from these scenarios to improve flight safety and prevent future mishaps. Aims and Methods: To learn from previously unsolved aircraft accidents, re-evaluations of the investigation files and modern molecular pathology studies were performed. Genetic testing involved predominantly PCR-based analysis of gene regulation, studying DNA promotor methylations, RNA transcription and posttranscriptional regulation. In addition, the presence or absence of infective agents, particularly DNA- and RNA-viruses, was studied. Technical adjustments of molecular genetic procedures when working with archived sample material were necessary. Standards for the proper interpretation of the respective findings had to be settled. Results and Discussion: Additional molecular genetic testing significantly contributes to the quality of forensic pathology assessment in aviation mishaps. Previously undetected cardiotropic viruses potentially explain e.g., a pilot’s sudden incapacitation resulting from cardiac failure or myocardial arrhythmia. In contrast, negative results for infective agents participate in ruling out concerns about an accident pilot’s fitness to fly and the aeromedical examiner’s precedent decision to issue him or her an aeromedical certificate. Care must be taken in the interpretation of genetic testing for pre-existing diseases such as hypertrophic cardiomyopathy or ischemic heart disease. Molecular markers such as mRNAs or miRNAs, which can establish these diagnoses in clinical patients, might be misleading in-flight crew members because of adaptive changes in their tissues resulting from repeated mild hypoxia during flight, for instance. Military pilots especially demonstrate significant physiological adjustments to their somatic burdens in flight, such as cardiocirculatory stress and air combat maneuvers. Their non-pathogenic alterations in gene regulation and expression will likely be misinterpreted for genuine disease by inexperienced investigators. Conclusions: The growing influence of molecular pathology on legal medicine practice has found its way into aircraft accident investigation. As appropriate quality standards for laboratory work and data interpretation are provided, forensic genetic testing supports the medico-legal analysis of aviation mishaps and potentially reduces the number of unsolved events in the future.

Keywords: aviation medicine, aircraft accident investigation, forensic pathology, molecular pathology

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Authors: Saeedeh Bakhtiari, Johannes Depessemier, Stijn Hertelé, Wim De Waele

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High cycle fatigue comprising up to 10⁷ load cycles has been the subject of many studies, and the behavior of many materials was recorded adequately in this regime. However, many applications involve larger numbers of load cycles during the lifetime of machine components. In this ultra-high cycle regime, other failure mechanisms play, and the concept of a fatigue endurance limit (assumed for materials such as steel) is often an oversimplification of reality. When machine component design demands a high geometrical complexity, cast iron grades become interesting candidate materials. Grey cast iron is known for its low cost, high compressive strength, and good damping properties. However, the ultra-high cycle fatigue behavior of cast iron is poorly documented. The current work focuses on the ultra-high cycle fatigue behavior of EN-GJL-250 (GG25) grey cast iron by developing an ultrasonic (20 kHz) fatigue testing system. Moreover, the testing machine is instrumented to measure the temperature and the displacement of  the specimen, and to control the temperature. The high resonance frequency allowed to assess the  behavior of the cast iron of interest within a matter of days for ultra-high numbers of cycles, and repeat the tests to quantify the natural scatter in fatigue resistance.

Keywords: GG25, cast iron, ultra-high cycle fatigue, ultrasonic test

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Authors: Roya Moradifar, Naser Agharezaee

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In this paper corrosion in the liquid sulphur storage tank at South pars gas complex phases 2&3 is presented. This full hot insulated field-erected storage tanks are used for the temporary storage of 1800m3 of molten sulphur. Sever corrosion inside the tank roof was observed during over haul inspections, in the direction of roof gradient. Investigation shown, in spite of other parts of tank there was no insulation around these manholes. Internal steam coils do not maintain a sufficiently high tank roof temperature in the vapor space. Sulphur and formation of liquid water at cool metal surface, this combination leads to the formation of iron sulfide. By employing a distributed external heating system, the temperatures of any point of the tank roof should be based on ambient dew point and the liquid storage solidification point. Also other construction and operation of tank is more important. This paper will review potential corrosion mechanism and operational case study which illustrate the importance of heating systems.

Keywords: tank, steam, corrosion, sulphur

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Authors: Andreas Aceranti, Guido Bighiani, Francesca Crotto, Marco Colorato, Stefania Zaghi, Marino Zanetti, Simonetta Vernocchi

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The management of eye parameters such as convergence, accommodation, and miosis is very complex; in fact, both the neurovegetative system and the complex Oculocephalgiria system come into play. We have found the effectiveness of the "highvelocity low amplitude" technique directed on C7-T1 (where the cilio-spinal nucleus of the budge is located) in improving the convergence parameter through the measurement of the point of maximum convergence. With this research, we set out to investigate whether the improvement obtained through the High Velocity Low Amplitude maneuver lasts over time, carrying out a pre-manipulation measurement, one immediately after manipulation and one month after manipulation. We took a population of 30 subjects with both refractive and non-refractive problems. Of the 30 patients tested, 27 gave a positive result after the High Velocity Low Amplitude maneuver, giving an improvement in the point of maximum convergence. After a month, we retested all 27 subjects: some further improved the result, others kept, and three subjects slightly lost the gain obtained. None of the re-tested patients returned to the point of maximum convergence starting pre-manipulation. This result opens the door to a multidisciplinary approach between ophthalmologists and osteopaths with the aim of addressing oculomotricity and convergence deficits that increasingly afflict our society due to the massive use of devices and for the conduct of life in closed and restricted environments.

Keywords: point of maximum convergence, HVLA, improvement in PPC, convergence

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Wei-Chih Huang, Pei-Lung Chung, Ching-Heng Lin, Hsuan-Chia Yang, Der-Ming Liou

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Background: In-Hospital Cardiac Arrest (IHCA) threaten life of the inpatients, cause serious effect to patient safety, quality of inpatients care and hospital service. Health providers must identify the signs of IHCA early to avoid the occurrence of IHCA. This study will consider the potential association between early signs of IHCA and the essence of patient care provided by nurses and other professionals before an IHCA occurs. The aim of this study is to identify significant associations between nursing interventions and abnormal early evaluation results of IHCA that can assist health care providers in monitoring inpatients at risk of IHCA to increase opportunities of IHCA early detection and prevention. Materials and Methods: This study used one of the data mining techniques called association rules mining to compute associations between nursing interventions and abnormal early evaluation results of IHCA. The nursing interventions and abnormal early evaluation results of IHCA were considered to be co-occurring if nursing interventions were provided within 24 hours of last being observed in abnormal early evaluation results of IHCA. The rule based methods were utilized 23.6 million electronic medical records (EMR) from a medical center in Taipei, Taiwan. This dataset includes 733 concepts of nursing interventions that coded by clinical care classification (CCC) codes and 13 early evaluation results of IHCA with binary codes. The values of interestingness and lift were computed as Q values to measure the co-occurrence and associations’ strength between all in-hospital patient care measures and abnormal early evaluation results of IHCA. The associations were evaluated by comparing the results of Q values and verified by medical experts. Results and Conclusions: The results show that there are 4195 pairs of associations between nursing interventions and abnormal early evaluation results of IHCA with their Q values. The indication of positive association is 203 pairs with Q values greater than 5. Inpatients with high blood sugar level (hyperglycemia) have positive association with having heart rate lower than 50 beats per minute or higher than 120 beats per minute, Q value is 6.636. Inpatients with temporary pacemaker (TPM) have significant association with high risk of IHCA, Q value is 47.403. There is significant positive correlation between inpatients with hypovolemia and happened abnormal heart rhythms (arrhythmias), Q value is 127.49. The results of this study can help to prevent IHCA from occurring by making health care providers early recognition of inpatients at risk of IHCA, assist with monitoring patients for providing quality of care to patients, improve IHCA surveillance and quality of in-hospital care.

Keywords: in-hospital cardiac arrest, patient safety, nursing intervention, association rule mining

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Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

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Authors: Mikael M. Johansson, Peter Stenvall, Leif Karlsson, Joel Andersson

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Sandvik Sanicro 25, UNS S31035, is an advanced high temperature austenitic stainless steel that potentially can be used in super-heaters and reheaters in the next generation of advanced ultra-super critical power plants. The material possesses both high creep strength and good corrosion resistance at temperatures up to 700°C. Its high temperature properties are positioned between other commercially available high temperature austenitic stainless steels and nickel-based alloys. It is, however, well known that an austenitic solidification mode combined with a fully austenitic microstructure exacerbate susceptibility towards hot cracking. The problem increases even more for thick walled material in multipass welding and could compromise the integrity of the welded component. Varestraint weldability testing is commonly used to evaluate susceptibility towards hot cracking of materials. In this paper, Varestraint test results are evaluated for base material of both UNS S31035 steel and are compared to those of the well-known and well-characterized UNS S31008 grade. The more creep resistant alloy, UNS S31035, is metallurgically more complicated than the UNS S31008 grade and has additions of several alloying elements to improve its high temperature properties. It benefits from both solid solution hardening as well as precipitation hardening. This investigation therefore attempts, based on the Varestraint weldability test, to understand if there are any differences in cracking mechanisms between these two grades due to the additional alloying elements used in UNS S31035. Results from Varestraint testing and crack type investigations will be presented and discussed in some detail. It is shown that hot cracking susceptibility of the UNS S31035 steel is only slightly higher than that of UNS S31008 despite the more complicated metallurgy. Weldability of the two alloys is therefore judged to be comparable making the newer alloy well suited also for critical applications.

Keywords: austenitic stainless steel, hot cracking susceptibility, UNS S31035, UNS S31008, varestraint weldability testing

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Authors: Asfa Hussain, Chee Tang, Mien Nguyen

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Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

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Authors: Abdul Malek Abdul Wahab, Emiliano Rustighi

Abstract:

The elastomeric dielectric material has become a new alternative for actuator technology recently. The characteristic of dielectric elastomer that induces significant strain by applying voltage attracts the attention of many researchers to study this material in actuator technology. Thus, for a couple of years, Danfoss Ventures A/S has established their dielectric electro-active polymer (DEAP), which called Polypower. The main objective of this work was to investigate the characterization of PolyPower folded actuator as a ‘pull’ actuator for vibration control. A range of experiment was carried out on folded actuator including passive (without electrical stimulate) and active (with electrical stimulate) testing. For both categories static and dynamic testing have been done to determine the behavior of folded DEAP actuator. Voltage-Strain experiment determines that DEAP folded actuator is the non-linear system. The voltage supplied has no effect on the natural frequency which shows by ongoing dynamic testing. Finally, varies AC voltage with different amplitude and frequency has been provided to DEAP folded actuator. This experiment shows the parameter that influences the performance of DEAP folded actuator. As a result, the actuator performance dominated by the frequency dependence of the elastic response and was less influenced by dielectric properties.

Keywords: elastomeric dielectric, dielectric electro-active polymer, folded actuator, voltage-strain

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Authors: K. A. Ibe, J. I. Mbonu, G. K. Umukoro

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The effects of wood ash on the ignition point of five common tropical woods in Nigeria were investigated. The ash and moisture contents of the wood saw dust from Mahogany (Khaya ivorensis), Opepe (Sarcocephalus latifolius), Abura (Hallealedermannii verdc), Rubber (Heavea brasilensis) and Poroporo (Sorghum bicolour) were determined using a furnace (Vecstar furnaces, model ECF2, serial no. f3077) and oven (Genlab laboratory oven, model MINO/040) respectively. The metal contents of the five wood sawdust ash samples were determined using a Perkin Elmer optima 3000 dv atomic absorption spectrometer while the ignition points were determined using Vecstar furnaces model ECF2. Poroporo had the highest ash content, 2.263 g while rubber had the least, 0.710 g. The results for the moisture content range from 2.971 g to 0.903 g. Magnesium metal had the highest concentration of all the metals, in all the wood ash samples; with mahogany ash having the highest concentration, 9.196 ppm while rubber ash had the least concentration of magnesium metal, 2.196 ppm. The ignition point results showed that the wood ashes from mahogany and opepe increased the ignition points of the test wood samples when coated on them while the ashes from poroporo, rubber and abura decreased the ignition points of the test wood samples when coated on them. However, Opepe saw dust ash decreased the ignition point in one of the test wood samples, suggesting that the metal content of the test wood sample was more than that of the Opepe saw dust ash. Therefore, Mahogany and Opepe saw dust ashes could be used in the surface treatment of wood to enhance their fire resistance or retardancy. However, the caution to be exercised in this application is that the metal content of the test wood samples should be evaluated as well.

Keywords: ash, fire, ignition point, retardant, wood saw dust

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Authors: Meng Wu

Abstract:

Unmanned aerial vehicle (UAV) landing technology is a common task that is required to be fulfilled by fly robots. In this paper, the crazyflie2.0 is located by ultra-wideband (UWB) localization system that contains 4 UWB anchors. Another UWB anchor is introduced and installed on a stationary platform. One cost function is designed to find the minimum distance between crazyflie2.0 and the anchor installed on the stationary platform. The coordinates of the anchor are unknown in advance, and the goal of the cost function is to define the location of the anchor, which can be considered as an optimal landing point. When the cost function reaches the minimum value, the corresponding coordinates of the UWB anchor fixed on the stationary platform can be calculated and defined as the landing point. The simulation shows the effectiveness of the method in this paper.

Keywords: UAV landing, UWB localization system, UWB anchor, cost function, stationary platform

Procedia PDF Downloads 64

Authors: M. Salvador, J. C. Martinez-Garcia, A. Moyano, M. C. Blanco-Lopez, M. Rivas

Abstract:

Biosensors play a crucial role in the detection of molecules nowadays due to their advantages of user-friendliness, high selectivity, the analysis in real time and in-situ applications. Among them, Lateral Flow Immunoassays (LFIAs) are presented among technologies for point-of-care bioassays with outstanding characteristics such as affordability, portability and low-cost. They have been widely used for the detection of a vast range of biomarkers, which do not only include proteins but also nucleic acids and even whole cells. Although the LFIA has traditionally been a positive/negative test, tremendous efforts are being done to add to the method the quantifying capability based on the combination of suitable labels and a proper sensor. One of the most successful approaches involves the use of magnetic sensors for detection of magnetic labels. Bringing together the required characteristics mentioned before, our research group has developed a biosensor to detect biomolecules. Superparamagnetic nanoparticles (SPNPs) together with LFIAs play the fundamental roles. SPMNPs are detected by their interaction with a high-frequency current flowing on a printed micro track. By means of the instant and proportional variation of the impedance of this track provoked by the presence of the SPNPs, quantitative and rapid measurement of the number of particles can be obtained. This way of detection requires no external magnetic field application, which reduces the device complexity. On the other hand, the major limitations of LFIAs are that they are only qualitative or semiquantitative when traditional gold or latex nanoparticles are used as color labels. Moreover, the necessity of always-constant ambient conditions to get reproducible results, the exclusive detection of the nanoparticles on the surface of the membrane, and the short durability of the signal are drawbacks that can be advantageously overcome with the design of magnetically labeled LFIAs. The approach followed was to coat the SPIONs with a specific monoclonal antibody which targets the protein under consideration by chemical bonds. Then, a sandwich-type immunoassay was prepared by printing onto the nitrocellulose membrane strip a second antibody against a different epitope of the protein (test line) and an IgG antibody (control line). When the sample flows along the strip, the SPION-labeled proteins are immobilized at the test line, which provides magnetic signal as described before. Preliminary results using this practical combination for the detection and quantification of the Prostatic-Specific Antigen (PSA) shows the validity and consistency of the technique in the clinical range, where a PSA level of 4.0 ng/mL is the established upper normal limit. Moreover, a LOD of 0.25 ng/mL was calculated with a confident level of 3 according to the IUPAC Gold Book definition. Its versatility has also been proved with the detection of other biomolecules such as troponin I (cardiac injury biomarker) or histamine.

Keywords: biosensor, lateral flow immunoassays, point-of-care devices, superparamagnetic nanoparticles

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Authors: Bency Ann Massinello, Nancy Day, Janet Fellini

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Background: The use of an appropriate mode of communication among the multidisciplinary care team members regarding coordination of care is an extremely complicated yet important patient safety initiative. Effective communication among the team members(nursing staff, medical staff, respiratory therapists, rehabilitation therapists, patient-family services team…) become essential to develop a culture of trust and collaboration to deliver the highest quality care to patients are their families. The inpatient post-acute pediatrics, where children and their caregivers come for continuity of care, is no exceptions to the increasing use of text messages as a means to communication among clinicians. One such platform is the Vocera Communications (Vocera Smart Mobile App called Vocera Edge) allows the teams to use the application and share sensitive patient information through an encrypted platform using IOS company provided shared and assigned mobile devices. Objective: This paper discusses the quality initiative of implementing the transition from Vocera Smartbage to Vocera Edge Mobile App, technology advantage, use case expansion, and lessons learned about a secure alternative modality that allows sending and receiving secure text messages in a pediatric post-acute setting using an IOS device. This implementation process included all direct care staff, ancillary teams, and administrative teams on the clinical units. Methods: Our institution launched this transition from voice prompted hands-free Vocera Smartbage to Vocera Edge mobile based app for secure care team texting using a big bang approach during the first PDSA cycle. The pre and post implementation data was gathered using a qualitative survey of about 500 multidisciplinary team members to determine the ease of use of the application and its efficiency in care coordination. The technology was further expanded in its use by implementing clinical alerts and alarms notification using middleware integration with patient monitoring (Masimo) and life safety (Nurse call) systems. Additional use of the smart mobile iPhone use include pushing out apps like Lexicomp and Up to Date to have it readily available for users for evident-based practice in medication and disease management. Results: Successful implementation of the communication system in a shared and assigned model with all of the multidisciplinary teams in our pediatric post-acute setting. In just a 3-monthperiod post implementation, we noticed a 14% increase from 7,993 messages in 6 days in December 2020 to 9,116messages in March 2021. This confirmed that all clinical and non-clinical teams were using this mode of communication for coordinating the care for their patients. System generated data analytics used in addition to the pre and post implementation staff survey for process evaluation. Conclusion: A secure texting option using a mobile device is a safe and efficient mode for care team communication and collaboration using technology in real time. This allows for the settings like post-acute pediatric care areas to be in line with the widespread use of mobile apps and technology in our mainstream healthcare.

Keywords: nursing informatics, mobile secure texting, multidisciplinary communication, pediatrics post acute care

Procedia PDF Downloads 187

Authors: Melanie Adrian, Elspeth McCulloch, Emily-Jean Gallant

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Resources -financial, physical, and human- are increasingly constrained in higher education. University classes are getting bigger, and the concomitant grading burden on faculty is growing rapidly. Multiple-choice exams are seen by some as one solution to these changes. How much students retain, however, and what their testing experience is, continues to be debated. Are multiple-choice exams serving students well, or are they bearing the burden of these developments? Is there a way to address both the resource constraints and make these types of exams more meaningful? In short, how do we engender evaluation methods for large-scale classes that provide opportunities for heightened student learning and enrichment? The following article lays out a testing approach we have employed in four iterations of the same third-year law class. We base our comments in this paper on our initial observations as well as data gathered from an ethics-approved study looking at student experiences. This testing approach provides students with multiple opportunities for revision (thus increasing chances for long term retention), is both individually and collaboratively driven (thus reflecting the individual effort and group effort) and is automatically graded (thus draining limited institutional resources). We found that overall students appreciated the approach and found it more ‘humane’, that it notably reduced pre-exam and intra-exam stress levels, increased ease, and lowered nervousness.

Keywords: exam, higher education, multiple-choice, law

Procedia PDF Downloads 117

Authors: Charirat Kusonwiriyawong, Supha Photichan, Wannarut Chutibutr

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Soil test kits for rapid analysis of the organic matter, available phosphorus and exchangeable potassium were developed to drive a low-cost field testing kit to farmers. The objective was to provide a decision tool for improving soil fertility. One aspect of soil test kit development was ease of use which is a time requirement for completing organic matter, available phosphorus and exchangeable potassium test in one soil sample. This testing kit required only two extractions and utilized no filtration consuming approximately 15 minutes per sample. Organic matter was principally created by oxidizing carbon KMnO₄ using the standard color chart. In addition, modified single extractant (Mehlich I) was applied to extract available phosphorus and exchangeable potassium. Molybdenum blue method and turbidimetric method using standard color chart were adapted to analyze available phosphorus and exchangeable potassium, respectively. Modified single extractant using in soil test kits were highly significant matching with analytical laboratory results (r=0.959** and 0.945** for available phosphorus and exchangeable potassium, respectively). Linear regressions were statistically calculated between modified single extractant and standard laboratory analysis (y=0.9581x-12.973 for available phosphorus and y=0.5372x+15.283 for exchangeable potassium, respectively). These equations were calibrated to formulate a fertilizer rate recommendation for specific corps. To validate quality, soil test kits were distributed to farmers and extension workers. We found that the accuracy of soil test kits were 71.0%, 63.9% and 65.5% for organic matter, available phosphorus, and exchangeable potassium, respectively. The quantitative survey was also conducted in order to assess their satisfaction with soil test kits. The survey showed that more than 85% of respondents said these testing kits were more convenient, economical and reliable than the other commercial soil test kits. Based upon the finding of this study, soil test kits can be another alternative for providing soil analysis and fertility recommendations when a soil testing laboratory is not available.

Keywords: available phosphorus, exchangeable potassium, modified single extractant, organic matter, soil test kits

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Authors: Junwon Seo, Bipin Adhikari, Euiseok Jeong

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This paper is intended to evaluate the structural performance of welded electronic road signs under various damage scenarios (DSs) using a finite element (FE) model calibrated with full-scale ultimate load testing results. The tested electronic road sign specimen was built with a back skin made of 5052 aluminum and two channels and a frame made of 6061 aluminum, where the back skin was connected to the frame by welding. The size of the tested specimen was 1.52 m long, 1.43 m wide, and 0.28 m deep. An actuator applied vertical loads at the center of the back skin of the specimen, resulting in a displacement of 158.7 mm and an ultimate load of 153.46 kN. Using these testing data, generation and calibration of a FE model of the tested specimen were executed in ABAQUS, indicating that the difference in the ultimate load between the calibrated model simulation and full-scale testing was only 3.32%. Then, six different DSs were simulated where the areas of the welded connection in the calibrated model were diminished for the DSs. It was found that the corners at the back skin-frame joint were prone to connection failure for all the DSs, and failure of the back skin-frame connection occurred remarkably from the distant edges.

Keywords: computational analysis, damage scenarios, electronic road signs, finite element, welded connections

Procedia PDF Downloads 81

Authors: Szu-Yi Chang, Jiin-Ru Rong

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This paper discussed a case involving a young female patient with schizophrenia. The patient's condition was deteriorating, and she was becoming increasingly reliant on her family to take care of her, and as her father did not understand the illness well and was afraid that others will learn about the presence of a mentally ill individual in their family, he and the patient's mother were thus unable to cope with the patient's deteriorating condition, which in turn caused her to suffer from a lack of self-confidence and low self-esteem. The patient received nursing care from July 26th to October 25th, 2017, during which counseling, family visits, and phone interviews were carried out, and her condition was monitored. By referring to the practical ability indicators for community psychiatric mental health nursing that were developed by the psychiatric mental health nurses' association of the Republic of China, defining categories such as 'self-construction,' 'self-management,' 'disease management,' and 'family nursing,' and incorporating indicators for empowerment and various skills into the steps and strategies used for nursing care, we will able to help the patient to construct her own identity, raise her self-esteem, improve her ability to independently perform activities of daily living, strengthen her disease management ability, and gradually build up her life management skills. The patient's family was also encouraged to communicate more among themselves, so as to align them with the nursing care objectives of improving the patient's ability to adapt to community life and her disease. The results indicated that the patient was able to maintain her mental stability within her community. By implementing effective self-management and maintaining a routine life, the patient was able to continue her active participation in community work and rehabilitation activities. Improvements were also achieved with respect to family role issues by establishing mutual understanding among the patient's family members and gaining their support. It is recommended that mental health nurses can leverage their community mental health nursing skills and the related strategies to promote adaptation to community life among mental life patients.

Keywords: community psychiatric mental health nursing, family nursing, schizophrenia, self-management

Procedia PDF Downloads 267

Authors: Rigas Dimakopoulos, Marianna Papadopoulou, Roser Pons

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Background: Participation in family, recreational activities and self-care is an integral part of health. It is also the main outcome of rehabilitation services for children and adolescents with motor disabilities. There are currently no tools in Greek to assess participation in young children. Purpose: To culturally adapt and validate the Greek version of the Child Engagement in Daily Living (CEDL). Method: The CEDL was cross-culturally translated into Greek using forward-backward translation, review by the expert committee, pretest application and final review. Internal consistency was evaluated using the Cronbach alpha and test-retest reliability using the intra-class correlation coefficient (ICC). Parents of children aged 18 months to 5 years and with motor disabilities were recruited. Participants completed the CEDL and the children’s gross motor function was classified using the Gross Motor Function Classification System (GMFCS). Results: Eighty-three children were included, GMFCS I-V. Mean ± standard deviation of the CEDL domains “frequency of participation” “enjoyment of participation” and “self-care” were 58.4±14.0, 3.8±1.0 and 49.9±24, respectively. Internal consistency of all domains was high; Cronbach alpha for “frequency of participation” was 0.83, for “enjoyment of participation” was 0.76 and for “self-care” was 0.92. Test-retest reliability (ICC) was excellent for the “self-care” (0.95) and good for “frequency of participation” and “enjoyment of participation” domains (0.90 and 0.88, respectively). Conclusion: The Greek CEDL has good reliability. It can be used to evaluate participation in Greek young children with motor disabilities GMFCS levels I-V.

Keywords: participation, child, disabilities, child engagement in daily living

Procedia PDF Downloads 169

Authors: Andrea Zielke-Nadkarni

Abstract:

Pain management is a question of quality of life and an indicator for nursing quality. Chronic pain which is predominant in oncology and palliative nursing situations is perceived today as a multifactorial, individual emotional experience with specific characteristics including the sociocultural dimension when dealing with migrant patients. This dimension of chronic pain is of major importance in professional nursing of migrant patients in hospices or palliative care units. Objectives of the study are: 1. To find out more about the sociocultural views on pain and nursing care, on customs and nursing practices connected with pain of both Turkish Muslim and German Christian women, 2. To improve individual and family oriented nursing practice with view to sociocultural needs of patients in severe pain in palliative care. In a qualitative-explorative comparative study 4 groups of women, Turkish Muslims immigrants (4 from the first generation, 5 from the second generation) and German Christian women of two generations (5 of each age group) of the same age groups as the Turkish women and with similar educational backgrounds were interviewed (semistructured ethnographic interviews using Spradley, 1979) on their perceptions and experiences of pain and nursing care within their families. For both target groups the presentation will demonstrate the following results in detail: Utterance of pain as well as “private” and “public” pain vary within different societies and cultures. Permitted forms of pain utterance are learned in childhood and determine attitudes and expectations in adulthood. Language, especially when metaphors and symbols are used, plays a major role for misunderstandings. The sociocultural context of illness may include specific beliefs that are important to the patients and yet seem more than far-fetched from a biomedical perspective. Pain can be an influential factor in family relationships where respect or hierarchies do not allow the direct utterance of individual needs. Specific resources are often, although not exclusively, linked to religious convictions and are significantly helpful in reducing pain. The discussion will evaluate the results of the study with view to the relevant literature and present nursing interventions and instruments beyond medication that are helpful when dealing with patients from various socio-cultural backgrounds in painful end-oflife situations.

Keywords: pain management, migrants, sociocultural context, palliative care

Procedia PDF Downloads 353

Authors: Lukas Kober, Vladimir Littva, Vladimir Siska

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The pandemic has had a significant impact on our lives. One of the most affected professions is the nursing profession. Nurses are closest to the patient, spend the most time with him, support him, often replace the closest family members, and of course, are part of the whole treatment process. Current nurses have more competencies and roles than in the past. The healthcare system has reached a turning point, also in connection with the spreading Delta variant and the risk of the arrival of the third wave. The lack of nurses is a long-term problem, but it did not arise by itself. The reasons for the departure of nurses from the health care system are not only due to the increasing average age of nurses and midwives in Slovakia and their retirement. Thousands of nurses are leaving due to poor working conditions, low wages, and poor management of individual workplaces. We need to keep older nurses in the health care system, otherwise, we risk their early departure. The pandemic only exacerbates this situation, and the associated risks, such as occupational infections or enormous overload and exhaustion, only accelerate the exit from the profession. According to current data from the register of nurses and midwives, we canceled 772 registrations from January to September 2021, and 584 nurses requested the suspension of registration due to non-performance of the profession. During the same period, we registered only 240 new nurses graduate. We have had this significant disparity here for a long time. For the whole of 2020, we canceled 911 registrations and suspended 973 registrations. We registered a total of 389 graduates. Our system loses hundreds of graduates a year and loses experienced nurses with decades of experience who leave due to poor working conditions, wages and suffer from burnout. Such compensation should also be awarded to the families of health professionals who have lost their lives due to work and to COVID-19. These options can also be motivating for promising people interested in studying nursing, who can gradually replace the missing workforce. This purchase is supported by the KEGA project no. 015KU-4/2019.

Keywords: pandemic, COVID-19, nursing, nursing workforce, lack of nurses

Procedia PDF Downloads 200

Authors: A. M. Gsiea, J. P. Goss, P. R. Briddon, Ramadan. M. Al-habashi, K. M. Etmimi, Khaled. A. S. Marghani

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Using first-principles methods based on density functional theory and pseudopotentials, we have performed a details study of native defects in ZnO. Native point defects are unlikely to be cause of the unintentional n-type conductivity. Oxygen vacancies, which considered most often been invoked as shallow donors, have high formation energies in n-type ZnO, in edition are a deep donors. Zinc interstitials are shallow donors, with high formation energies in n-type ZnO, and thus unlikely to be responsible on their own for unintentional n-type conductivity under equilibrium conditions, as well as Zn antisites which have higher formation energies than zinc interstitials. Zinc vacancies are deep acceptors with low formation energies for n-type and in which case they will not play role in p-type coductivity of ZnO. Oxygen interstitials are stable in the form of electrically inactive split interstitials as well as deep acceptors at the octahedral interstitial site under n-type conditions. Our results may provide a guide to experimental studies of point defects in ZnO.

Keywords: DFT, native, n-type, ZnO

Procedia PDF Downloads 579