Search results for: open failure
4319 Improvement of the Traditional Techniques of Artistic Casting through the Development of Open Source 3D Printing Technologies Based on Digital Ultraviolet Light Processing
Authors: Drago Diaz Aleman, Jose Luis Saorin Perez, Cecile Meier, Itahisa Perez Conesa, Jorge De La Torre Cantero
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Traditional manufacturing techniques used in artistic contexts compete with highly productive and efficient industrial procedures. The craft techniques and associated business models tend to disappear under the pressure of the appearance of mass-produced products that compete in all niche markets, including those traditionally reserved for the work of art. The surplus value derived from the prestige of the author, the exclusivity of the product or the mastery of the artist, do not seem to be sufficient reasons to preserve this productive model. In the last years, the adoption of open source digital manufacturing technologies in small art workshops can favor their permanence by assuming great advantages such as easy accessibility, low cost, and free modification, adapting to specific needs of each workshop. It is possible to use pieces modeled by computer and made with FDM (Fused Deposition Modeling) 3D printers that use PLA (polylactic acid) in the procedures of artistic casting. Models printed by PLA are limited to approximate minimum sizes of 3 cm, and optimal layer height resolution is 0.1 mm. Due to these limitations, it is not the most suitable technology for artistic casting processes of smaller pieces. An alternative to solve size limitation, are printers from the type (SLS) "selective sintering by laser". And other possibility is a laser hardens, by layers, metal powder and called DMLS (Direct Metal Laser Sintering). However, due to its high cost, it is a technology that is difficult to introduce in small artistic foundries. The low-cost DLP (Digital Light Processing) type printers can offer high resolutions for a reasonable cost (around 0.02 mm on the Z axis and 0.04 mm on the X and Y axes), and can print models with castable resins that allow the subsequent direct artistic casting in precious metals or their adaptation to processes such as electroforming. In this work, the design of a DLP 3D printer is detailed, using backlit LCD screens with ultraviolet light. Its development is totally "open source" and is proposed as a kit made up of electronic components, based on Arduino and easy to access mechanical components in the market. The CAD files of its components can be manufactured in low-cost FDM 3D printers. The result is less than 500 Euros, high resolution and open-design with free access that allows not only its manufacture but also its improvement. In future works, we intend to carry out different comparative analyzes, which allow us to accurately estimate the print quality, as well as the real cost of the artistic works made with it.Keywords: traditional artistic techniques, DLP 3D printer, artistic casting, electroforming
Procedia PDF Downloads 1424318 Complex Management of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Authors: Abdullah A. Al Qurashi, Hattan A. Hassani, Bader K. Alaslap
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Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an uncommon, inheritable cardiac disorder characterized by the progressive substitution of cardiac myocytes by fibro-fatty tissues. This pathologic substitution predisposes patients to ventricular arrhythmias and right ventricular failure. The underlying genetic defect predominantly involves genes encoding for desmosome proteins, particularly plakophilin-2 (PKP2). These aberrations lead to impaired cell adhesion, heightening the susceptibility to fibrofatty scarring under conditions of mechanical stress. Primarily, ARVD/C affects the right ventricle, but it can also compromise the left ventricle, potentially leading to biventricular heart failure. Clinical presentations can vary, spanning from asymptomatic individuals to those experiencing palpitations, syncopal episodes, and, in severe instances, sudden cardiac death. The establishment of a diagnostic criterion specifically tailored for ARVD/C significantly aids in its accurate diagnosis. Nevertheless, the task of early diagnosis is complicated by the disease's frequently asymptomatic initial stages, and the overall rarity of ARVD/C cases reported globally. In some cases, as exemplified by the adult female patient in this report, the disease may advance to terminal stages, rendering therapies like Ventricular Tachycardia (VT) ablation ineffective. This case underlines the necessity for increased awareness and understanding of ARVD/C to aid in its early detection and management. Through such efforts, we aim to decrease morbidity and mortality associated with this challenging cardiac disorder.Keywords: arrhythmogenic right ventricular dysplasia, cardiac disease, interventional cardiology, cardiac electrophysiology
Procedia PDF Downloads 594317 Taleb's Complexity Theory Concept of 'Antifragility' Has a Significant Contribution to Make to Positive Psychology as Applied to Wellbeing
Authors: Claudius Peter Van Wyk
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Given the increasingly manifest phenomena, as described in complexity theory, of volatility, uncertainty, complexity and ambiguity (VUCA), Taleb's notion of 'antifragility, has a significant contribution to make to positive psychology applied to wellbeing. Antifragility is argued to be fundamentally different from the concepts of resiliency; as the ability to recover from failure, and robustness; as the ability to resist failure. Rather it describes the capacity to reorganise in the face of stress in such a way as to cope more effectively with systemic challenges. The concept, which has been applied in disciplines ranging from physics, molecular biology, planning, engineering, and computer science, can now be considered for its application in individual human and social wellbeing. There are strong correlations to Antonovsky's model of 'salutogenesis' in which an attitude and competencies are developed of transforming burdening factors into greater resourcefulness. We demonstrate, from the perspective of neuroscience, how technology measuring nervous system coherence can be coupled to acquired psychodynamic approaches to not only identify contextual stressors, utilise biofeedback instruments for facilitating greater coherence, but apply these insights to specific life stressors that compromise well-being. Employing an on-going case study with BMW South Africa, the neurological mapping is demonstrated together with 'reframing' and emotional anchoring techniques from neurolinguistic programming. The argument is contextualised in the discipline of psychoneuroimmunology which describes the stress pathways from the CNS and endocrine systems and their impact on immune function and the capacity to restore homeostasis.Keywords: antifragility, complexity, neuroscience, psychoneuroimmunology, salutogenesis, volatility
Procedia PDF Downloads 3774316 The Vulnerability of a Small, Open Economy in a Situation of Global Fiscal Crisis: The Impact of the Greek Debt Crisis on the Foreign Direct Investments to Macedonia
Authors: Viktorija Mano
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The objective of my research is to critique the International Monetary Fund (IMF) stance on foreign investment and the benefits for small, open economies of allowing the free movement of capital. In my research as a whole I will explore the extent to which this stance impacted upon and influenced the economic policies of Macedonia. This will involve providing a contextualized, critical account of the policy of the IMF focusing on a comparison of its policies during the early 2000s through policy documents, political discourse and enacted policies in Macedonia. The conditionality associated with these policies, such as the enforcement of austerity measures (including cutting public spending and reducing debt) and the privatization of public institutions has provoked strong reactions in countries which receive such loans. My main focus in my research is on exploring how the process of Financial Liberalization (FL) of the Macedonian economy affected capital flows in the form of foreign direct investments (FDI) in the private sector and how the recent Greek crisis of 2008 has impacted on this. In the case of Macedonia, the reality of FL was tested by the collapse of the Greek economy. However, this paper will highlight the main duties of the IMF and the goals of the FL process implemented in various countries.Additionally, I will undertake a rhetorical documentary analysis on the IMF reports regarding the process of FL in Macedonia since its independence until today.Keywords: FDI, financial liberalization, Greece, IMF, Macedonia
Procedia PDF Downloads 5664315 Comparison of Low Velocity Impact Test on Coir Fiber Reinforced Polyester Composites
Authors: Ricardo Mendoza, Jason Briceño, Juan F. Santa, Gabriel Peluffo, Mauricio Márquez, Beatriz Cardozo, Carlos Gutiérrez
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The most common controlled method to obtain impact strength of composites materials is performing a Charpy Impact Test which consists of a pendulum with calibrated mass and length released from a known height. In fact, composites components experience impact events in normal operations such as when a tool drops or a foreign object strikes it. These events are categorized into low velocity impact (LVI) which typically occurs at velocities below 10m/s. In this study, the major aim was to calculate the absorbed energy during the impact. Tests were performed on three types of composite panels: fiberglass laminated panels, coir fiber reinforced polyester and coir fiber reinforced polyester subjected to water immersion for 48 hours. Coir fibers were obtained in local plantations of the Caribbean coast of Colombia. They were alkali treated in 5% aqueous NaOH solution for 2h periods. Three type of shape impactors were used on drop-weight impact test including hemispherical, ogive and pointed. Failure mechanisms and failure modes of specimens were examined using an optical microscope. Results demonstrate a reduction in absorbed energy correlated with the increment of water absorption of the panels. For each level of absorbed energy, it was possible to associate a different fracture state. This study compares results of energy absorbed obtained from two impact test methods.Keywords: coir fiber, polyester composites, low velocity impact, Charpy impact test, drop-weight impact test
Procedia PDF Downloads 4544314 Progressive Collapse of Cooling Towers
Authors: Esmaeil Asadzadeh, Mehtab Alam
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Well documented records of the past failures of the structures reveals that the progressive collapse of structures is one of the major reasons for dramatic human loss and economical consequences. Progressive collapse is the failure mechanism in which the structure fails gradually due to the sudden removal of the structural elements. The sudden removal of some structural elements results in the excessive redistributed loads on the others. This sudden removal may be caused by any sudden loading resulted from local explosion, impact loading and terrorist attacks. Hyperbolic thin walled concrete shell structures being an important part of nuclear and thermal power plants are always prone to such terrorist attacks. In concrete structures, the gradual failure would take place by generation of initial cracks and its propagation in the supporting columns along with the tower shell leading to the collapse of the entire structure. In this study the mechanism of progressive collapse for such high raised towers would be simulated employing the finite element method. The aim of this study would be providing clear conceptual step-by-step descriptions of various procedures for progressive collapse analysis using commercially available finite element structural analysis software’s, with the aim that the explanations would be clear enough that they will be readily understandable and will be used by practicing engineers. The study would be carried out in the following procedures: 1. Provide explanations of modeling, simulation and analysis procedures including input screen snapshots; 2. Interpretation of the results and discussions; 3. Conclusions and recommendations.Keywords: progressive collapse, cooling towers, finite element analysis, crack generation, reinforced concrete
Procedia PDF Downloads 4814313 A Pattern Recognition Neural Network Model for Detection and Classification of SQL Injection Attacks
Authors: Naghmeh Moradpoor Sheykhkanloo
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Structured Query Language Injection (SQLI) attack is a code injection technique in which malicious SQL statements are inserted into a given SQL database by simply using a web browser. Losing data, disclosing confidential information or even changing the value of data are the severe damages that SQLI attack can cause on a given database. SQLI attack has also been rated as the number-one attack among top ten web application threats on Open Web Application Security Project (OWASP). OWASP is an open community dedicated to enabling organisations to consider, develop, obtain, function, and preserve applications that can be trusted. In this paper, we propose an effective pattern recognition neural network model for detection and classification of SQLI attacks. The proposed model is built from three main elements of: a Uniform Resource Locator (URL) generator in order to generate thousands of malicious and benign URLs, a URL classifier in order to: 1) classify each generated URL to either a benign URL or a malicious URL and 2) classify the malicious URLs into different SQLI attack categories, and an NN model in order to: 1) detect either a given URL is a malicious URL or a benign URL and 2) identify the type of SQLI attack for each malicious URL. The model is first trained and then evaluated by employing thousands of benign and malicious URLs. The results of the experiments are presented in order to demonstrate the effectiveness of the proposed approach.Keywords: neural networks, pattern recognition, SQL injection attacks, SQL injection attack classification, SQL injection attack detection
Procedia PDF Downloads 4704312 Data and Model-based Metamodels for Prediction of Performance of Extended Hollo-Bolt Connections
Authors: M. Cabrera, W. Tizani, J. Ninic, F. Wang
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Open section beam to concrete-filled tubular column structures has been increasingly utilized in construction over the past few decades due to their enhanced structural performance, as well as economic and architectural advantages. However, the use of this configuration in construction is limited due to the difficulties in connecting the structural members as there is no access to the inner part of the tube to install standard bolts. Blind-bolted systems are a relatively new approach to overcome this limitation as they only require access to one side of the tubular section to tighten the bolt. The performance of these connections in concrete-filled steel tubular sections remains uncharacterized due to the complex interactions between concrete, bolt, and steel section. Over the last years, research in structural performance has moved to a more sophisticated and efficient approach consisting of machine learning algorithms to generate metamodels. This method reduces the need for developing complex, and computationally expensive finite element models, optimizing the search for desirable design variables. Metamodels generated by a data fusion approach use numerical and experimental results by combining multiple models to capture the dependency between the simulation design variables and connection performance, learning the relations between different design parameters and predicting a given output. Fully characterizing this connection will transform high-rise and multistorey construction by means of the introduction of design guidance for moment-resisting blind-bolted connections, which is currently unavailable. This paper presents a review of the steps taken to develop metamodels generated by means of artificial neural network algorithms which predict the connection stress and stiffness based on the design parameters when using Extended Hollo-Bolt blind bolts. It also provides consideration of the failure modes and mechanisms that contribute to the deformability as well as the feasibility of achieving blind-bolted rigid connections when using the blind fastener.Keywords: blind-bolted connections, concrete-filled tubular structures, finite element analysis, metamodeling
Procedia PDF Downloads 1584311 Qf-Pcr as a Rapid Technique for Routine Prenatal Diagnosis of Fetal Aneuploidies
Authors: S. H. Atef
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Background: The most common chromosomal abnormalities identified at birth are aneuploidies of chromosome 21, 18, 13, X and Y. Prenatal diagnosis of fetal aneuploidies is routinely done by traditional cytogenetic culture, a major drawback of this technique is the long period of time required to reach a diagnosis. In this study, we evaluated the QF-PCR as a rapid technique for prenatal diagnosis of common aneuploidies. Method:This work was carried out on Sixty amniotic fluid samples taken from patients with one or more of the following indications: Advanced maternal age (3 case), abnormal biochemical markers (6 cases), abnormal ultrasound (12 cases) or previous history of abnormal child (39 cases).Each sample was tested by QF-PCR and traditional cytogenetic. Aneuploidy screenings were performed amplifying four STRs on chromosomes 21, 18, 13, two pseudoautosomal,one X linked, as well as the AMXY and SRY; markers were distributed in two multiplex QFPCR assays (S1 and S2) in order to reduce the risk of sample mishandling. Results: All the QF-PCR results were successful, while there was two culture failures, only one of them was repeated. No discrepancy was seen between the results of both techniques. Fifty six samples showed normal patterns, three sample showed trisomy 21, successfully detected by both techniques and one sample showed normal pattern by QF-PCR but could not be compared to the cytogenetics due to culture failure, the pregnancy outcome of this case was a normal baby. Conclusion: Our study concluded that QF-PCR is a reliable technique for prenatal diagnosis of the common chromosomal aneuploidies. It has the advantages over the cytogenetic culture of being faster with the results appearing within 24-48 hours, simpler, doesn't need a highly qualified staff, less prone to failure and more cost effective.Keywords: QF-PCR, traditional cytogenetic fetal aneuploidies, trisomy 21, prenatal diagnosis
Procedia PDF Downloads 4194310 Comparison of Hydrogen and Electrification Perspectives in Decarbonizing the Transport Sector
Authors: Matteo Nicoli, Gianvito Colucci, Valeria Di Cosmo, Daniele Lerede, Laura Savoldi
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The transport sector is currently responsible for approximately 1/3 of greenhouse gas emissions in Europe. In the wider context of achieving carbon neutrality of the global energy system, different alternatives are available to decarbonizethe transport sector. In particular, while electricity is already the most consumed energy commodity in rail transport, battery electric vehicles are one of the zero-emissions options on the market for road transportation. On the other hand, hydrogen-based fuel cell vehicles are available for road and non-road vehicles. The European Commission is strongly pushing toward the integration of hydrogen in the energy systems of European countries and its widespread adoption as an energy vector to achieve the Green Deal targets. Furthermore, the Italian government is defining hydrogen-related objectives with the publication of a dedicated Hydrogen Strategy. The adoption of energy system optimization models to study the possible penetration of alternative zero-emitting transport technologies gives the opportunity to perform an overall analysis of the effects that the development of innovative technologies has on the entire energy system and on the supply-side, devoted to the production of energy carriers such as hydrogen and electricity. Using an open-source modeling framework such as TEMOA, this work aims to compare the role of hydrogen and electric vehicles in the decarbonization of the transport sector. The analysis investigates the advantages and disadvantages of adopting the two options, from the economic point of view (costs associated with the two options) and the environmental one (looking at the emissions reduction perspectives). Moreover, an analysis on the profitability of the investments in hydrogen and electric vehicles will be performed. The study investigates the evolution of energy consumption and greenhouse gas emissions in different transportation modes (road, rail, navigation, and aviation) by detailed analysis of the full range of vehicles included in the techno-economic database used in the TEMOA model instance adopted for this work. The transparency of the analysis is guaranteed by the accessibility of the TEMOA models, based on an open-access source code and databases.Keywords: battery electric vehicles, decarbonization, energy system optimization models, fuel cell vehicles, hydrogen, open-source modeling, TEMOA, transport
Procedia PDF Downloads 1144309 Investigating the Factors Affecting the Innovation of Firms in Metropolitan Regions: The Case of Mashhad Metropolitan Region, Iran
Authors: Hashem Dadashpoor, Sadegh Saeidi Shirvan
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While with the evolution of the economy towards a knowledge-based economy, innovation is a requirement for metropolitan regions, the adoption of an open innovation strategy is an option and a requirement for many industrial firms in these regions. Studies show that investing in research and development units cannot alone increase innovation. Within the framework of the theory of learning regions, this gap, which scholars call it the ‘innovation gap’, is filled with regional features of firms. This paper attempts to investigate the factors affecting the open innovation of firms in metropolitan regions, and it searches for these in territorial innovation models and, in particular, the theory of learning regions. In the next step, the effect of identified factors which is considered as regional learning factors in this research is analyzed on the innovation of sample firms by SPSS software using multiple linear regression. The case study of this research is constituted of industrial enterprises from two groups of food industry and auto parts in Toos industrial town in Mashhad metropolitan region. For data gathering of this research, interviews were conducted with managers of industrial firms using structured questionnaires. Based on this study, the effect of factors such as size of firms, inter-firm competition, the use of local labor force and institutional infrastructures were significant in the innovation of the firms studied, and 44% of the changes in the firms’ innovation occurred as a result of the change in these factors.Keywords: regional knowledge networks, learning regions, interactive learning, innovation
Procedia PDF Downloads 1804308 Studying the Effectiveness of Using Narrative Animation on Students’ Understanding of Complex Scientific Concepts
Authors: Atoum Abdullah
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The purpose of this research is to determine the extent to which computer animation and narration affect students’ understanding of complex scientific concepts and improve their exam performance, this is compared to traditional lectures that include PowerPoints with texts and static images. A mixed-method design in data collection was used, including quantitative and qualitative data. Quantitative data was collected using a pre and post-test method and a close-ended questionnaire. Qualitative data was collected through an open-ended questionnaire. A pre and posttest strategy was used to measure the level of students’ understanding with and without the use of animation. The test included multiple-choice questions to test factual knowledge, open-ended questions to test conceptual knowledge, and to label the diagram questions to test application knowledge. The results showed that students on average, performed significantly higher on the posttest as compared to the pretest on all areas of acquired knowledge. However, the increase in the posttest score with respect to the acquisition of conceptual and application knowledge was higher compared to the increase in the posttest score with respect to the acquisition of factual knowledge. This result demonstrates that animation is more beneficial when acquiring deeper, conceptual, and cognitive knowledge than when only factual knowledge is acquired.Keywords: animation, narration, science, teaching
Procedia PDF Downloads 1704307 Recycling Motivations and Barriers in Kota Kinabalu, Malaysia
Authors: Jasmine Adela Mutang, Rosnah Ismail, Chua Bee Seok, Ferlis Bahari, Lailawati Madlan, Walton Wider, Rickless Das
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Waste projection is increasing and most landfills in Malaysia are running out of space. Due to that, waste management is now becoming a major challenge. The most sustainable solution is by practicing sustainable practices such as recycling. Since 1993 the government has launched several recycling campaigns and implemented the National Recycling Policy. However, public participation is still very low. Only 10.5% of solid waste was recycled up to now which is far below than of in developed countries. Nevertheless the government is optimistic that the target of 22% recycling by 2020 will be achieved if there is a positive flow pattern in sustainable practices in particular recycling behavior among Malaysian. Understanding public motivations towards recycling domestic waste are important to improve current recycling rate. Thus this study attempts to identify what are the possible motivations and hindrances for the public to recycle. Open-ended questions format were administered to 484 people in Kota Kinabalu, Sabah, Malaysia. Two specific questions we asked to explore their general determinants and barriers in practicing recycling: “What motivates you to recycle?” and “What are the barriers you encountered in doing recycling activities?” Thematic analysis was conducted on the open-ended questions in which themes were created with the raw comments. It was found that the underlying recycling motivations are awareness’ towards the environment, benefits to the society and individual, and social influence. Non participations are influence by attitudes, commitment, facilities, knowledge, inconvenience, and enforcement.Keywords: recycling motivation, recycling barrier, sustainable, household waste
Procedia PDF Downloads 5544306 Early Adolescents Motivation and Engagement Levels in Learning in Low Socio-Economic Districts in Sri Lanka (Based on T-Tests Results)
Authors: Ruwandika Perera
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Even though the Sri Lankan government provides a reasonable level of support for students at all levels of the school system, for example, free education, textbooks, school uniforms, subsidized public transportation, and school meals, low participation in learning among secondary students is an issue warranting investigation, particularly in low socio-economic districts. This study attempted to determine the levels of motivation and engagement amongst students in a number of schools in two low socio-economic districts of Sri Lanka. This study employed quantitative research design in an attempt to determine levels of motivation and engagement amongst Sri Lankan secondary school students. Motivation and Engagement Scale-Junior School (MES-JS) was administered among 100 Sinhala-medium and 100 Tamil-medium eighth-grade students (50 students from each gender). The mean age of the students was 12.8 years. Schools were represented by type 2 government schools located in Monaragala and Nuwara Eliya districts in Sri Lanka. Confirmatory factor analysis (CFA) was conducted to measure the construct validity of the scale. Since this did not provide a robust solution, exploratory factor analysis (EFA) was conducted. Four factors were identified; Failure Avoidance and Anxiety (FAA), Positive Motivation (PM), Uncertain Control (UC), and Positive Engagement (PE). An independent-samples t-test was conducted to compare PM, PE, FAA, and UC in gender and ethnic groups. There was no significant difference identified for PE, FAA, and UC scales based upon gender. These results indicate that for the participants in this study, there were no significant differences based on gender in the levels of failure avoidance and anxiety, uncertain control, and positive engagement in the school experience. But, the result for the PM scale was close to significant, indicating there may be differences based on gender for positive motivation. A significant difference exists for all scales based on ethnicity, with the mean result for the Tamil students being significantly higher than that for the Sinhala students. These results indicate those Sinhala-medium students’ levels of positive motivation and positive engagement in learning was lower than Tamil-medium students. Also, these results indicate those Tamil-medium students’ levels of failure avoidance, anxiety, and uncertain control was higher than Sinhala-medium students. It could be concluded that male students levels of PM were significantly lower than female students. Also, Sinhala-medium students’ levels of PM and PE was lower than Tamil-medium students, and Tamil-medium students levels of FAA and UC was significantly higher than Sinhala-medium students. Thus, there might be particular school-related conditions affecting this situation, which are related to early adolescents’ motivation and engagement in learning.Keywords: early adolescents, engagement, low socio-economic districts, motivation
Procedia PDF Downloads 1644305 Sweden’s SARS-CoV-2 Mitigation Failure as a Science and Solutions Principle Case Study
Authors: Dany I. Doughan, Nizam S. Najd
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Different governments in today’s global pandemic are approaching the challenging and complex issue of mitigating the spread of the SARS-CoV-2 virus differently while simultaneously considering their national economic and operational bottom lines. One of the most notable successes has been Taiwan's multifaceted virus containment approach, which resulted in a substantially lower incidence rate compared to Sweden’s chief mitigation tactic of herd immunity. From a classic Swiss Cheese Model perspective, integrating more fail-safe layers of defense against the virus in Taiwan’s approach compared to Sweden’s meant that in Taiwan, the government did not have to resort to extreme measures like the national lockdown Sweden is currently contemplating. From an optimized virus spread mitigation solution development standpoint using the Solutions Principle, the Taiwanese and Swedish solutions were desirable economically by businesses that remained open and non-economically or socially by individuals who enjoyed fewer disruptions from what they considered normal before the pandemic. Out of the two, the Taiwanese approach was more feasible long-term from a workforce management and quality control perspective for healthcare facilities and their professionals who were able to provide better, longer, more attentive care to the fewer new positive COVID-19 cases. Furthermore, the Taiwanese approach was more applicable as an overall model to emulate thanks in part to its short-term and long-term multilayered approach, which allows for the kind of flexibility needed by other governments to fully or partially adapt or adopt said, model. The Swedish approach, on the other hand, ignored the biochemical nature of the virus and relied heavily on short-term personal behavioral adjustments and conduct modifications, which are not as reliable as establishing required societal norms and awareness programs. The available international data on COVID-19 cases and the published governmental approaches to control the spread of the coronavirus support a better fit into the Solutions Principle of Taiwan’s Swiss Cheese Model success story compared to Sweden’s.Keywords: coronavirus containment and mitigation, solutions principle, Swiss Cheese Model, viral mutation
Procedia PDF Downloads 1354304 Applying Failure Modes and Effect Analysis Concept in a Global Software Development Process
Authors: Camilo Souza, Lidia Melo, Fernanda Terra, Francisco Caio, Marcelo Reis
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SIDIA is a research and development (R&D) institute that belongs to Samsung’s global software development process. The SIDIA’s Model Team (MT) is a part of Samsung’s Mobile Division Area, which is responsible for the development of Android releases embedded in Samsung mobile devices. Basically, in this software development process, the kickoff occurs in some strategic countries (e.g., South Korea) where some software requirements are applied and the initial software tests are performed. When the software achieves a more mature level, a new branch is derived, and the development continues in subsidiaries from other strategic countries (e.g., SIDIA-Brazil). However, even in the newly created branches, there are several interactions between developers from different nationalities in order to fix bugs reported during test activities, apply some specific requirements from partners and develop new features as well. Despite the GSD strategy contributes to improving software development, some challenges are also introduced as well. In this paper, we share the initial results about the application of the failure modes and effect analysis (FMEA) concept in the software development process followed by the SIDIA’s model team. The main goal was to identify and mitigate the process potential failures through the application of recommended actions. The initial results show that the application of the FMEA concept allows us to identify the potential failures in our GSD process as well as to propose corrective actions to mitigate them. Finally, FMEA encouraged members of different teams to take actions that contribute to improving our GSD process.Keywords: global software development, potential failures, FMEA, recommended actions
Procedia PDF Downloads 2274303 Facilitated Massive Open Online Course (MOOC) Based Teacher Professional Development in Kazakhstan: Connectivism-Oriented Practices
Authors: A. Kalizhanova, T. Shelestova
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Teacher professional development (TPD) in Kazakhstan has followed a fairly standard format for centuries, with teachers learning new information from a lecturer and being tested using multiple-choice questions. In the online world, self-access courses have become increasingly popular. Due to their extensive multimedia content, peer-reviewed assignments, adaptable class times, and instruction from top university faculty from across the world, massive open online courses (MOOCs) have found a home in Kazakhstan's system for lifelong learning. Recent studies indicate the limited use of connectivism-based tools such as discussion forums by Kazakhstani pre-service and in-service English teachers, whose professional interests are limited to obtaining certificates rather than enhancing their teaching abilities and exchanging knowledge with colleagues. This paper highlights the significance of connectivism-based tools and instruments, such as MOOCs, for the continuous professional development of pre- and in-service English teachers, facilitators' roles, and their strategies for enhancing trainees' conceptual knowledge within the MOOCs' curriculum and online learning skills. Reviewing the most pertinent papers on Connectivism Theory, facilitators' function in TPD, and connectivism-based tools, such as MOOCs, a code extraction method was utilized. Three experts, former active participants in a series of projects initiated across Kazakhstan to improve the efficacy of MOOCs, evaluated the excerpts and selected the most appropriate ones to propose the matrix of teacher professional competencies that can be acquired through MOOCs. In this paper, we'll look at some of the strategies employed by course instructors to boost their students' English skills and knowledge of course material, both inside and outside of the MOOC platform. Participants' interactive learning contributed to their language and subject conceptual knowledge and prepared them for peer-reviewed assignments in the MOOCs, and this approach of small group interaction was given to highlight the outcomes of participants' interactive learning. Both formal and informal continuing education institutions can use the findings of this study to support teachers in gaining experience with MOOCs and creating their own online courses.Keywords: connectivism-based tools, teacher professional development, massive open online courses, facilitators, Kazakhstani context
Procedia PDF Downloads 834302 The Impact of Quality Cost on Revenue Sharing in Supply Chain Management
Authors: Fayza M. Obied-Allah
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Customer’ needs, quality, and value creation while reducing costs through supply chain management provides challenges and opportunities for companies and researchers. In the light of these challenges, modern ideas must contribute to counter these challenges and exploit opportunities. Perhaps this paper will be one of these contributions. This paper discusses the impact of the quality cost on revenue sharing as a most important incentive to configure business networks. No doubt that the costs directly affect the size of income generated by a business network, so this paper investigates the impact of quality costs on business networks revenue, and their impact on the decision to participate the revenue among the companies in the supply chain. This paper develops the quality cost approach to align with the modern era, the developed model includes five categories besides the well-known four categories (namely prevention costs, appraisal costs, internal failure costs, and external failure costs), a new category has been developed in this research as a new vision of the relationship between quality costs and innovations of industry. This new category is Recycle Cost. This paper is organized into six sections, Section I shows quality costs overview in the supply chain. Section II discusses revenue sharing between the parties in supply chain. Section III investigates the impact of quality costs in revenue sharing decision between partners in supply chain. The fourth section includes survey study and presents statistical results. Section V discusses the results and shows future opportunities for research. Finally, Section VI summarizes the theoretical and practical results of this paper.Keywords: quality cost, recycle cost, revenue sharing, supply chain management
Procedia PDF Downloads 4494301 Multilevel of Factors Affected Optimal Adherence to Antiretroviral Therapy and Viral Suppression amongst HIV-Infected Prisoners in South Ethiopia: A Prospective Cohort Study
Authors: Terefe Fuge, George Tsourtos , Emma Miller
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Objectives: Maintaining optimal adherence and viral suppression in people living with HIV (PLWHA) is essential to ensure both preventative and therapeutic benefits of antiretroviral therapy (ART). Prisoners bear a particularly high burden of HIV infection and are highly likely to transmit to others during and after incarceration. However, the level of adherence and viral suppression, as well as its associated factors in incarcerated populations in low-income countries is unknown. This study aimed to determine the prevalence of non-adherence and viral failure, and contributing factors to this amongst prisoners in South Ethiopia. Methods: A prospective cohort study was conducted between June 1, 2019 and July 31, 2020 to compare the level of adherence and viral suppression between incarcerated and non-incarcerated PLWHA. The study involved 74 inmates living with HIV (ILWHA) and 296 non-incarcerated PLWHA. Background information including sociodemographic, socioeconomic, psychosocial, behavioural, and incarceration-related characteristics was collected using a structured questionnaire. Adherence was determined based on participants’ self-report and pharmacy refill records, and plasma viral load measurements which were undertaken within the study period were prospectively extracted to determine viral suppression. Various univariate and multivariate regression models were used to analyse data. Results: Self-reported dose adherence was approximately similar between ILWHA and non-incarcerated PLWHA (81% and 83% respectively), but ILWHA had a significantly higher medication possession ratio (MPR) (89% vs 75%). The prevalence of viral failure (VF) was slightly higher (6%) in ILWHA compared to non-incarcerated PLWHA (4.4%). The overall dose non-adherence (NA) was significantly associated with missing ART appointments, level of satisfaction with ART services, patient’s ability to comply with a specified medication schedule and types of methods used to monitor the schedule. In ILWHA specifically, accessing ART services from a hospital compared to a health centre, an inability to always attend clinic appointments, experience of depression and a lack of social support predicted NA. VF was significantly higher in males, people of age 31-35 years and in those who experienced social stigma, regardless of their incarceration status. Conclusions: This study revealed that HIV-infected prisoners in South Ethiopia were more likely to be non-adherent to doses and so to develop viral failure compared to their non-incarcerated counterparts. A multitude of factors was found to be responsible for this requiring multilevel intervention strategies focusing on the specific needs of prisoners.Keywords: Adherence , Antiretroviral therapy, Incarceration, South Ethiopia, Viral suppression
Procedia PDF Downloads 1354300 Success of Trabeculectomy: May Not Always Depend on Mitomycin C
Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty
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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation
Procedia PDF Downloads 2754299 Correlation Between Diastolic Function and Lower GLS in Hypertensive Patients
Authors: A. Kherraf, S. Ouarrak, L. Azzouzi, R. Habbal
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Introduction: Preserved LVEF heart failure is an important cause of mortality and morbidity in hypertensive patients. A strong correlation between impaired diastolic function and longitudinal systolic dysfunction. could have several explanations, first, the diastole is an energy dependent process, especially during its first phase, it also includes active systolic components during the phase of iso volumetric relaxation, in addition, the impairment of the intrinsic myocytic function is part of hypertensive pathology as evidenced by recent studies. METHODS AND MATERIALS: This work consists of performing in a series of 333 hypertensive patients (aged 25 to 75 years) a complete echocardiographic study, including LVEF by Simpson biplane method, the calculation of the indexed left ventricular mass, the analysis of the diastolic function, and finally, the study of the longitudinal deformation of the LV by the technique of speckletracking (calculation of the GLS). Patients with secondary hypertension, leaky or stenosing valve disease, arrhythmia, and a history of coronary insufficiency were excluded from this study. RESULTS: Of the 333 hypertensive patients, 225 patients (67.5%) had impaired diastolic function, of which 60 patients (18%) had high filling pressures. 49.39% had echocardigraphic HVG, Almost all of these patients (60 patients) had low GLS. There is a statistically very significant relationship between lower GLS and increased left ventricular filling pressures in hypertensive patients. These results suggest that increased filling pressures are closely associated with atrioventricular interaction in patients with hypertension, with a strong correlation with impairment of longitudinal systolic function and diastolic function CONCLUSION: Overall, a linear relationship is established between increased left ventricular mass, diastolic dysfunction, and longitudinal LV systolic dysfunctionKeywords: hypertension, diastolic function, left ventricle, heart failure
Procedia PDF Downloads 1274298 Numerical Analysis for Soil Compaction and Plastic Points Extension in Pile Drivability
Authors: Omid Tavasoli, Mahmoud Ghazavi
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A numerical analysis of drivability of piles in different geometry is presented. In this paper, a three-dimensional finite difference analysis for plastic point extension and soil compaction in the effect of pile driving is analyzed. Four pile configurations such as cylindrical pile, fully tapered pile, T-C pile consists of a top tapered segment and a lower cylindrical segment and C-T pile has a top cylindrical part followed by a tapered part are investigated. All piles which driven up to a total penetration depth of 16 m have the same length with equivalent surface area and approximately with identical material volumes. An idealization for pile-soil system in pile driving is considered for this approach. A linear elastic material is assumed to model the vertical pile behaviors and the soil obeys the elasto-plastic constitutive low and its failure is controlled by the Mohr-Coulomb failure criterion. A slip which occurred at the pile-soil contact surfaces along the shaft and the toe in pile driving procedures is simulated with interface elements. All initial and boundary conditions are the same in all analyses. Quiet boundaries are used to prevent wave reflection in the lateral and vertical directions for the soil. The results obtained from numerical analyses were compared with available other numerical data and laboratory tests, indicating a satisfactory agreement. It will be shown that with increasing the angle of taper, the permanent piles toe settlement increase and therefore, the extension of plastic points increase. These are interesting phenomena in pile driving and are on the safe side for driven piles.Keywords: pile driving, finite difference method, non-uniform piles, pile geometry, pile set, plastic points, soil compaction
Procedia PDF Downloads 4844297 A Comparative Analysis of Solid Waste Treatment Technologies on Cost and Environmental Basis
Authors: Nesli Aydin
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Waste management decision making in developing countries has moved towards being more pragmatic, transparent, sustainable and comprehensive. Turkey is required to make its waste related legislation compatible with European Legislation as it is a candidate country of the European Union. Improper Turkish practices such as open burning and open dumping practices must be abandoned urgently, and robust waste management systems have to be structured. The determination of an optimum waste management system in any region requires a comprehensive analysis in which many criteria are taken into account by stakeholders. In conducting this sort of analysis, there are two main criteria which are evaluated by waste management analysts; economic viability and environmentally friendliness. From an analytical point of view, a central characteristic of sustainable development is an economic-ecological integration. It is predicted that building a robust waste management system will need significant effort and cooperation between the stakeholders in developing countries such as Turkey. In this regard, this study aims to provide data regarding the cost and environmental burdens of waste treatment technologies such as an incinerator, an autoclave (with different capacities), a hydroclave and a microwave coupled with updated information on calculation methods, and a framework for comparing any proposed scenario performances on a cost and environmental basis.Keywords: decision making, economic viability, environmentally friendliness, waste management systems
Procedia PDF Downloads 3064296 Complex Management of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Authors: Fahad Almehmadi, Abdullah Alrajhi, Bader K. Alaslab, Abdullah A. Al Qurashi, Hattan A. Hassani
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Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C) is an uncommon, inheritable cardiac disorder characterized by the progressive substitution of cardiac myocytes by fibro-fatty tissues. This pathologic substitution predisposes patients to ventricular arrhythmias and right ventricular failure. The underlying genetic defect predominantly involves genes encoding for desmosome proteins, particularly plakophilin-2 (PKP2). These aberrations lead to impaired cell adhesion, heightening the susceptibility to fibrofatty scarring under conditions of mechanical stress. Primarily, ARVD/C affects the right ventricle, but it can also compromise the left ventricle, potentially leading to biventricular heart failure. Clinical presentations can vary, spanning from asymptomatic individuals to those experiencing palpitations, syncopal episodes, and, in severe instances, sudden cardiac death. The establishment of a diagnostic criterion specifically tailored for ARVD/C significantly aids in its accurate diagnosis. Nevertheless, the task of early diagnosis is complicated by the disease's frequently asymptomatic initial stages, and the overall rarity of ARVD/C cases reported globally. In some cases, as exemplified by the adult female patient in this report, the disease may advance to terminal stages, rendering therapies like Ventricular Tachycardia (VT) ablation ineffective. This case underlines the necessity for increased awareness and understanding of ARVD/C to aid in its early detection and management. Through such efforts, we aim to decrease morbidity and mortality associated with this challenging cardiac disorder.Keywords: ARVD/C, cardiology, interventional cardiology, cardiac electrophysiology
Procedia PDF Downloads 654295 Prediction of Boundary Shear Stress with Gradually Tapering Flood Plains
Authors: Spandan Sahu, Amiya Kumar Pati, Kishanjit Kumar Khatua
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River is the main source of water. It is a form of natural open channel which gives rise to many complex phenomenon of sciences that needs to be tackled such as the critical flow conditions, boundary shear stress and depth averaged velocity. The development of society more or less solely depends upon the flow of rivers. The rivers are major sources of many sediments and specific ingredients which are much essential for human beings. During floods, part of a river is carried by the simple main channel and rest is carried by flood plains. For such compound asymmetric channels, the flow structure becomes complicated due to momentum exchange between main channel and adjoining flood plains. Distribution of boundary shear in subsections provides us with the concept of momentum transfer between the interface of main channel and the flood plains. Experimentally, to get better data with accurate results are very complex because of the complexity of the problem. Hence, Conveyance Estimation System (CES) software has been used to tackle the complex processes to determine the shear stresses at different sections of an open channel having asymmetric flood plains on both sides of the main channel and the results are compared with the symmetric flood plains for various geometrical shapes and flow conditions. Error analysis is also performed to know the degree of accuracy of the model implemented.Keywords: depth average velocity, non prismatic compound channel, relative flow depth , velocity distribution
Procedia PDF Downloads 1234294 Investigation of Heat Transfer by Natural Convection in an Open Channel
Authors: Mahmoud S. Ahmed, Hany A. Mohamed, Mohamed A. Omara, Mohamed F. Abdeen
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Experimental study of natural convection heat transfer inside smooth and rough surfaces of vertical and inclined equilateral triangular channels of different inclination angles with a uniformly heated surface are performed. The inclination angle is changed from 15º to 90º. Smooth and rough surface of average roughness (0.02 mm) are used and their effect on the heat transfer characteristics are studied. The local and average heat transfer coefficients and Nusselt number are obtained for smooth and rough channels at different heat flux values, different inclination angles and different Rayleigh numbers (Ra) 6.48 × 105 ≤ Ra ≤ 4.78 × 106. The results show that the local Nusselt number decreases with increase of axial distance from the lower end of the triangular channel to a point near the upper end of channel, and then, it slightly increases. Higher values of local Nusselt number for rough channel along the axial distance compared with the smooth channel. The average Nusselt number of rough channel is higher than that of smooth channel by about 8.1% for inclined case at θ = 45o and 10% for vertical case. The results obtained are correlated using dimensionless groups for both rough and smooth surfaces of the inclined and vertical triangular channels.Keywords: natural heat transfer convection, constant heat flux, open channels, heat transfer
Procedia PDF Downloads 3944293 The Factors Affecting the Use of Massive Open Online Courses in Blended Learning by Lecturers in Universities
Authors: Taghreed Alghamdi, Wendy Hall, David Millard
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Massive Open Online Courses (MOOCs) have recently gained widespread interest in the academic world, starting a wide range of discussion of a number of issues. One of these issues, using MOOCs in teaching and learning in the higher education by integrating MOOCs’ contents with traditional face-to-face activities in blended learning format, is called blended MOOCs (bMOOCs) and is intended not to replace traditional learning but to enhance students learning. Most research on MOOCs has focused on students’ perception and institutional threats whereas there is a lack of published research on academics’ experiences and practices. Thus, the first aim of the study is to develop a classification of blended MOOCs models by conducting a systematic literature review, classifying 19 different case studies, and identifying the broad types of bMOOCs models namely: Supplementary Model and Integrated Model. Thus, the analyses phase will emphasize on these different types of bMOOCs models in terms of adopting MOOCs by lecturers. The second aim of the study is to improve the understanding of lecturers’ acceptance of bMOOCs by investigate the factors that influence academics’ acceptance of using MOOCs in traditional learning by distributing an online survey to lecturers who participate in MOOCs platforms. These factors can help institutions to encourage their lecturers to integrate MOOCs with their traditional courses in universities.Keywords: acceptance, blended learning, blended MOOCs, higher education, lecturers, MOOCs, professors
Procedia PDF Downloads 1314292 Protection of Steel Bars in Reinforce Concrete with Zinc Based Coverings
Authors: Hamed Rajabzadeh Gatabi, Soroush Dastgheibifard, Mahsa Asnafi
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There is no doubt that reinforced concrete is known as one of the most significant materials which is used in construction industry for many years. Although, some natural elements in dealing with environment can contribute to its corrosion or failure. One of which is bar or so-called reinforcement failure. So as to combat this problem, one of the oxidization prevention methods investigated was the barrier protection method implemented over the application of an organic coating, specifically fusion-bonded epoxy. In this study comparative method is prepared on two different kinds of covered bars (zinc-riches epoxy and polyamide epoxy coated bars) and also uncoated bar. With the aim of evaluate these reinforced concretes, the stickiness, toughness, thickness and corrosion performance of coatings were compared by some tools like Cu/CuSo4 electrodes, EIS and etc. Different types of concretes were exposed to the salty environment (NaCl 3.5%) and their durability was measured. As stated by the experiments in research and investigations, thick coatings (named epoxies) have acceptable stickiness and strength. Polyamide epoxy coatings stickiness to the bars was a bit better than that of zinc-rich epoxy coatings; nonetheless it was stiffer than the zinc rich epoxy coatings. Conversely, coated bars with zinc-rich epoxy showed more negative oxidization potentials, which take revenge protection of bars by zinc particles. On the whole, zinc-rich epoxy coverings is more corrosion-proof than polyamide epoxy coatings due to consuming zinc elements and some other parameters, additionally if the epoxy coatings without surface defects are applied on the rebar surface carefully, it can be said that the life of steel structures is subjected to increase dramatically.Keywords: surface coating, epoxy polyamide, reinforce concrete bars, salty environment
Procedia PDF Downloads 2904291 Dynamics of Mach Zehnder Modulator in Open and Closed Loop Bias Condition
Authors: Ramonika Sengupta, Stuti Kachhwaha, Asha Adhiya, K. Satya Raja Sekhar, Rajwinder Kaur
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Numerous efforts have been done in the past decade to develop the methods of secure communication that are free from interception and eavesdropping. In fiber optic communication, chaotic optical carrier signals are used for data encryption in secure data transmission. Mach-Zehnder Modulators (MZM) are the key components for generating the chaotic signals to be used as optical carriers. This paper presents the dynamics of a lithium niobate MZM modulator under various biasing conditions. The chaotic fluctuations of the intensity of a laser diode have been generated using the electro-optic MZM modulator operating in a highly nonlinear regime. The modulator is driven in closed loop by its own output at an earlier time. When used as an electro-optic oscillator employing delayed feedback, the MZM displays a wide range of output waveforms of varying complexity. The dynamical behavior of the system ranges from periodic to nonlinear oscillations. The nonlinearity displayed by the system is reproducible and is easily controllable. In this paper, we demonstrate a wide variety of optical signals generated by MZM using easily controllable device parameters in both open and close loop bias conditions.Keywords: chaotic carrier, fiber optic communication, Mach-Zehnder modulator, secure data transmission
Procedia PDF Downloads 2734290 Association between Severe Acidemia before Endotracheal Intubation and the Lower First Attempt Intubation Success Rate
Authors: Keiko Naito, Y. Nakashima, S. Yamauchi, Y. Kunitani, Y. Ishigami, K. Numata, M. Mizobe, Y. Homma, J. Takahashi, T. Inoue, T. Shiga, H. Funakoshi
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Background: A presence of severe acidemia, defined as pH < 7.2, is common during endotracheal intubation for critically ill patients in the emergency department (ED). Severe acidemia is widely recognized as a predisposing factor for intubation failure. However, it is unclear that acidemic condition itself actually makes endotracheal intubation more difficult. We aimed to evaluate if a presence of severe acidemia before intubation is associated with the lower first attempt intubation success rate in the ED. Methods: This is a retrospective observational cohort study in the ED of an urban hospital in Japan. The collected data included patient demographics, such as age, sex, and body mass index, presence of one or more factors of modified LEMON criteria for predicting difficult intubation, reasons for intubation, blood gas levels, airway equipment, intubation by emergency physician or not, and the use of the rapid sequence intubation technique. Those with any of the following were excluded from the analysis: (1) no blood gas drawn before intubation, (2) cardiopulmonary arrest, and (3) under 18 years of age. The primary outcome was the first attempt intubation success rates between a severe acidemic patients (SA) group and a non-severe acidemic patients (NA) group. Logistic regression analysis was used to test the first attempt success rates for intubations between those two groups. Results: Over 5 years, a total of 486 intubations were performed; 105 in the SA group and 381 in the NA group. The univariate analysis showed that the first attempt intubation success rate was lower in the SA group than in the NA group (71.4% vs 83.5%, p < 0.01). The multivariate logistic regression analysis identified that severe acidemia was significantly associated with the first attempt intubation failure (OR 1.9, 95% CI 1.03-3.68, p = 0.04). Conclusions: A presence of severe acidemia before endotracheal intubation lowers the first attempt intubation success rate in the ED.Keywords: acidemia, airway management, endotracheal intubation, first-attempt intubation success rate
Procedia PDF Downloads 248