Search results for: prevent pressure injury

Authors: Olusola Olorunfemi Bamisile, Mustafa Dagbasi, Serkan Abbasoglu

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Feasibility of an Energy Audit program is the main aim of this paper. LEDs are used to replace Sodium Vapor lamps and High Pressured Mercury Vapor lamps that are currently used for the street lighting system in Turkish Republic of Northern Cyprus. 44% of the fossil fuels imported into Turkish Republic of Northern Cyprus are used for electricity generation which makes the reduction in the consumption of electricity very important. This project will save as much as 40,206,210 kWh on site annually and 121,837,000 kWh can be saved from source. The economic environmental and fossil fuels saving of this project is also evaluated.

Keywords: energy conservation management, LEDs, sodium vapor, high pressure mercury vapor, life cycle costing

Procedia PDF Downloads 460

Authors: P. Adibi, M. R. Ansari, S. Jafari, B. Habibpour, E. Salimi

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In this paper, the effects of gas and liquid superficial inlet velocities and for the first time the effect of liquid holdup on slug initiation position are studied experimentally. Empirical correlations are also presented based on the obtained results. The tests are conducted for three liquid holdups in a long horizontal channel with dimensions of 5cmx10cm and 36m length. Usl and Usg rated as to 0.11m/s to 0.56m/s and 1.88m/s to 13m/s, respectively. The obtained results show that as αl=0.25, slug initiation position is increasing monotonically with Usl and Usg. During αl=0.50, slug initiation position is almost constant. For αl=0.75, slug initiation position is decreasing monotonically with Usl and Usg. In the case of equal void fraction of phases, generated slugs are weakly (low pressure). However, for the unequal void fraction of phases strong slugs (high pressure) are formed.

Keywords: liquid holdup, long horizontal channel, slug initiation position, superficial inlet velocity

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Authors: Waqed H. Almohammed, Mohammed Y. Fattah, Sajjad E. Rasheed

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Dynamic traffic loads cause deformation of underground pipes, resulting in vehicle discomfort. This makes it necessary to reinforce the layers of soil above underground pipes. In this study, the subbase layer was reinforced. Finite element software (PLAXIS 3D) was used to in the simulation, which includes geocell reinforcement, vehicle loading, soil layers and Glass Fiber Reinforced Plastic (GRP) pipe. Geocell reinforcement was modeled using a geogrid element, which was defined as a slender structure element that has the ability to withstand axial stresses but not to resist bending. Geogrids cannot withstand compression but they can withstand tensile forces. Comparisons have been made between the numerical models and experimental works, and a good agreement was obtained. Using the mathematical model, the performance of three different pipes of diameter 600 mm, 800 mm, and 1000 mm, and three different vehicular speeds of 20 km/h, 40 km/h, and 60 km/h, was examined to determine their impact on surface settlement and vertical pressure at the pipe crown for two cases: with and without geocell reinforcement. The results showed that, for a pipe diameter of 600 mm under geocell reinforcement, surface settlement decreases by 94 % when the speed of the vehicle is 20 km/h and by 98% when the speed of the vehicle is 60 km/h. Vertical pressure decreases by 81 % when the diameter of the pipe is 600 mm, while the value decreases to 58 % for a pipe with diameter 1000 mm. The results show that geocell reinforcement causes a significant and positive reduction in surface settlement and vertical stress above the pipe crown, leading to an increase in pipe safety.

Keywords: dynamic loading, finite element, geocell-reinforcement, GRP pipe, PLAXIS 3D, surface settlement

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Authors: Ravindra Mallya, B. Satish Shenoy, B. Raghuvir Pai

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The study deals with the challenges in developing a test rig to test the performance of water lubricated journal bearing. The test rig is designed to simulate the working conditions of the bearing in order to understand their performance before they are put in operation. The bearing that is studied is the commercially available water lubricated bearing which has a rubber liner bonded with a rigid metal shell. The lubricant enters the bearing axially through a pressurized inlet tank and exits to an outlet tank which is at sufficiently low pressure. The load on the bearing is applied through the dead weight system which acts both in upward and downward direction so that net load acts on the bearing. The issues in feeding the lubricant into the bearing from the inlet side and preventing the leakage of the lubricant is discussed. The application of the load on the test bearing while maintaining the bearing afloat is also discussed.

Keywords: axial groove, hydrodynamic pressure, journal bearing, test rig, water lubrication

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Authors: Yunzhe Tong, Jun Fan, Bin Wang

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The vibroacoustic behavior of an immersed infinite cylindrical shell with periodic lengthwise ribs has been studied in this paper. The motions of the shell are described by the Donnell equations. Each lengthwise rib is modeled as an elastic beam. The motions of the bulkheads are decomposed into the longitudinal motions and flexural motions. The analytical expressions of the shell motions can be obtained through circumferential mode expansion, Fourier Transform and periodic boundary condition in the circumferential direction. Furthermore, the far-field radiated pressure has been obtained using the stationary phase. The analysis of wavenumber domain shows that periodic lengthwise stiffeners in the circumferential direction can produce flexural Bloch waves. The dominant feature in far-field pressure amplitude is the resonance of the supersonic components of the flexural Bloch waves in the circumferential direction.

Keywords: flexural Bloch wave, stiffened shell, vibroacoustics, wavenumber analysis

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Authors: Ticijana Prijon, Branko Ermenc

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Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall.An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: aorta, blunt trauma, car accidents, morphology, risk factors

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Authors: S. B. Q. Tran

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Drop condensation is the phenomenon that the tiny drops form when the oversaturated vapour present in the environment condenses on a substrate and makes the droplet growth. Recently, this subject has received much attention due to its applications in many fields such as thin film growth, heat transfer, recovery of atmospheric water and polymer templating. In literature, many papers investigated theoretically and experimentally in macro droplet growth with the size of millimeter scale of radius. However few papers about nanodroplet condensation are found in the literature especially theoretical work. In order to understand the droplet growth in nanoscale, we perform the numerical simulation work to study nanodroplet growth. We investigate and discuss the role of the droplet shape and monomer diffusion on drop growth and their effect on growth law. The effect of droplet shape is studied by doing parametric studies of contact angle and disjoining pressure magnitude. Besides, the effect of pinning and de-pinning behaviours is also studied. We investigate the axisymmetric homogeneous growth of 10–100 nm single water nanodroplet on a substrate surface. The main mechanism of droplet growth is attributed to the accumulation of laterally diffusing water monomers, formed by the absorption of water vapour in the environment onto the substrate. Under assumptions of quasi-steady thermodynamic equilibrium, the nanodroplet evolves according to the augmented Young–Laplace equation. Using continuum theory, we model the dynamics of nanodroplet growth including the coupled effects of disjoining pressure, contact angle and monomer diffusion with the assumption of constant flux of water monomers at the far field. The simulation result is validated by comparing with the published experimental result. For the case of nanodroplet growth with constant contact angle, our numerical results show that the initial droplet growth is transient by monomer diffusion. When the flux at the far field is small, at the beginning, the droplet grows by the diffusion of initially available water monomers on the substrate and after that by the flux at the far field. In the steady late growth rate of droplet radius and droplet height follow a power law of 1/3, which is unaffected by the substrate disjoining pressure and contact angle. However, it is found that the droplet grows faster in radial direction than high direction when disjoining pressure and contact angle increase. The simulation also shows the information of computational domain effect in the transient growth period. When the computational domain size is larger, the mass coming in the free substrate domain is higher. So the mass coming in the droplet is also higher. The droplet grows and reaches the steady state faster. For the case of pinning and de-pinning droplet growth, the simulation shows that the disjoining pressure does not affect the droplet radius growth law 1/3 in steady state. However the disjoining pressure modifies the growth rate of the droplet height, which then follows a power law of 1/4. We demonstrate how spatial depletion of monomers could lead to a growth arrest of the nanodroplet, as observed experimentally.

Keywords: augmented young-laplace equation, contact angle, disjoining pressure, nanodroplet growth

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Authors: Ranjan Chakravarty, Satpal Yadav, Biswajit Basumatary, Arvind S. Sajwan

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The purpose of this study is to compare the basketball players of different level on selected respiratory indices. Ninety male basketball players from different universities those who participated in intercollegiate and inter- varsity championship. Selected respiratory indices were resting pulse rate, resting blood pressure, vital capacity and resting respiratory rate. Mean and standard deviation of selected respiratory indices were calculated and three different levels i.e. beginners, intermediate and advanced were compared by using analysis of variance. In order to test the hypothesis, level of significance was set at 0.05. It was concluded that variability does not exist among the basketball players of different groups with respect to their selected respiratory indices i.e. resting pulse rate, resting blood pressure, vital capacity and resting respiratory rate.

Keywords: respiratory indices, sports performance, basketball players, intervarsity level

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Authors: İbrahim Hakkı Erkan, Özcan Tan

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The performance of jet grout columns was affected by many controlled and uncontrolled parameters. The leading parameters for the controlled ones can be listed as injection pressure, rod pulling speed, rod rotation speed, number of nozzles, nozzle diameter and Water/Cement ratio. And the uncontrolled parameters are soil type, soil structure, soil layering condition, underground water level, the changes in strength parameters and the rheologic properties of cement in time. In this study, the performance of jet grout columns and the effects of pulling speed and rotation speed were investigated experimentally. For this purpose, a laboratory type jet grouting system was designed for the experiments. Through this system, jet grout columns were produced in three different conditions. The results of the study showed that the grout pressure and the lifting speed significantly affect the performance of the jet grouting columns.

Keywords: jet grout, sandy soils, soil improvement, soilcreate

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Authors: Mani Mofidi, Neda Valizadeh, Ali Hashemaghaee, Mona Hashemaghaee, Soudabeh Shafiee Ardestani

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Background: Acute pain and its management remained the most complaint of emergency service admission. Diagnostic and therapeutic procedures add to patients’ pain. Diminishing the pain increases the quality of patient’s feeling and improves the patient-physician relationship. Aim: The aim of this study was to evaluate the outcomes and side effects of opioid administration in emergency patients. Material and Methods: patients admitted to ward II emergency service of Imam Khomeini hospital, who received one of the opioids: morphine, pethidine, methadone or fentanyl as an analgesic were evaluated. Their vital signs and general condition were examined before and after drug injection. Also, patient’s pain experience were recorded as numerical rating score (NRS) before and after analgesic administration. Results: 268 patients were studied. 34 patients were addicted to opioid drugs. Morphine had the highest rate of prescription (86.2%), followed by pethidine (8.5%), methadone (3.3%) and fentanyl (1.68). While initial NRS did not show significant difference between addicted patients and non-addicted ones, NRS decline and its score after drug injection were significantly lower in addicted patients. All patients had slight but statistically significant lower respiratory rate, heart rate, blood pressure and O2 saturation. There was no significant difference between different kind of opioid prescription and its outcomes or side effects. Conclusion: Pain management should be always in physicians’ mind during emergency admissions. It should not be assumed that an addicted patient complaining of pain is malingering to receive drug. Titration of drug and close monitoring must be in the curriculum to prevent any hazardous side effects.

Keywords: numerical rating score, opioid, pain, emergency department

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Authors: Ramin Zargarbashi, Hamid Rabie, Behnam Panjavi, Hooman Kamran, Seyedarad Mosalamiaghili, Zohre Erfani, Seyed Peyman Mirghaderi, Maryam Salimi

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Background: Posterior shoulder dislocation is one of the disabling complications of brachial plexus birth injury (BPBI), and various treatment options, including capsule and surrounding muscles release for open reduction, humeral derotational osteotomy, and tendon transfers, have been recommended to manage it. In the present study, we aimed to determine the clinical outcome of open reduction with soft tissue release, tendon transfer, and glenoid osteotomy inpatients with BPBI and posterior shoulder dislocation or subluxation. Methods: From 2018 to 2020, 33 patients that underwent open reduction, glenoid osteotomy, and tendon transfer were included. The glenohumeral deformity was classified according to the Waters radiographic classification. Functional assessment was performed using the Mallet grading system before and at least two years after the surgery. Results: The patients were monitored for 26.88± 5.47 months. Their average age was 27.5±14 months. Significant improvement was seen in the overall Mallet score (from 13.5 to 18.91 points) and its segments, including hand to mouth, hand to the neck, global abduction, global external rotation, abduction degree, and external rotation degree. Hand-to-back score and the presence of trumpet sign were significantly decreased in the post-operation phase (all p values<0.001). The above-mentioned variables significantly changed for both infantile and non-infantile dislocations. Conclusion: Our study demonstrated that open reduction along with glenoid osteotomy improves retroversion, and muscle strengthening with different muscle transfers is an effective technique for BPBI.

Keywords: birth injuries, nerve injury, brachial plexus birth palsy, Erb palsy, tendon transfer

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Authors: T. Hirata, M. G. Silva, L. M. Rosa

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The balance ability during task kick in soccer is a determining factor in the execution of functional movements that require a high-performance motor coordination. The current experiment explored it during an instep soccer kick and functional task kicking. Their kicking performance was measured in terms of the sway characteristics using lateral and antero-posterior balance of the center of pressure (COP) for the supporting leg and the kinematic data, the supporting leg’s knee angle. The motion was realized with one-legged stance of five male indoor soccer players and using the trigger device ball controller. The results showed large balance in antero-posterior direction than in lateral direction. However, each player adopts a different way to kick the ball, and the media-lateral displacement of the COP showed no correlation with the balance skill.

Keywords: kicking performance, center of pressure, one-legged stance, balance ability

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Authors: Suresh Sharma, Neeti Goutam

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In India abortions are legal and with the exceedingly liberal and broadened law that was passed in 1971, “Medical Termination of Pregnancy Act” had opened a new window to Women’s’ freedom and choice over their fertility. This paper would like to focus on the factors responsible for or leading to unsafe abortion as well as such high incidence of abortion in India which can help in understanding the ways in which we can prevent this apathy. To study the intricacies involved in delivering safety to womanhood in terms of safe abortion practice which includes more trained personnel, detailed explanation and consequences of conducting an abortion, fine reporting, awareness regarding family planning measures and not only pressurizing them to sterilize immediately after an abortion but also prior to that informing them and lastly easy accessibility of Contraceptives with a educated and brief information on that. Data has been drawn from various sources such as National Family Household Survey (1, 2, 3), Health Management Information System and Annual Health Survey. To safeguard the interest of women when it comes to complications resulting from unsafe abortions, Reproductive Health laid its strict adherence to it in its guidelines. The Government could induce more measures in terms of family planning measures and increase in the number of skilled medical health force, chiefly in rural areas to prevent the illegality of abortions. But before that fine reporting on the number of abortions performed will give an insight to this very issue only then policies and programs will work much better in favor of women.

Keywords: abortion, MTP act, India, women

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Authors: Xinyu Wang

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In the context of the rapid development of Internet technology and the increasing prevalence of online social media, this study investigates the impact of digital communication on social learning. Through three behavioral experiments, we explore both affective and cognitive social learning in online environments. Experiment 1 manipulates the content of experimental materials and two forms of feedback, emotional valence, sociability, and repetition, to verify whether individuals can achieve online emotional social learning through reinforcement using two social learning strategies. Results reveal that both social learning strategies can assist individuals in affective, social learning through reinforcement, with feedback-based learning strategies outperforming frequency-dependent strategies. Experiment 2 similarly manipulates the content of experimental materials and two forms of feedback to verify whether individuals can achieve online knowledge social learning through reinforcement using two social learning strategies. Results show that similar to online affective social learning, individuals adopt both social learning strategies to achieve cognitive social learning through reinforcement, with feedback-based learning strategies outperforming frequency-dependent strategies. Experiment 3 simultaneously observes online affective and cognitive social learning by manipulating the content of experimental materials and feedback at different levels of social pressure. Results indicate that online affective social learning exhibits different learning effects under different levels of social pressure, whereas online cognitive social learning remains unaffected by social pressure, demonstrating more stable learning effects. Additionally, to explore the sustained effects of online social learning and differences in duration among different types of online social learning, all three experiments incorporate two test time points. Results reveal significant differences in pre-post-test scores for online social learning in Experiments 2 and 3, whereas differences are less apparent in Experiment 1. To accurately measure the sustained effects of online social learning, the researchers conducted a mini-meta-analysis of all effect sizes of online social learning duration. Results indicate that although the overall effect size is small, the effect of online social learning weakens over time.

Keywords: online social learning, affective social learning, cognitive social learning, social learning strategies, social reinforcement, social pressure, duration

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Authors: Mengke Zhan, Cheng-Gang Xie, Jian-Jun Shu

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A venturi flowmeter is a common device used in multiphase flow rate measurement in the upstream oil and gas industry. Having a robust computational model for multiphase flow in a venturi is desirable for understanding the gas-liquid and fluid-pipe interactions and predicting pressure and phase distributions under various flow conditions. A steady Eulerian-Eulerian framework is used to simulate upward gas-liquid flow in a vertical venturi. The simulation results are compared with experimental measurements of venturi differential pressure and chord-averaged gas holdup in the venturi throat section. The choice of turbulence model is nontrivial in the multiphase flow modelling in a venturi. The performance cross-comparison of the k-ϵ model, Reynolds stress model (RSM) and shear-stress transport (SST) k-ω turbulence model is made in the study. In terms of accuracy and computational cost, the SST k-ω turbulence model is observed to be the most efficient.

Keywords: computational fluid dynamics (CFD), gas-liquid flow, turbulence modelling, venturi

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Authors: Yuguang Wang, Chuanjun Wang

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At present, many coastal areas around the world suffer from seawater intrusion. Seawater intrusion is the superimposed result of two factors which are nature and human social economical activities in particular area. In recent years, due to excessive exploitation of groundwater, the seawater intrusion phenomenon aggravate in coastal zone of the Bohai and Huanghai seas in our country. Moreover, with sea-level rising, the original hydrodynamic equilibrium between saltwater and freshwater has been damaged to a certain extent, and it will further aggravate seawater intrusion in the land plains. In addition, overexploitation of groundwater declined groundwater level and increase saltwater intrusion in coastal areas. Therefore, in view of the sensitivity and vulnerability of the impact of sea-level rise in the future, the risk of sea-level rise in coastal zone should be considered, reasonable exploitation, utilization and management of coastal zone’s groundwater should be formulated. The response mechanism of sea-level rise should be studied to prevent and reduce the harm of seawater intrusion, which has important theoretical and realistic significances. In this paper, through the long-term monitoring of groundwater level and conductibility in the transition region of seawater intrusion for the sand coast area, realtimely master the situation of seawater intrusion. Combined with the seasonal exploitation station of groundwater and sea level variation, early alert the seawater intrusion to prevent and reduce the harm of seawater intrusion.

Keywords: groundwater level, sea level, seawater intrusion, sand coast

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Authors: Zeynep Aytaç, Nuri Yücel

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Today, as the need for high efficiency and fuel-efficient engines have increased, centrifugal compressor designs are expected to be high-efficient and have high-pressure ratios than ever. The present study represents a design methodology of centrifugal compressor placed in a mini jet engine for the design and off-design points with the utilization of computational fluid dynamics (CFD) and compares the performance characteristics at the mentioned two points. Although the compressor is expected to provide the required specifications at the design point, it is known that it is important for the design to deliver the required parameters at the off-design point also as it will not operate at the design point always. It was observed that the obtained mass flow rate, pressure ratio, and efficiency values are within the limits of the design specifications for the design and off-design points. Despite having different design inputs for the mentioned two points, they reveal similar flow characteristics in the general frame.

Keywords: centrifugal compressor, computational fluid dynamics, design point, off-design point

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Authors: Sameer Masood, Lucas Chartier

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Head injuries are a commonly encountered presentation in emergency departments (ED) and the Choosing Wisely Canada (CWC) campaign was released in June 2015 in an attempt to decrease imaging utilization for patients with minor head injuries. The impact of the CWC campaign on imaging utilization for head injuries has not been explored in the ED setting. In our study, we describe the characteristics of patients with head injuries presenting to a tertiary care academic ED and the impact of the CWC campaign on CT head utilization. This retrospective cohort study used linked databases from the province of Ontario, Canada to assess emergency department visits with a primary diagnosis of head injury made between June 1, 2014 and Aug 31, 2016 at the University Health Network in Toronto, Canada. We examined the number of visits during the study period, the proportion of patients that had a CT head performed before and after the release of the CWC campaign, as well as mode of arrival, and disposition. There were 4,322 qualifying visits at our site during the study period. The median presenting age was 44.12 years (IQR 27.83,67.45), the median GCS was 15 (IQR 15,15) and the majority of patients presenting had intermediate acuity (CTAS 3). Overall, 43.17% of patients arrived via ambulance, 49.24 % of patients received a CT head and 10.46% of patients were admitted. Compared to patients presenting before the CWC campaign release, there was no significant difference in the rate of CT heads after the CWC (50.41% vs 47.68%, P = 0.07). There were also no significant differences between the two groups in mode of arrival (ambulance vs ambulatory) (42.94% vs 43.48%, P = 0.72) or admission rates (9.85% vs 11.26%, P = 0.15). However, more patients belonged to the high acuity groups (CTAS 1 or 2) in the post CWC campaign release group (12.98% vs 8.11% P <0.001). Visits for head injuries make up a significant proportion of total ED visits and approximately half of these patients receive CT imaging in the ED. The CWC campaign did not seem to impact imaging utilization for head injuries in the 14 months following its launch. Further efforts, including local quality improvement initiatives, are likely needed to increase adherence to its recommendation and reduce imaging utilization for head injuries.

Keywords: choosing wisely, emergency department, head injury, quality improvement

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Authors: Y. Hu, X. Zhao, T. Yamaguchi, M. Sasajima, Y. Koike

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To focus on the vibration mode of a cone loudspeaker, which acts as an electroacoustic transducer, excitation experiments were performed using two types of loudspeaker units: one employing an impulse hammer and the other a sweep signal. The on-axis sound pressure frequency properties of the loudspeaker were evaluated, and the characteristic properties of the loudspeakers were successfully determined in both excitation experiments. Moreover, under conditions identical to the experiment conditions, a coupled analysis of the vibration-acoustics of the cone loudspeaker was performed using an acoustic analysis software program that considers the impact of damping caused by air viscosity. The result of sound pressure frequency properties with the numerical analysis are the most closely match that measured in the excitation experiments over a wide range of frequency bands.

Keywords: anechoic room, finite element method, impulse hammer, loudspeaker, reverberation room, sweep signal

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Authors: Keshari Shrestha, Philip Vatterott

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Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal drug-related syndrome. DRESS classically presents with a diffuse maculopapular rash, fevers, and eosinophilia more than three weeks after drug exposure. DRESS can present with multi-organ involvement, with liver damage being the most common and severe. Pulmonary involvement is a less common manifestation and is associated with poor clinical outcomes. Chest imaging is often nonspecific, and symptoms can range from mild cough to acute respiratory distress syndrome (ARDS) . This is a case of a 49-year-old female with a history of recent clostridium difficile colitis status post treatment with oral vancomycin who presented with rash, acute liver and kidney failure, as well as diffuse nodular alveolar lung opacities concerning for DRESS syndrome with multi-organ involvement. Clinical Course: This patient initially presented to an outside hospital with clostridium difficile colitis, acute liver injury, and acute kidney injury. She developed a desquamating maculopapular rash in the setting of recent oral vancomycin, meloxicam, and furosemide initiation. She was hospitalized on two additional occasions with worsening altered mental status, liver injury, and acute kidney injury and was initiated on intermittent hemodialysis. Notably, she was found to have systemic eosinophilia (4100 cells/microliter) several weeks prior. She was transferred to this institution for further management where she was found to have encephalopathy, jaundice, lower extremity edema, and diffuse bilateral rhonchorous breath sounds on pulmonary examination. The patient was started on methylprednisolone for suspected DRESS syndrome. She underwent an evaluation for alternative causes of her organ failure. Her workup included a negative infectious, autoimmune, metabolic, toxic, and malignant work-up. Abdominal computed tomography (CT) and ultrasound were remarkable for evidence of hepatic steatosis and possible cirrhotic morphology. Additionally, a chest CT demonstrated diffuse and symmetric nodular alveolar lung opacities with peripheral sparing not consistent with acute respiratory distress syndrome or edema. Ultimately, her condition continued to decline, and she required intubation on several occasions. On hospital day 25 she succumbed to distributive shock in the setting of probable sepsis and multi-organ failure. Discussion: DRESS syndrome occurs in 1 in 1,000 to 10,000 patients with a mortality rate of around 10%. Anti-convulsant, anti-bacterial, anti-viral, and sulfonamide drugs are the most common drugs implicated in the development of DRESS syndrome; however, the list of offending agents is extensive . The diagnosis of DRESS syndrome is made after excluding other causes of disease such as infectious and autoimmune etiologies. The RegiSCAR scoring system is used to diagnose DRESS syndrome with 2-3 points indicating possible disease, 4-5 probable disease, and >5 definite disease. This patient scored a 7 on the RegiSCAR scale for eosinophilia, rash, organ involvement, and exclusion of other causes (infectious and autoimmune). While the pharmacologic trigger in this case is unknown, it is speculated to be caused by vancomycin, meloxicam, or furosemide due to the favorable timeline of initiation. Despite aggressive treatment, DRESS syndrome can often be fatal. Because of this, early diagnosis and treatment of patients with suspected DRESS syndrome is imperative.

Keywords: drug reaction with eosinophilia and systemic symptoms, multi-organ failure, pulmonary involvement, renal failure

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Authors: Karuna Sutthibenjakul, Sunisa Chatmongkolchart

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Background: Postinduction hypotension is common and occurs more often in elderly patients. We aimed to determine risk factors for hypotension after induction among elderly patients (aged 65 years and older) who underwent elective non-cardiac surgery under general anesthesia. Methods: This cohort study analyzed from 580 data between December 2017 and July 2018 at a tertiary university hospital in south of Thailand. Hypotension is defined as more than 30% decrease mean arterial pressure from baseline after induction within 20 minutes or the use of vasopressive agent to treat low blood pressure. Intraoperative parameters were blood pressure and heart rate at T0, TEI, T5, T10, T15 and T20 (immediately after arrival at operating room, time after intubation, 5, 10, 15 and 20 minutes after intubation) respectively. Results: The median age was 72.5 (68, 78) years. A prevalence of post-induction hypotension was 64.8%. The highest prevalence (39.7%) was at 15 minutes after intubation. The association of post-induction hypotension is rising with diuretic drug as preoperative medication (P-value=0.016), hematocrit level (P-value=0.031) and the degree of hypertension immediately after arrival at operating room (P-value<0.001). Increasing fentanyl dosage during induction was associated with hypotension at intubation time (P-value<0.01) and 5 minutes after intubation (P-value<0.001). There was no statistically significant difference in the increasing propofol dosage. Conclusion: The degree of hypertension immediately after arrival at operating room and increasing fentanyl dosage were a significant risk factors for postinduction hypotension in elderly patients.

Keywords: risk factors, post-induction, hypotension, elderly

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Authors: Jagmeet S. Kanwal, Julia F. Langley

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Music can heal the body, but a mechanistic understanding of this phenomenon is lacking. This study explores the effects of music presentation on neurologic and physiologic responses leading to metabolic changes in the human body. The mind and body co-exist in a corporeal entity and within this framework, sickness ensues when the mind-body balance goes awry. It is further hypothesized that music has the capacity to directly reset this balance. Two lines of inquiry taken together can provide a mechanistic understanding of this phenomenon 1) Empirical evidence for a sound-sensitive pressure sensor system in the body, and 2) The notion of a “healing center” within the brain that is activated by specific patterns of sounds. From an acoustics perspective, music is spatially distributed as pressure waves ranging from a few cm to several meters in wavelength. These waves interact and propagate in three-dimensions in unique ways, depending on the wavelength. Furthermore, music creates dynamically changing wave-fronts. Frequencies between 200 Hz and 1 kHz generate wavelengths that range from 5'6" to 1 foot. These dimensions are in the range of the body size of most people making it plausible that these pressure waves can geometrically interact with the body surface and create distinct patterns of pressure stimulation across the skin surface. For humans, short wavelength, high frequency (> 200 Hz) sounds are best received via cochlear receptors. For low frequency (< 200 Hz), long wavelength sound vibrations, however, the whole body may act as an ideal receiver. A vast array of highly sensitive pressure receptors (Pacinian corpuscles) is present just beneath the skin surface, as well as in the tendons, bones, several organs in the abdomen, and the sexual organs. Per the available empirical evidence, these receptors contribute to music perception by allowing the whole body to function as a sound receiver, and knowledge of how they function is essential to fully understanding the therapeutic effect of music. Neuroscientific studies have established that music stimulates the limbic system that can trigger states of anxiety, arousal, fear, and other emotions. These emotional states of brain activity play a crucial role in filtering top-down feedback from thoughts and bottom-up sensory inputs to the autonomic system, which automatically regulates bodily functions. Music likely exerts its pleasurable and healing effects by enhancing functional and effective connectivity and feedback mechanisms between brain regions that mediate reward, autonomic, and cognitive processing. Stimulation of pressure receptors under the skin by low-frequency music-induced sensations can activate multiple centers in the brain, including the amygdala, the cingulate cortex, and nucleus accumbens. Melodies in music in the low (< 600 Hz) frequency range may augment auditory inputs after convergence of the pressure-sensitive inputs from the vagus nerve onto emotive processing regions within the limbic system. The integration of music-generated auditory and somato-visceral inputs may lead to a synergistic input to the brain that promotes healing. Thus, music can literally heal humans through “touch” as it energizes the brain’s autonomic system for restoring homeostasis.

Keywords: acoustics, brain, music healing, pressure receptors

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Authors: Goudjil kamel, Boukhatem Ghania, Jlailia Djihene

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This paper delves into the development of a sophisticated desktop application designed to calculate soil bearing capacity and predict limit pressure. Drawing from an extensive review of existing methodologies, the study meticulously examines various approaches employed in soil bearing capacity calculations, elucidating their theoretical foundations and practical applications. Furthermore, the study explores the burgeoning intersection of artificial intelligence (AI) and geotechnical engineering, underscoring the transformative potential of AI- driven solutions in enhancing predictive accuracy and efficiency.Central to the research is the utilization of cutting-edge machine learning techniques, including Artificial Neural Networks (ANN), XGBoost, and Random Forest, for predictive modeling. Through comprehensive experimentation and rigorous analysis, the efficacy and performance of each method are rigorously evaluated, with XGBoost emerging as the preeminent algorithm, showcasing superior predictive capabilities compared to its counterparts. The study culminates in a nuanced understanding of the intricate dynamics at play in geotechnical analysis, offering valuable insights into optimizing soil bearing capacity calculations and limit pressure predictions. By harnessing the power of advanced computational techniques and AI-driven algorithms, the paper presents a paradigm shift in the realm of geotechnical engineering, promising enhanced precision and reliability in civil engineering projects.

Keywords: limit pressure of soil, xgboost, random forest, bearing capacity

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Authors: Myriam Ben Said, Dhekra Trabelsi, Faouzi Achouri, Marwa Ben Saad, Latifa Bousselmi, Ahmed Ghrabi

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This present study suggests the use of biological and natural bactericide, cheap, safe to handle, natural, environmentally benign agents to enhance the conventional wastewater treatment process. In the same sense, to highlight the enhancement of wastewater photocatalytic treatability, we were used virulent bacteriophage(s) and essential oils (EOs). The pre-phago-treatment of wastewater with lytic phage(s), leads to a decrease in bacterial density and, consequently, limits the establishment of intercellular communication (QS), thus preventing biofilm formation and inhibiting the expression of other virulence factors after photocatalysis. Moreover, to increase the photocatalytic efficiency, we were added to the secondary treated wastewater 1/1000 (w/v) of EO of thyme (T. vulgaris). This EO showed in vitro an anti-biofilm activity through the inhibition of plonctonic cell mobility and their attachment on an inert surface and also the deterioration of the sessile structure. The presence of photoactivatable molecules (photosensitizes) in this type of oil allows the optimization of photocatalytic efficiency without hazards relayed to dyes and chemicals reagent. The use of ‘biological and natural tools’ in combination with usual water treatment process can be considered as a safety procedure to reduce and/or to prevent the recontamination of treated water and also to prevent the re-expression of virulent factors by pathogenic bacteria such as biofilm formation with friendly processes.

Keywords: biofilm, essential oil, optimization, phage, photocatalysis, wastewater

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Authors: A. Majczak, G. Baranski, K. Pietrykowski

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Due to the growing popularity of light aircraft, it has become necessary to develop aircraft engines for this type of construction. One of engine system, designed to increase efficiency and reduce weight, is the engine with opposed pistons. In such an engine, the combustion chamber is formed by two pistons moving in one cylinder. Therefore, this type of engines run in a two-stroke cycle, so they have many advantages such as high power and torque, high efficiency, or a favorable power-to-weight ratio. Tests of one of the available aircraft engines with opposing piston system fueled with diesel oil were carried out on an engine dynamometer equipped with an eddy current brake and the necessary measuring and testing equipment. In order to get to know the basic parameters of the engine, the tests were carried out under partial load conditions for the following torque values: 40, 60, 80, 100 Nm. The rotational speed was changed from 1600 to 2500 rpm. Measurements were also taken for designated points of propeller characteristics. During the tests, the engine torque, engine power, fuel consumption, intake manifold pressure, and oil pressure were recorded. On the basis of the measurements carried out for particular loads, the power curve, hourly and specific fuel consumption curves were determined. Characteristics of charge pressure as a function of rotational speed as well as power, torque, hourly and specific fuel consumption curves for propeller characteristics were also prepared. The obtained characteristics make it possible to select the optimal points of engine operation.

Keywords: aircraft, diesel, engine testing, opposed piston

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Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman

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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.

Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism

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Authors: Akhila Vasudev, Himanshu Kaushik, Tadikonda Venkata Bharat

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A large number of mine tailings are produced every year as part of the extraction process of phosphates, gold, copper, and other materials. Mine tailings are high in water content and have very slow dewatering behavior. The efficient design of tailings dam and economical disposal of these slurries requires the knowledge of tailings consolidation behavior. The large-strain consolidation theory closely predicts the self-weight consolidation of these slurries as the theory considers the conservation of mass and momentum conservation and considers the hydraulic conductivity as a function of void ratio. Classical laboratory techniques, such as settling column test, seepage consolidation test, etc., are expensive and time-consuming for the estimation of hydraulic conductivity variation with void ratio. Inverse estimation of the constitutive relationships from the measured settlement versus time curves is explored. In this work, inverse analysis based on metaheuristics techniques will be explored for predicting the hydraulic conductivity parameters for mine tailings from the base excess pore water pressure dissipation curve and the initial conditions of the mine tailings. The proposed inverse model uses particle swarm optimization (PSO) algorithm, which is based on the social behavior of animals searching for food sources. The finite-difference numerical solution of the forward analytical model is integrated with the PSO algorithm to solve the inverse problem. The method is tested on synthetic data of base excess pore pressure dissipation curves generated using the finite difference method. The effectiveness of the method is verified using base excess pore pressure dissipation curve obtained from a settling column experiment and further ensured through comparison with available predicted hydraulic conductivity parameters.

Keywords: base excess pore pressure, hydraulic conductivity, large strain consolidation, mine tailings

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Authors: Serpa A. M., Gómez Hoyos C., Velásquez-Cock J. A., Ruiz L. F., Vélez Acosta L. M., Gañan P., Zuluaga R.

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Turmeric (Curcuma Longa L) is an Indian rhizome known for its biological properties, derived from its active compounds such as curcuminoids. Curcumin, the main polyphenol in turmeric, only represents around 3.5% of the dehydrated rhizome and extraction yields between 41 and 90% have been reported. Therefore, for every 1000 tons of turmeric powder used for the extraction of curcumin, around 970 tons of residues are generated. The present study evaluates the effect of different mechanical treatments (waring blender, grinder and high-pressure homogenization) on the physical and chemical properties of turmeric, as an alternative for the transformation of the entire rhizome. Suspensions of turmeric (10, 20 y 30%) were processed by waring blender during 3 min at 12000 rpm, while the samples treated by grinder were processed evaluating two different Gaps (-1 and -1,5). Finally, the process by high-pressure homogenization, was carried out at 500 bar. According to the results, the luminosity of the samples increases with the severity of the mechanical treatment, due to the stabilization of the color associated with the inactivation of the oxidative enzymes. Additionally, according to the microstructure of the samples, the process by grinder (Gap -1,5) and by high-pressure homogenization allowed the largest size reduction, reaching sizes up to 3 m (measured by optical microscopy). This processes disrupts the cells and breaks their fragments into small suspended particles. The infrared spectra obtained from the samples using an attenuated total reflectance accessory indicates changes in the 800-1200 cm⁻¹ region, related mainly to changes in the starch structure. Finally, the thermogravimetric analysis shows the presence of starch, curcumin and some minerals in the suspensions.

Keywords: characterization, mechanical treatments, suspensions, turmeric rhizome

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Authors: Mostafa Zandi, Ramin Mansouri

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Spillways are one of the most important hydraulic structures of dams that provide the stability of the dam and downstream areas at the time of flood. Morning-Glory spillway is one of the common spillways for discharging the overflow water behind dams, these kinds of spillways are constructed in dams with small reservoirs. In this research, the hydraulic flow characteristics of a morning-glory spillways are investigated with CFD model. Two dimensional unsteady RANS equations were solved numerically using Finite Volume Method. The PISO scheme was applied for the velocity-pressure coupling. The mostly used two-equation turbulence models, k- and k-, were chosen to model Reynolds shear stress term. The power law scheme was used for discretization of momentum, k , and  equations. The VOF method (geometrically reconstruction algorithm) was adopted for interface simulation. The results show that the fine computational grid, the input speed condition for the flow input boundary, and the output pressure for the boundaries that are in contact with the air provide the best possible results. Also, the standard wall function is chosen for the effect of the wall function, and the turbulent model k -ε (Standard) has the most consistent results with experimental results. When the jet is getting closer to end of basin, the computational results increase with the numerical results of their differences. The lower profile of the water jet has less sensitivity to the hydraulic jet profile than the hydraulic jet profile. In the pressure test, it was also found that the results show that the numerical values of the pressure in the lower landing number differ greatly in experimental results. The characteristics of the complex flows over a Morning-Glory spillway were studied numerically using a RANS solver. Grid study showed that numerical results of a 57512-node grid had the best agreement with the experimental values. The desired downstream channel length was preferred to be 1.5 meter, and the standard k-ε turbulence model produced the best results in Morning-Glory spillway. The numerical free-surface profiles followed the theoretical equations very well.

Keywords: morning-glory spillway, CFD model, hydraulic characteristics, wall function

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Authors: M. Fozan Ur Rab, Mahrukh, M. Alam, N. Sheikh

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The purpose of this study is to analyze various high lift low Reynolds number airfoils using two-dimensional Computational Fluid Dynamics (CFD) code in the isolated flow field and select optimum airfoil to suit the motorsports application. The airfoil is selected after comparing the stall behavior, transition location, pressure recovery, pressure distribution and boundary layer characteristics of various airfoils. The prime consideration while selecting airfoil is highest Cl while achieving the sustainable performance over a range of Reynolds numbers encountered on the race track. The increase in Cl is always accompanied by the increase in Cd but this must be compromised since the main goal is to increase an aerodynamic grip. It is always desirable to increase the down-force in Formula One (F1)/Formula Student (FS) to gain reduction in lap time. This paper establishes the criteria for selection of high lift low Reynolds number airfoil while considering various parameters which affect the performance of airfoils.

Keywords: aerodynamics, airfoil, downforce, formula student, lap time

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