Search results for: physical and mechanical tests for Marls
209 Investigation of Attitude of Production Workers towards Job Rotation in Automotive Industry against the Background of Demographic Change
Authors: Franciska Weise, Ralph Bruder
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Due to the demographic change in Germany along with the declining birth rate and the increasing age of population, the share of older people in society is rising. This development is also reflected in the work force of German companies. Therefore companies should focus on improving ergonomics, especially in the area of age-related work design. Literature shows that studies on age-related work design have been carried out in the past, some of whose results have been put into practice. However, there is still a need for further research. One of the most important methods for taking into account the needs of an aging population is job rotation. This method aims at preventing or reducing health risks and inappropriate physical strain. It is conceived as a systematic change of workplaces within a group. Existing literature does not cover any methods for the investigation of the attitudes of employees towards job rotation. However, in order to evaluate job rotation, it is essential to have knowledge of the views of people towards rotation. In addition to an investigation of attitudes, the design of rotation plays a crucial role. The sequence of activities and the rotation frequency influence the worker and as well the work result. The evaluation of preliminary talks on the shop floor showed that team speakers and foremen share a common understanding of job rotation. In practice, different varieties of job rotation exist. One important aspect is the frequency of rotation. It is possible to rotate never, more than one time or even during every break, or more often than every break. It depends on the opportunity or possibility to rotate whenever workers want to rotate. From the preliminary talks some challenges can be derived. For example a rotation in the whole team is not possible, if a team member requires to be trained for a new task. In order to be able to determine the relation of the design and the attitude towards job rotation, a questionnaire is carried out in the vehicle manufacturing. The questionnaire will be employed to determine the different varieties of job rotation that exist in production, as well as the attitudes of workers towards those different frequencies of job rotation. In addition, younger and older employees will be compared with regard to their rotation frequency and their attitudes towards rotation. There are three kinds of age groups. Three questions are under examination. The first question is whether older employees rotate less frequently than younger employees. Also it is investigated to know whether the frequency of job rotation and the attitude towards the frequency of job rotation are interconnected. Moreover, the attitudes of the different age groups towards the frequency of rotation will be examined. Up to now 144 employees, all working in production, took part in the survey. 36.8 % were younger than thirty, 37.5 % were between thirty und forty-four and 25.7 % were above forty-five years old. The data shows no difference between the three age groups in relation to the frequency of job rotation (N=139, median=4, Chi²=.859, df=2, p=.651). Most employees rotate between six and seven workplaces per day. In addition there is a statistically significant correlation between the frequency of job rotation and the attitude towards the frequency (Spearman-Rho: 2-sided=.008, correlation coefficient=.223). Less than four workplaces per day are not enough for the employees. The third question, which differences can be found between older and younger people who rotate in a different way and with different attitudes towards job rotation, cannot be possible answered. Till now the data shows that younger people would like to rotate very often. Regarding to older people no correlation can be found with acceptable significance. The results of the survey will be used to improve the current practice of job rotation. In addition, the discussions during the survey are expected to help sensitize the employees with respect to rotation issues, and to contribute to optimizing rotation by means of qualification and an improved design of job rotation. Together with the employees and the results of the survey there must be found standards which show how to rotate in an ergonomic way while consider the attitude towards job rotation.Keywords: job rotation, age-related work design, questionnaire, automotive industry
Procedia PDF Downloads 303208 Development of a Context Specific Planning Model for Achieving a Sustainable Urban City
Authors: Jothilakshmy Nagammal
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This research paper deals with the different case studies, where the Form-Based Codes are adopted in general and the different implementation methods in particular are discussed to develop a method for formulating a new planning model. The organizing principle of the Form-Based Codes, the transect is used to zone the city into various context specific transects. An approach is adopted to develop the new planning model, city Specific Planning Model (CSPM), as a tool to achieve sustainability for any city in general. A case study comparison method in terms of the planning tools used, the code process adopted and the various control regulations implemented in thirty two different cities are done. The analysis shows that there are a variety of ways to implement form-based zoning concepts: Specific plans, a parallel or optional form-based code, transect-based code /smart code, required form-based standards or design guidelines. The case studies describe the positive and negative results from based zoning, Where it is implemented. From the different case studies on the method of the FBC, it is understood that the scale for formulating the Form-Based Code varies from parts of the city to the whole city. The regulating plan is prepared with the organizing principle as the transect in most of the cases. The various implementation methods adopted in these case studies for the formulation of Form-Based Codes are special districts like the Transit Oriented Development (TOD), traditional Neighbourhood Development (TND), specific plan and Street based. The implementation methods vary from mandatory, integrated and floating. To attain sustainability the research takes the approach of developing a regulating plan, using the transect as the organizing principle for the entire area of the city in general in formulating the Form-Based Codes for the selected Special Districts in the study area in specific, street based. Planning is most powerful when it is embedded in the broader context of systemic change and improvement. Systemic is best thought of as holistic, contextualized and stake holder-owned, While systematic can be thought of more as linear, generalisable, and typically top-down or expert driven. The systemic approach is a process that is based on the system theory and system design principles, which are too often ill understood by the general population and policy makers. The system theory embraces the importance of a global perspective, multiple components, interdependencies and interconnections in any system. In addition, the recognition that a change in one part of a system necessarily alters the rest of the system is a cornerstone of the system theory. The proposed regulating plan taking the transect as an organizing principle and Form-Based Codes to achieve sustainability of the city has to be a hybrid code, which is to be integrated within the existing system - A Systemic Approach with a Systematic Process. This approach of introducing a few form based zones into a conventional code could be effective in the phased replacement of an existing code. It could also be an effective way of responding to the near-term pressure of physical change in “sensitive” areas of the community. With this approach and method the new Context Specific Planning Model is created towards achieving sustainability is explained in detail this research paper.Keywords: context based planning model, form based code, transect, systemic approach
Procedia PDF Downloads 338207 Low- and High-Temperature Methods of CNTs Synthesis for Medicine
Authors: Grzegorz Raniszewski, Zbigniew Kolacinski, Lukasz Szymanski, Slawomir Wiak, Lukasz Pietrzak, Dariusz Koza
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One of the most promising area for carbon nanotubes (CNTs) application is medicine. One of the most devastating diseases is cancer. Carbon nanotubes may be used as carriers of a slowly released drug. It is possible to use of electromagnetic waves to destroy cancer cells by the carbon nanotubes (CNTs). In our research we focused on thermal ablation by ferromagnetic carbon nanotubes (Fe-CNTs). In the cancer cell hyperthermia functionalized carbon nanotubes are exposed to radio frequency electromagnetic field. Properly functionalized Fe-CNTs join the cancer cells. Heat generated in nanoparticles connected to nanotubes warm up nanotubes and then the target tissue. When the temperature in tumor tissue exceeds 316 K the necrosis of cancer cells may be observed. Several techniques can be used for Fe-CNTs synthesis. In our work, we use high-temperature methods where arc-discharge is applied. Low-temperature systems are microwave plasma with assisted chemical vapor deposition (MPCVD) and hybrid physical-chemical vapor deposition (HPCVD). In the arc discharge system, the plasma reactor works with a pressure of He up to 0,5 atm. The electric arc burns between two graphite rods. Vapors of carbon move from the anode, through a short arc column and forms CNTs which can be collected either from the reactor walls or cathode deposit. This method is suitable for the production of multi-wall and single-wall CNTs. A disadvantage of high-temperature methods is a low purification, short length, random size and multi-directional distribution. In MPCVD system plasma is generated in waveguide connected to the microwave generator. Then containing carbon and ferromagnetic elements plasma flux go to the quartz tube. The additional resistance heating can be applied to increase the reaction effectiveness and efficiency. CNTs nucleation occurs on the quartz tube walls. It is also possible to use substrates to improve carbon nanotubes growth. HPCVD system involves both chemical decomposition of carbon containing gases and vaporization of a solid or liquid source of catalyst. In this system, a tube furnace is applied. A mixture of working and carbon-containing gases go through the quartz tube placed inside the furnace. As a catalyst ferrocene vapors can be used. Fe-CNTs may be collected then either from the quartz tube walls or on the substrates. Low-temperature methods are characterized by higher purity product. Moreover, carbon nanotubes from tested CVD systems were partially filled with the iron. Regardless of the method of Fe-CNTs synthesis the final product always needs to be purified for applications in medicine. The simplest method of purification is an oxidation of the amorphous carbon. Carbon nanotubes dedicated for cancer cell thermal ablation need to be additionally treated by acids for defects amplification on the CNTs surface what facilitates biofunctionalization. Application of ferromagnetic nanotubes for cancer treatment is a promising method of fighting with cancer for the next decade. Acknowledgment: The research work has been financed from the budget of science as a research project No. PBS2/A5/31/2013Keywords: arc discharge, cancer, carbon nanotubes, CVD, thermal ablation
Procedia PDF Downloads 449206 Development and Evaluation of Surgical Sutures Coated with Antibiotic Loaded Gold Nanoparticles
Authors: Sunitha Sampathi, Pankaj Kumar Tiriya, Sonia Gera, Sravanthi Reddy Pailla, V. Likhitha, A. J. Maruthi
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Surgical site infections (SSIs) are the most common nosocomial infections localized at the incision site. With an estimated 27 million surgical procedures each year in USA, approximately 2-5% rate of SSIs are predicted to occur annually. SSIs are treated with antibiotic medication. Current trend suggest that the direct drug delivery from the suture to the scared tissue can improve patient comfort and wound recovery. For that reason coating the surface of the medical device such as suture and catguts with broad spectrum antibiotics can prevent the formation of bactierial colonies with out comprimising the mechanical properties of the sutures.Hence, the present study was aimed to develop and evaluate a surgical suture coated with an antibiotic Ciprofloxacin hydrochloride loaded on gold nanoparticles. Gold nanoparticles were synthesized by chemical reduction method and conjugated with ciprofloxacin using Polyvinylpyrolidone as stabilizer and gold as carrier. Ciprofloxacin conjugated gold nanoparticles were coated over an absorbable surgical suture made of Polyglactan using sodium alginate as an immobilising agent by slurry dipping technique. The average particle size and Polydispersity Index of drug conjugated gold NPs were found to be 129±2.35 nm and 0.243±0.36 respectively. Gold nanoparticles are characterized by UV-Vis absorption spectroscopy, Fourier Transform Infrared Spectroscopy (FT-IR), Scanning electron microscopy and Transmission electron microscopy. FT-IR revealed that there is no chemical interaction between drug and polymer. Antimicrobial activity for coated sutures was evaluated by disc diffusion method on culture plates of both gram negative (E-coli) and gram positive bacteria (Staphylococcus aureus) and results found to be satisfactory. In vivo studies for coated sutures was performed on Swiss albino mice and histological evaluation of intestinal wound healing parameters such as wound edges in mucosa, muscularis, presence of necrosis, exudates, granulation tissue, granulocytes, macrophages, restoration, and repair of mucosal epithelium and muscularis propria on day 7 after surgery were studied. The control animal group, sutured with plain suture (uncoated suture) showed signs of restoration and repair, but presence of necrosis, heamorraghic infiltration and granulation tissue was still noticed. Whereas the animal group treated with ciprofloxacin and ciprofloxacin gold nanoparticle coated sutures has shown promising decrease in terms of haemorraghic infiltration, granulation tissue, necrosis and better repaired muscularis layers on comparision with plain coated sutures indicating faster rate of repair and less chance of sepsis. Hence coating of sutures with broad spectrum antibiotics can be an alternate technique to reduce SSIs.Keywords: ciprofloxacin hydrochloride, gold nanoparticles, surgical site infections, sutures
Procedia PDF Downloads 256205 The Achievements and Challenges of Physics Teachers When Implementing Problem-Based Learning: An Exploratory Study Applied to Rural High Schools
Authors: Osman Ali, Jeanne Kriek
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Introduction: The current instructional approach entrenched in memorizing does not assist conceptual understanding in science. Instructional approaches that encourage research, investigation, and experimentation, which depict how scientists work, should be encouraged. One such teaching strategy is problem-based learning (PBL). PBL has many advantages; enhanced self-directed learning and improved problem-solving and critical thinking skills. However, despite many advantages, PBL has challenges. Research confirmed is time-consuming and difficult to formulate ill-structured questions. Professional development interventions are needed for in-service educators to adopt the PBL strategy. The purposively selected educators had to implement PBL in their classrooms after the intervention to develop their practice and then reflect on the implementation. They had to indicate their achievements and challenges. This study differs from previous studies as the rural educators were subjected to implementing PBL in their classrooms and reflected on their experiences, beliefs, and attitudes regarding PBL. Theoretical Framework: The study reinforced Vygotskian sociocultural theory. According to Vygotsky, the development of a child's cognitive is sustained by the interaction between the child and more able peers in his immediate environment. The theory suggests that social interactions in small groups create an opportunity for learners to form concepts and skills on their own better than working individually. PBL emphasized learning in small groups. Research Methodology: An exploratory case study was employed. The reason is that the study was not necessarily for specific conclusive evidence. Non-probability purposive sampling was adopted to choose eight schools from 89 rural public schools. In each school, two educators were approached, teaching physical sciences in grades 10 and 11 (N = 16). The research instruments were questionnaires, interviews, and lesson observation protocol. Two open-ended questionnaires were developed before and after intervention and analyzed thematically. Three themes were identified. The semi-structured interviews and responses were coded and transcribed into three themes. Subsequently, the Reform Teaching Observation Protocol (RTOP) was adopted for lesson observation and was analyzed using five constructs. Results: Evidence from analyzing the questionnaires before and after the intervention shows that participants knew better what was required to develop an ill-structured problem during the implementation. Furthermore, indications from the interviews are that participants had positive views about the PBL strategy. They stated that they only act as facilitators, and learners’ problem-solving and critical thinking skills are enhanced. They suggested a change in curriculum to adopt the PBL strategy. However, most participants may not continue to apply the PBL strategy stating that it is time-consuming and difficult to complete the Annual Teaching Plan (ATP). They complained about materials and equipment and learners' readiness to work. Evidence from RTOP shows that after the intervention, participants learn to encourage exploration and use learners' questions and comments to determine the direction and focus of classroom discussions.Keywords: problem-solving, self-directed, critical thinking, intervention
Procedia PDF Downloads 119204 Characterization of Platelet Mitochondrial Metabolism in COVID-19 Caused Acute Respiratory Distress Syndrome (ARDS)
Authors: Anna Höfer, Johannes Herrmann, Patrick Meybohm, Christopher Lotz
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Mitochondria are pivotal for energy supply and regulation of cellular functions. Deficiencies of mitochondrial metabolism have been implicated in diverse stressful conditions including infections. Platelets are key mediators for thrombo-inflammation during development and resolution of acute respiratory distress syndrome (ARDS). Previous data point to an exhausted platelet phenotype in critically-ill patients with coronavirus 19 disease (COVID-19) impacting the course of disease. The objective of this work was to characterize platelet mitochondrial metabolism in patients suffering from COVID-19 ARDSA longitudinal analysis of platelet mitochondrial metabolism in 24 patients with COVID-19 induced ARDS compared to 35 healthy controls (ctrl) was performed. Blood samples were analyzed at two time points (t1=day 1; t2=day 5-7 after study inclusion). The activity of mitochondrial citrate synthase was photometrically measured. The impact of oxidative stress on mitochondrial permeability was assessed by a photometric calcium-induced swelling assay and the activity of superoxide dismutase (SOD) by a SOD assay kit. The amount of protein carbonylation and the activity of mitochondria complexes I-IV were photometrically determined. Levels of interleukins (IL)-1α, IL-1β and tumor necrosis factor (TNF-) α were measured by a Multiplex assay kit. Median age was 54 years, 63 % were male and BMI was 29.8 kg/m2. SOFA (12; IQR: 10-15) and APACHE II (27; IQR: 24-30) indicated critical illness. Median Murray Score was 3.4 (IQR: 2.8-3.4), 21/24 (88%) required mechanical ventilation and V-V ECMO support in 14/24 (58%). Platelet counts in ARDS did not change during ICU stay (t1: 212 vs. t2: 209 x109/L). However, mean platelet volume (MPV) significantly increased (t1: 10.6 vs. t2: 11.9 fL; p<0.0001). Citrate synthase activity showed no significant differences between ctrl and ARDS patients. Calcium induced swelling was more pronounced in patients at t1 compared to t2 and to ctrl (50µM; t1: 0.006 vs. ctrl: 0.016 ΔOD; p=0.001). The amount of protein carbonylation as marker for irreversible proteomic modification constantly increased during ICU stay and compared to ctrl., without reaching significance. In parallel, superoxid dismutase activity gradually declined during ICU treatment vs. ctrl (t2: - 29 vs. ctrl.: - 17 %; p=0.0464). Complex I analysis revealed significantly stronger activity in ARDS vs. ctrl. (t1: 0.633 vs. ctrl.: 0.415 ΔOD; p=0.0086). There were no significant differences in complex II, III or IV activity in platelets from ARDS patients compared to ctrl. IL-18 constantly increased during the observation period without reaching significance. IL-1α and TNF-α did not differ from ctrl. However, IL-1β levels were significantly elevated in ARDS (t1: 16.8; t2: 16.6 vs. ctrl.: 12.4 pg/mL; p1=0.0335, p2=0.0032). This study reveals new insights in platelet mitochondrial metabolism during COVID-19 caused ARDS. it data point towards enhanced platelet activity with a pronounced turnover rate. We found increased activity of mitochondria complex I and evidence for enhanced oxidative stress. In parallel, protective mechanisms against oxidative stress were narrowed with elevated levels of IL-1β likely causing a pro-apoptotic environment. These mechanisms may contribute to platelet exhaustion in ARDS.Keywords: acute respiratory distress syndrome (ARDS), coronavirus 19 disease (COVID-19), oxidative stress, platelet mitochondrial metabolism
Procedia PDF Downloads 59203 Method of Nursing Education: History Review
Authors: Cristina Maria Mendoza Sanchez, Maria Angeles Navarro Perán
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Introduction: Nursing as a profession, from its initial formation and after its development in practice, has been built and identified mainly from its technical competence and professionalization within the positivist approach of the XIX century that provides a conception of the disease built on the basis of to the biomedical paradigm, where the care provided is more focused on the physiological processes and the disease than on the suffering person understood as a whole. The main issue that is in need of study here is a review of the nursing profession's history to get to know how the nursing profession was before the XIX century. It is unclear if there were organizations or people with knowledge about looking after others or if many people survived by chance. The holistic care, in which the appearance of the disease directly affects all its dimensions: physical, emotional, cognitive, social and spiritual. It is not a concept from the 21st century. It is common practice, most probably since established life in this world, with the final purpose of covering all these perspectives through quality care. Objective: In this paper, we describe and analyze the history of education in nursing learning in terms of reviewing and analysing theoretical foundations of clinical teaching and learning in nursing, with the final purpose of determining and describing the development of the nursing profession along the history. Method: We have done a descriptive systematic review study, doing a systematically searched of manuscripts and articles in the following health science databases: Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL. The selection of articles has been made according to PRISMA criteria, doing a critical reading of the full text using the CASPe method. A compliment to this, we have read a range of historical and contemporary sources to support the review, such as manuals of Florence Nightingale and John of God as primary manuscripts to establish the origin of modern nursing and her professionalization. We have considered and applied ethical considerations of data processing. Results: After applying inclusion and exclusion criteria in our search, in Pubmed, Scopus, Web of Science, Temperamentvm and CINAHL, we have obtained 51 research articles. We have analyzed them in such a way that we have distinguished them by year of publication and the type of study. With the articles obtained, we can see the importance of our background as a profession before modern times in public health and as a review of our past to face challenges in the near future. Discussion: The important influence of key figures other than Nightingale has been overlooked and it emerges that nursing management and development of the professional body has a longer and more complex history than is generally accepted. Conclusions: There is a paucity of studies on the subject of the review to be able to extract very precise evidence and recommendations about nursing before modern times. But even so, as more representative data, an increase in research about nursing history has been observed. In light of the aspects analyzed, the need for new research in the history of nursing emerges from this perspective; in order to germinate studies of the historical construction of care before the XIX century and theories created then. We can assure that pieces of knowledge and ways of care were taught before the XIX century, but they were not called theories, as these concepts were created in modern times.Keywords: nursing history, nursing theory, Saint John of God, Florence Nightingale, learning, nursing education
Procedia PDF Downloads 113202 Treatment Process of Sludge from Leachate with an Activated Sludge System and Extended Aeration System
Authors: A. Chávez, A. Rodríguez, F. Pinzón
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Society is concerned about measures of environmental, economic and social impacts generated in the solid waste disposal. These places of confinement, also known as landfills, are locations where problems of pollution and damage to human health are reduced. They are technically designed and operated, using engineering principles, storing the residue in a small area, compact it to reduce volume and covering them with soil layers. Problems preventing liquid (leachate) and gases produced by the decomposition of organic matter. Despite planning and site selection for disposal, monitoring and control of selected processes, remains the dilemma of the leachate as extreme concentration of pollutants, devastating soil, flora and fauna; aggressive processes requiring priority attention. A biological technology is the activated sludge system, used for tributaries with high pollutant loads. Since transforms biodegradable dissolved and particulate matter into CO2, H2O and sludge; transform suspended and no Settleable solids; change nutrients as nitrogen and phosphorous; and degrades heavy metals. The microorganisms that remove organic matter in the processes are in generally facultative heterotrophic bacteria, forming heterogeneous populations. Is possible to find unicellular fungi, algae, protozoa and rotifers, that process the organic carbon source and oxygen, as well as the nitrogen and phosphorus because are vital for cell synthesis. The mixture of the substrate, in this case sludge leachate, molasses and wastewater is maintained ventilated by mechanical aeration diffusers. Considering as the biological processes work to remove dissolved material (< 45 microns), generating biomass, easily obtained by decantation processes. The design consists of an artificial support and aeration pumps, favoring develop microorganisms (denitrifying) using oxygen (O) with nitrate, resulting in nitrogen (N) in the gas phase. Thus, avoiding negative effects of the presence of ammonia or phosphorus. Overall the activated sludge system includes about 8 hours of hydraulic retention time, which does not prevent the demand for nitrification, which occurs on average in a value of MLSS 3,000 mg/L. The extended aeration works with times greater than 24 hours detention; with ratio of organic load/biomass inventory under 0.1; and average stay time (sludge age) more than 8 days. This project developed a pilot system with sludge leachate from Doña Juana landfill - RSDJ –, located in Bogota, Colombia, where they will be subjected to a process of activated sludge and extended aeration through a sequential Bach reactor - SBR, to be dump in hydric sources, avoiding ecological collapse. The system worked with a dwell time of 8 days, 30 L capacity, mainly by removing values of BOD and COD above 90%, with initial data of 1720 mg/L and 6500 mg/L respectively. Motivating the deliberate nitrification is expected to be possible commercial use diffused aeration systems for sludge leachate from landfills.Keywords: sludge, landfill, leachate, SBR
Procedia PDF Downloads 272201 A Critical Analysis of How the Role of the Imam Can Best Meet the Changing Social, Cultural, and Faith-Based Needs of Muslim Families in 21st Century Britain
Authors: Christine Hough, Eddie Abbott-Halpin, Tariq Mahmood, Jessica Giles
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This paper draws together the findings from two research studies, each undertaken with cohorts of South Asian Muslim respondents located in the North of England between 2017 and 2019. The first study, entitled Faith Family and Crime (FFC), investigated the extent to which a Muslim family’s social and health well-being is affected by a family member’s involvement in the Criminal Justice System (CJS). This study captured a range of data through a detailed questionnaire and structured interviews. The data from the interview transcripts were analysed using open coding and an application of aspects of the grounded theory approach. The findings provide clear evidence that the respondents were neither well-informed nor supported throughout the processes of the CJS, from arrest to post-sentencing. These experiences gave rise to mental and physical stress, potentially unfair sentencing, and a significant breakdown in communication within the respondents’ families. They serve to highlight a particular aspect of complexity in the current needs of those South Asian Muslim families who find themselves involved in the CJS and is closely connected to family structure, culture, and faith. The second study, referred to throughout this paper as #ImamsBritain (that provides the majority of content for this paper), explores how Imams, in their role as community faith leaders, can best address the complex – and changing - needs of South Asian Muslims families, such as those that emerged in the findings from FFC. The changing socio-economic and political climates of the last thirty or so years have brought about significant changes to the lives of Muslim families, and these have created more complex levels of social, cultural, and faith-based needs for families and individuals. As a consequence, Imams now have much greater demands made of them, and so their role has undergone far-reaching changes in response to this. The #ImamsBritain respondents identified a pressing need to develop a wider range of pastoral and counseling skills, which they saw as extending far beyond the traditional role of the Imam as a religious teacher and spiritual guide. The #ImamsBritain project was conducted with a cohort of British Imams in the North of England. Data was collected firstly through a questionnaire that related to the respondents’ training and development needs and then analysed in depth using the Delphi approach. Through Delphi, the data were scrutinized in depth using interpretative content analysis. The findings from this project reflect the respondents’ individual perceptions of the kind of training and development they need to fulfill their role in 21st Century Britain. They also provide a unique framework for constructing a professional guide for Imams in Great Britain. The discussions and critical analyses in this paper draw on the discourses of professionalization and pastoral care and relevant reports and reviews on Imam training in Europe and Canada.Keywords: criminal justice system, faith and culture, Imams, Muslim community leadership, professionalization, South Asian family structure
Procedia PDF Downloads 138200 Design and Construction of a Solar Dehydration System as a Technological Strategy for Food Sustainability in Difficult-to-Access Territories
Authors: Erika T. Fajardo-Ariza, Luis A. Castillo-Sanabria, Andrea Nieto-Veloza, Carlos M. Zuluaga-Domínguez
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The growing emphasis on sustainable food production and preservation has driven the development of innovative solutions to minimize postharvest losses and improve market access for small-scale farmers. This project focuses on designing, constructing, and selecting materials for solar dryers in certain regions of Colombia where inadequate infrastructure limits access to major commercial hubs. Postharvest losses pose a significant challenge, impacting food security and farmer income. Addressing these losses is crucial for enhancing the value of agricultural products and supporting local economies. A comprehensive survey of local farmers revealed substantial challenges, including limited market access, inefficient transportation, and significant postharvest losses. For crops such as coffee, bananas, and citrus fruits, losses range from 0% to 50%, driven by factors like labor shortages, adverse climatic conditions, and transportation difficulties. To address these issues, the project prioritized selecting effective materials for the solar dryer. Various materials, recovered acrylic, original acrylic, glass, and polystyrene, were tested for their performance. The tests showed that recovered acrylic and glass were most effective in increasing the temperature difference between the interior and the external environment. The solar dryer was designed using Fusion 360® software (Autodesk, USA) and adhered to architectural guidelines from Architectural Graphic Standards. It features up to sixteen aluminum trays, each with a maximum load capacity of 3.5 kg, arranged in two levels to optimize drying efficiency. The constructed dryer was then tested with two locally available plant materials: green plantains (Musa paradisiaca L.) and snack bananas (Musa AA Simonds). To monitor performance, Thermo hygrometers and an Arduino system recorded internal and external temperature and humidity at one-minute intervals. Despite challenges such as adverse weather conditions and delays in local government funding, the active involvement of local producers was a significant advantage, fostering ownership and understanding of the project. The solar dryer operated under conditions of 31°C dry bulb temperature (Tbs), 55% relative humidity, and 21°C wet bulb temperature (Tbh). The drying curves showed a consistent drying period with critical moisture content observed between 200 and 300 minutes, followed by a sharp decrease in moisture loss, reaching an equilibrium point after 3,400 minutes. Although the solar dryer requires more time and is highly dependent on atmospheric conditions, it can approach the efficiency of an electric dryer when properly optimized. The successful design and construction of solar dryer systems in difficult-to-access areas represent a significant advancement in agricultural sustainability and postharvest loss reduction. By choosing effective materials such as recovered acrylic and implementing a carefully planned design, the project provides a valuable tool for local farmers. The initiative not only improves the quality and marketability of agricultural products but also offers broader environmental benefits, such as reduced reliance on fossil fuels and decreased waste. Additionally, it supports economic growth by enhancing the value of crops and potentially increasing farmer income. The successful implementation and testing of the dryer, combined with the engagement of local stakeholders, highlight its potential for replication and positive impact in similar contexts.Keywords: drying technology, postharvest loss reduction, solar dryers, sustainable agriculture
Procedia PDF Downloads 30199 Quality Assessment of Pedestrian Streets in Iran: Case Study of Saf, Tehran
Authors: Fstemeh Rais Esmaili, Ehsan Ranjbar
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Pedestrian streets as one type of urban public spaces have an important role in improving the quality of urban life. In Iran, planning and designing of pedestrian streets is in its primary steps. In spite of starting this approach in Iran, and designing several pedestrian streets, there are still not organized studies about quality assessment of pedestrian streets. As a result, the strength and weakness points of the initial experiences have not been utilized. This inattention to quality assessment have caused designing pedestrian streets to be limited to just vehicles traffic control and preliminary actions like paving; so that, special potentials of pedestrian streets for creating social, livable and dynamic public spaces have not been used. This article, as an organized study about quality assessment of pedestrian streets in Iran, tries to reach two main goals: first, introducing a framework for quality assessment of pedestrian streets in Iran, and second, creating a context for improving the quality of pedestrian streets especially for further experiences. The main research methods are description and context analyzing. With respect to comparative analysis of ideas about quality, considering international and local case studies and analyzing existing condition of Saf Pedestrian Street, a particular model for quality assessment has been introduced. In this model, main components and assessment criteria have been presented. On the basis of this model, questionnaire and checklist for assessment have been prepared. The questionnaire and interview have been used to assess qualities which are in direct contact with people and the checklist has been used for analyzing visual qualities by authors through observation. Some results of questionnaire and checklist show that 7 of 11 primary components, diversity, flexibility, cleanness, legibility and imaginably, identity, livability, form and physical setting are rated low and very low in quality degree. Three components, efficiency, comfort and distinctiveness, have medium and low quality degree and one component, access, linkage and permeability has high quality degree. Therefore, based on implemented analyzing process, Saf Pedestrian Street needs to be improved and these quality improvement priorities are determined based on presented criteria. Adaption of final results with existing condition illustrates the shortage of services for satisfying user’s needs, inflexibility and impossibility of using spaces in various times, lack of facilities for different climatic conditions, lack of facilities such as drinking fountain, inappropriate designing of existing urban furniture like garbage cans, and creating pollution and unsuitable view, lack of visual attractions, neglecting disabled persons in designing entrances, shortage of benches and their undesirable designing, lack of vegetation, absence of special characters making it different from other streets, preventing people taking part in the space causing lack of affiliation, lack of appropriate elements for leisure time and lack of exhilaration in the space. On the other hand, these results present high access and permeability, high safety, less sound pollution and more relief, comfortable movement along the way due to suitable pavement and economic efficiency, as the strength points of Saf pedestrian street.Keywords: pedestrian streets, quality assessment, quality criteria, Saf Pedestrian Street
Procedia PDF Downloads 255198 Comparative Studies on the Needs and Development of Autotronic Maintenance Training Modules for the Training of Automobile Independent Workshop Service Technicians in North – Western Region, Nigeria
Authors: Muhammad Shuaibu Birniwa
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Automobile Independent Workshop Service Technicians (popularly called roadside mechanics) are technical personals that repairs most of the automobile vehicles in Nigeria. Majority of these mechanics acquired their skills through apprenticeship training. Modern vehicle imported into the country posed greater challenges to the present automobile technicians particularly in the area of carrying out maintenance repairs of these latest automobile vehicles (autotronics vehicle) due to their inability to possessed autotronic skills competency. To source for solution to the above mentioned problems, therefore a research is carried out in North – Western region of Nigeria to produce a suitable maintenance training modules that can be used to train the technicians for them to upgrade/acquire the needed competencies for successful maintenance repair of the autotronic vehicles that were running everyday on the nation’s roads. A cluster sampling technique is used to obtain a sample from the population. The population of the study is all autotronic inclined lecturers, instructors and independent workshop service technicians that are within North – Western region of Nigeria. There are seven states (Jigawa, Kaduna, Kano, Katsina, Kebbi, Sokoto and Zamfara) in the study area, these serves as clusters in the population. Five (5) states were randomly selected to serve as the sample size. The five states are Jigawa, Kano, Katsina, Kebbi and Zamfara, the entire population of the five states which serves as clusters is (183), lecturers (44), instructors (49) and autotronic independent workshop service technicians (90), all of them were used in the study because of their manageable size. 183 copies of autotronic maintenance training module questionnaires (AMTMQ) with 174 and 149 question items respectively were administered and collected by the researcher with the help of an assistants, they are administered to 44 Polytechnic lecturers in the department of mechanical engineering, 49 instructors in skills acquisition centres/polytechnics and 90 master craftsmen of an independent workshops that are autotronic inclined. Data collected for answering research questions 1, 3, 4 and 5 were analysed using SPSS software version 22, Grand Mean and standard deviation were used to answer the research questions. Analysis of Variance (ANOVA) was used to test null hypotheses one (1) to three (3) and t-test statistical tool is used to analyzed hypotheses four (4) and five (5) all at 0.05 level of significance. The research conducted revealed that; all the objectives, contents/tasks, facilities, delivery systems and evaluation techniques contained in the questionnaire were required for the development of the autotronic maintenance training modules for independent workshop service technicians in the north – western zone of Nigeria. The skills upgrade training conducted by federal government in collaboration with SURE-P, NAC and SMEDEN was not successful because the educational status of the target population was not considered in drafting the needed training modules. The mode of training used does not also take cognizance of the theoretical aspect of the trainees, especially basic science which rendered the programme ineffective and insufficient for the tasks on ground.Keywords: autotronics, roadside, mechanics, technicians, independent
Procedia PDF Downloads 73197 Epidemiological Patterns of Pediatric Fever of Unknown Origin
Authors: Arup Dutta, Badrul Alam, Sayed M. Wazed, Taslima Newaz, Srobonti Dutta
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Background: In today's world, with modern science and contemporary technology, a lot of diseases may be quickly identified and ruled out, but children's fever of unknown origin (FUO) still presents diagnostic difficulties in clinical settings. Any fever that reaches 38 °C and lasts for more than seven days without a known cause is now classified as a fever of unknown origin (FUO). Despite tremendous progress in the medical sector, fever of unknown origin, or FOU, persists as a major health issue and a major contributor to morbidity and mortality, particularly in children, and its spectrum is sometimes unpredictable. The etiology is influenced by geographic location, age, socioeconomic level, frequency of antibiotic resistance, and genetic vulnerability. Since there are currently no known diagnostic algorithms, doctors are forced to evaluate each patient one at a time with extreme caution. A persistent fever poses difficulties for both the patient and the doctor. This prospective observational study was carried out in a Bangladeshi tertiary care hospital from June 2018 to May 2019 with the goal of identifying the epidemiological patterns of fever of unknown origin in pediatric patients. Methods: It was a hospital-based prospective observational study carried out on 106 children (between 2 months and 12 years) with prolonged fever of >38.0 °C lasting for more than 7 days without a clear source. Children with additional chronic diseases or known immunodeficiency problems were not allowed. Clinical practices that helped determine the definitive etiology were assessed. Initial testing included a complete blood count, a routine urine examination, PBF, a chest X-ray, CRP measurement, blood cultures, serology, and additional pertinent investigations. The analysis focused mostly on the etiological results. The standard program SPSS 21 was used to analyze all of the study data. Findings: A total of 106 patients identified as having FUO were assessed, with over half (57.5%) being female and the majority (40.6%) falling within the 1 to 3-year age range. The study categorized the etiological outcomes into five groups: infections, malignancies, connective tissue conditions, miscellaneous, and undiagnosed. In the group that was being studied, infections were found to be the main cause in 44.3% of cases. Undiagnosed cases came in at 31.1%, cancers at 10.4%, other causes at 8.5%, and connective tissue disorders at 4.7%. Hepato-splenomegaly was seen in people with enteric fever, malaria, acute lymphoid leukemia, lymphoma, and hepatic abscesses, either by itself or in combination with other conditions. About 53% of people who were not diagnosed also had hepato-splenomegaly at the same time. Conclusion: Infections are the primary cause of PUO (pyrexia of unknown origin) in children, with undiagnosed cases being the second most common cause. An incremental approach is beneficial in the process of diagnosing a condition. Non-invasive examinations are used to diagnose infections and connective tissue disorders, while invasive investigations are used to diagnose cancer and other ailments. According to this study, the prevalence of undiagnosed diseases is still remarkable, so extensive historical analysis and physical examinations are necessary in order to provide a precise diagnosis.Keywords: children, diagnostic challenges, fever of unknown origin, pediatric fever, undiagnosed diseases
Procedia PDF Downloads 27196 Innovation Outputs from Higher Education Institutions: A Case Study of the University of Waterloo, Canada
Authors: Wendy De Gomez
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The University of Waterloo is situated in central Canada in the Province of Ontario- one hour from the metropolitan city of Toronto. For over 30 years, it has held Canada’s top spot as the most innovative university; and has been consistently ranked in the top 25 computer science and top 50 engineering schools in the world. Waterloo benefits from the federal government’s over 100 domestic innovation policies which have assisted in the country’s 15th place global ranking in the World Intellectual Property Organization’s (WIPO) 2022 Global Innovation Index. Yet undoubtedly, the University of Waterloo’s unique characteristics are what propels its innovative creativeness forward. This paper will provide a contextual definition of innovation in higher education and then demonstrate the five operational attributes that contribute to the University of Waterloo’s innovative reputation. The methodology is based on statistical analyses obtained from ranking bodies such as the QS World University Rankings, a secondary literature review related to higher education innovation in Canada, and case studies that exhibit the operationalization of the attributes outlined below. The first attribute is geography. Specifically, the paper investigates the network structure effect of the Toronto-Waterloo high-tech corridor and the resultant industrial relationships built there. The second attribute is University Policy 73-Intellectal Property Rights. This creator-owned policy grants all ownership to the creator/inventor regardless of the use of the University of Waterloo property or funding. Essentially, through the incentivization of IP ownership by all researchers, further commercialization and entrepreneurship are formed. Third, this IP policy works hand in hand with world-renowned business incubators such as the Accelerator Centre in the dedicated research and technology park and velocity, a 14-year-old facility that equips and guides founders to build and scale companies. Communitech, a 25-year-old provincially backed facility in the region, also works closely with the University of Waterloo to build strong teams, access capital, and commercialize products. Fourth, Waterloo’s co-operative education program contributes 31% of all co-op participants to the Canadian economy. Home to the world’s largest co-operative education program, data shows that over 7,000 from around the world recruit Waterloo students for short- and long-term placements- directly contributing to the student’s ability to learn and optimize essential employment skills when they graduate. Finally, the students themselves at Waterloo are exceptional. The entrance average ranges from the low 80s to the mid-90s depending on the program. In computer, electrical, mechanical, mechatronics, and systems design engineering, to have a 66% chance of acceptance, the applicant’s average must be 95% or above. Singularly, none of these five attributes could lead to the university’s outstanding track record of innovative creativity, but when bundled up into a 1000 acre- 100 building main campus with 6 academic faculties, 40,000+ students, and over 1300 world-class faculty, the recipe for success becomes quite evident.Keywords: IP policy, higher education, economy, innovation
Procedia PDF Downloads 70195 Development of Adaptive Proportional-Integral-Derivative Feeding Mechanism for Robotic Additive Manufacturing System
Authors: Andy Alubaidy
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In this work, a robotic additive manufacturing system (RAMS) that is capable of three-dimensional (3D) printing in six degrees of freedom (DOF) with very high accuracy and virtually on any surface has been designed and built. One of the major shortcomings in existing 3D printer technology is the limitation to three DOF, which results in prolonged fabrication time. Depending on the techniques used, it usually takes at least two hours to print small objects and several hours for larger objects. Another drawback is the size of the printed objects, which is constrained by the physical dimensions of most low-cost 3D printers, which are typically small. In such cases, large objects are produced by dividing them into smaller components that fit the printer’s workable area. They are then glued, bonded or otherwise attached to create the required object. Another shortcoming is material constraints and the need to fabricate a single part using different materials. With the flexibility of a six-DOF robot, the RAMS has been designed to overcome these problems. A feeding mechanism using an adaptive Proportional-Integral-Derivative (PID) controller is utilized along with a national instrument compactRIO (NI cRIO), an ABB robot, and off-the-shelf sensors. The RAMS have the ability to 3D print virtually anywhere in six degrees of freedom with very high accuracy. It is equipped with an ABB IRB 120 robot to achieve this level of accuracy. In order to convert computer-aided design (CAD) files to digital format that is acceptable to the robot, Hypertherm Robotic Software Inc.’s state-of-the-art slicing software called “ADDMAN” is used. ADDMAN is capable of converting any CAD file into RAPID code (the programing language for ABB robots). The robot uses the generated code to perform the 3D printing. To control the entire process, National Instrument (NI) compactRIO (cRio 9074), is connected and communicated with the robot and a feeding mechanism that is designed and fabricated. The feeding mechanism consists of two major parts, cold-end and hot-end. The cold-end consists of what is conventionally known as an extruder. Typically, a stepper-motor is used to control the push on the material, however, for optimum control, a DC motor is used instead. The hot-end consists of a melt-zone, nozzle, and heat-brake. The melt zone ensures a thorough melting effect and consistent output from the nozzle. Nozzles are made of brass for thermo-conductivity while the melt-zone is comprised of a heating block and a ceramic heating cartridge to transfer heat to the block. The heat-brake ensures that there is no heat creep-up effect as this would swell the material and prevent consistent extrusion. A control system embedded in the cRio is developed using NI Labview which utilizes adaptive PID to govern the heating cartridge in conjunction with a thermistor. The thermistor sends temperature feedback to the cRio, which will issue heat increase or decrease based on the system output. Since different materials have different melting points, our system will allow us to adjust the temperature and vary the material.Keywords: robotic, additive manufacturing, PID controller, cRIO, 3D printing
Procedia PDF Downloads 217194 Entrepreneurial Venture Creation through Anchor Event Activities: Pop-Up Stores as On-Site Arenas
Authors: Birgit A. A. Solem, Kristin Bentsen
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Scholarly attention in entrepreneurship is currently directed towards understanding entrepreneurial venture creation as a process -the journey of new economic activities from nonexistence to existence often studied through flow- or network models. To complement existing research on entrepreneurial venture creation with more interactivity-based research of organized activities, this study examines two pop-up stores as anchor events involving on-site activities of fifteen participating entrepreneurs launching their new ventures. The pop-up stores were arranged in two middle-sized Norwegian cities and contained different brand stores that brought together actors of sub-networks and communities executing venture creation activities. The pop-up stores became on-site arenas for the entrepreneurs to create, maintain, and rejuvenate their networks, at the same time as becoming venues for temporal coordination of activities involving existing and potential customers in their venture creation. In this work, we apply a conceptual framework based on frequently addressed dilemmas within entrepreneurship theory (discovery/creation, causation/effectuation) to further shed light on the broad aspect of on-site anchor event activities and their venture creation outcomes. The dilemma-based concepts are applied as an analytic toolkit to pursue answers regarding the nature of anchor event activities typically found within entrepreneurial venture creation and how these anchor event activities affect entrepreneurial venture creation outcomes. Our study combines researcher participation with 200 hours of observation and twenty in-depth interviews. Data analysis followed established guidelines for hermeneutic analysis and was intimately intertwined with ongoing data collection. Data was coded and categorized in NVivo 12 software, and iterated several times as patterns were steadily developing. Our findings suggest that core anchor event activities typically found within entrepreneurial venture creation are; a concept- and product experimentation with visitors, arrangements to socialize (evening specials, auctions, and exhibitions), store-in-store concepts, arranged meeting places for peers and close connection with municipality and property owners. Further, this work points to four main entrepreneurial venture creation outcomes derived from the core anchor event activities; (1) venture attention, (2) venture idea-realization, (3) venture collaboration, and (4) venture extension. Our findings show that, depending on which anchor event activities are applied, the outcomes vary. Theoretically, this study offers two main implications. First, anchor event activities are both discovered and created, following the logic of causation, at the same time as being experimental, based on “learning by doing” principles of effectuation during the execution. Second, our research enriches prior studies on venture creation as a process. In this work, entrepreneurial venture creation activities and outcomes are understood through pop-up stores as on-site anchor event arenas, particularly suitable for interactivity-based research requested by the entrepreneurship field. This study also reveals important managerial implications, such as that entrepreneurs should allow themselves to find creative physical venture creation arenas (e.g., pop-up stores, showrooms), as well as collaborate with partners when discovering and creating concepts and activities based on new ideas. In this way, they allow themselves to both strategically plan for- and continually experiment with their venture.Keywords: anchor event, interactivity-based research, pop-up store, entrepreneurial venture creation
Procedia PDF Downloads 91193 Readout Development of a LGAD-based Hybrid Detector for Microdosimetry (HDM)
Authors: Pierobon Enrico, Missiaggia Marta, Castelluzzo Michele, Tommasino Francesco, Ricci Leonardo, Scifoni Emanuele, Vincezo Monaco, Boscardin Maurizio, La Tessa Chiara
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Clinical outcomes collected over the past three decades have suggested that ion therapy has the potential to be a treatment modality superior to conventional radiation for several types of cancer, including recurrences, as well as for other diseases. Although the results have been encouraging, numerous treatment uncertainties remain a major obstacle to the full exploitation of particle radiotherapy. To overcome therapy uncertainties optimizing treatment outcome, the best possible radiation quality description is of paramount importance linking radiation physical dose to biological effects. Microdosimetry was developed as a tool to improve the description of radiation quality. By recording the energy deposition at the micrometric scale (the typical size of a cell nucleus), this approach takes into account the non-deterministic nature of atomic and nuclear processes and creates a direct link between the dose deposited by radiation and the biological effect induced. Microdosimeters measure the spectrum of lineal energy y, defined as the energy deposition in the detector divided by most probable track length travelled by radiation. The latter is provided by the so-called “Mean Chord Length” (MCL) approximation, and it is related to the detector geometry. To improve the characterization of the radiation field quality, we define a new quantity replacing the MCL with the actual particle track length inside the microdosimeter. In order to measure this new quantity, we propose a two-stage detector consisting of a commercial Tissue Equivalent Proportional Counter (TEPC) and 4 layers of Low Gain Avalanche Detectors (LGADs) strips. The TEPC detector records the energy deposition in a region equivalent to 2 um of tissue, while the LGADs are very suitable for particle tracking because of the thickness thinnable down to tens of micrometers and fast response to ionizing radiation. The concept of HDM has been investigated and validated with Monte Carlo simulations. Currently, a dedicated readout is under development. This two stages detector will require two different systems to join complementary information for each event: energy deposition in the TEPC and respective track length recorded by LGADs tracker. This challenge is being addressed by implementing SoC (System on Chip) technology, relying on Field Programmable Gated Arrays (FPGAs) based on the Zynq architecture. TEPC readout consists of three different signal amplification legs and is carried out thanks to 3 ADCs mounted on a FPGA board. LGADs activated strip signal is processed thanks to dedicated chips, and finally, the activated strip is stored relying again on FPGA-based solutions. In this work, we will provide a detailed description of HDM geometry and the SoC solutions that we are implementing for the readout.Keywords: particle tracking, ion therapy, low gain avalanche diode, tissue equivalent proportional counter, microdosimetry
Procedia PDF Downloads 175192 Assessing P0.1 and Occlusion Pressures in Brain-Injured Patients on Pressure Support Ventilation: A Study Protocol
Authors: S. B. R. Slagmulder
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Monitoring inspiratory effort and dynamic lung stress in patients on pressure support ventilation in the ICU is important for protecting against self inflicted lung injury (P-SILI) and diaphragm dysfunction. Strategies to address the detrimental effects of respiratory drive and effort can lead to improved patient outcomes. Two non-invasive estimation methods, occlusion pressure (Pocc) and P0.1, have been proposed for achieving lung and diaphragm protective ventilation. However, their relationship and interpretation in neuro ICU patients is not well understood. P0.1 is the airway pressure measured during a 100-millisecond occlusion of the inspiratory port. It reflects the neural drive from the respiratory centers to the diaphragm and respiratory muscles, indicating the patient's respiratory drive during the initiation of each breath. Occlusion pressure, measured during a brief inspiratory pause against a closed airway, provides information about the inspiratory muscles' strength and the system's total resistance and compliance. Research Objective: Understanding the relationship between Pocc and P0.1 in brain-injured patients can provide insights into the interpretation of these values in pressure support ventilation. This knowledge can contribute to determining extubation readiness and optimizing ventilation strategies to improve patient outcomes. The central goal is to asses a study protocol for determining the relationship between Pocc and P0.1 in brain-injured patients on pressure support ventilation and their ability to predict successful extubation. Additionally, comparing these values between brain-damaged and non-brain-damaged patients may provide valuable insights. Key Areas of Inquiry: 1. How do Pocc and P0.1 values correlate within brain injury patients undergoing pressure support ventilation? 2. To what extent can Pocc and P0.1 values serve as predictive indicators for successful extubation in patients with brain injuries? 3. What differentiates the Pocc and P0.1 values between patients with brain injuries and those without? Methodology: P0.1 and occlusion pressures are standard measurements for pressure support ventilation patients, taken by attending doctors as per protocol. We utilize electronic patient records for existing data. Unpaired T-test will be conducted to compare P0.1 and Pocc values between both study groups. Associations between P0.1 and Pocc and other study variables, such as extubation, will be explored with simple regression and correlation analysis. Depending on how the data evolve, subgroup analysis will be performed for patients with and without extubation failure. Results: While it is anticipated that neuro patients may exhibit high respiratory drive, the linkage between such elevation, quantified by P0.1, and successful extubation remains unknown The analysis will focus on determining the ability of these values to predict successful extubation and their potential impact on ventilation strategies. Conclusion: Further research is pending to fully understand the potential of these indices and their impact on mechanical ventilation in different patient populations and clinical scenarios. Understanding these relationships can aid in determining extubation readiness and tailoring ventilation strategies to improve patient outcomes in this specific patient population. Additionally, it is vital to account for the influence of sedatives, neurological scores, and BMI on respiratory drive and occlusion pressures to ensure a comprehensive analysis.Keywords: brain damage, diaphragm dysfunction, occlusion pressure, p0.1, respiratory drive
Procedia PDF Downloads 68191 Varieties of Capitalism and Small Business CSR: A Comparative Overview
Authors: Stéphanie Looser, Walter Wehrmeyer
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Given the limited research on Small and Mediumsized Enterprises’ (SMEs) contribution to Corporate Social Responsibility (CSR) and even scarcer research on Swiss SMEs, this paper helps to fill these gaps by enabling the identification of supranational SME parameters and to make a contribution to the evolving field of these topics. Thus, the paper investigates the current state of SME practices in Switzerland and across 15 other countries. Combining the degree to which SMEs demonstrate an explicit (or business case) approach or see CSR as an implicit moral activity with the assessment of their attributes for “variety of capitalism” defines the framework of this comparative analysis. According to previous studies, liberal market economies, e.g. in the United States (US) or United Kingdom (UK), are aligned with extrinsic CSR, while coordinated market systems (in Central European or Asian countries) evolve implicit CSR agendas. To outline Swiss small business CSR patterns in particular, 40 SME owner-managers were interviewed. The transcribed interviews were coded utilising MAXQDA for qualitative content analysis. A secondary data analysis of results from different countries (i.e., Australia, Austria, Chile, Cameroon, Catalonia (notably a part of Spain that seeks autonomy), China, Finland, Germany, Hong Kong (a special administrative region of China), Italy, Netherlands, Singapore, Spain, Taiwan, UK, US) lays groundwork for this comparative study on small business CSR. Applying the same coding categories (in MAXQDA) for the interview analysis as well as for the secondary data research while following grounded theory rules to refine and keep track of ideas generated testable hypotheses and comparative power on implicit (and the lower likelihood of explicit) CSR in SMEs retrospectively. The paper identifies Swiss small business CSR as deep, profound, “soul”, and an implicit part of the day-to-day business. Similar to most Central European, Mediterranean, Nordic, and Asian countries, explicit CSR is still very rare in Swiss SMEs. Astonishingly, also UK and US SMEs follow this pattern in spite of their strong and distinct liberal market economies. Though other findings show that nationality matters this research concludes that SME culture and its informal CSR agenda are strongly formative and superseding even forces of market economies, nationally cultural patterns, and language. In a world of “big business”, explicit “business case” CSR, and the mantra that “CSR must pay”, this study points to a distinctly implicit small business CSR model built on trust, physical closeness, and virtues that is largely detached from the bottom line. This pattern holds for different cultural contexts and it is concluded that SME culture is stronger than nationality leading to a supra-national, monolithic SME CSR approach. Hence, classifications of countries by their market system or capitalism, as found in the comparative capitalism literature, do not match the CSR practices in SMEs as they do not mirror the peculiarities of their business. This raises questions on the universality and generalisability of management concepts.Keywords: CSR, comparative study, cultures of capitalism, small, medium-sized enterprises
Procedia PDF Downloads 433190 Health Risk Assessment from Potable Water Containing Tritium and Heavy Metals
Authors: Olga A. Momot, Boris I. Synzynys, Alla A. Oudalova
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Obninsk is situated in the Kaluga region 100 km southwest of Moscow on the left bank of the Protva River. Several enterprises utilizing nuclear energy are operating in the town. A special attention in the region where radiation-hazardous facilities are located has traditionally been paid to radioactive gas and aerosol releases into the atmosphere; liquid waste discharges into the Protva river and groundwater pollution. Municipal intakes involve 34 wells arranged 15 km apart in a sequence north-south along the foot of the left slope of the Protva river valley. Northern and southern water intakes are upstream and downstream of the town, respectively. They belong to river valley intakes with mixed feeding, i.e. precipitation infiltration is responsible for a smaller part of groundwater, and a greater amount is being formed by overflowing from Protva. Water intakes are maintained by the Protva river runoff, the volume of which depends on the precipitation fallen out and watershed area. Groundwater contamination with tritium was first detected in a sanitary-protective zone of the Institute of Physics and Power Engineering (SRC-IPPE) by Roshydromet researchers when realizing the “Program of radiological monitoring in the territory of nuclear industry enterprises”. A comprehensive survey of the SRC-IPPE’s industrial site and adjacent territories has revealed that research nuclear reactors and accelerators where tritium targets are applied as well as radioactive waste storages could be considered as potential sources of technogenic tritium. All the above sources are located within the sanitary controlled area of intakes. Tritium activity in water of springs and wells near the SRC-IPPE is about 17.4 – 3200 Bq/l. The observed values of tritium activity are below the intervention levels (7600 Bq/l for inorganic compounds and 3300 Bq/l for organically bound tritium). The risk has being assessed to estimate possible effect of considered tritium concentrations on human health. Data on tritium concentrations in pipe-line drinking water were used for calculations. The activity of 3H amounted to 10.6 Bq/l and corresponded to the risk of such water consumption of ~ 3·10-7 year-1. The risk value given in magnitude is close to the individual annual death risk for population living near a NPP – 1.6·10-8 year-1 and at the same time corresponds to the level of tolerable risk (10-6) and falls within “risk optimization”, i.e. in the sphere for planning the economically sound measures on exposure risk reduction. To estimate the chemical risk, physical and chemical analysis was made of waters from all springs and wells near the SRC-IPPE. Chemical risk from groundwater contamination was estimated according to the EPA US guidance. The risk of carcinogenic diseases at a drinking water consumption amounts to 5·10-5. According to the classification accepted the health risk in case of spring water consumption is inadmissible. The compared assessments of risk associated with tritium exposure, on the one hand, and the dangerous chemical (e.g. heavy metals) contamination of Obninsk drinking water, on the other hand, have confirmed that just these chemical pollutants are responsible for health risk.Keywords: radiation-hazardous facilities, water intakes, tritium, heavy metal, health risk
Procedia PDF Downloads 240189 A Clinico-Bacteriological Study and Their Risk Factors for Diabetic Foot Ulcer with Multidrug-Resistant Microorganisms in Eastern India
Authors: Pampita Chakraborty, Sukumar Mukherjee
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This study was done to determine the bacteriological profile and antibiotic resistance of the isolates and to find out the potential risk factors for infection with multidrug-resistant organisms. Diabetic foot ulcer is a major medical, social, economic problem and a leading cause of morbidity and mortality, especially in the developing countries like India. 25 percent of all diabetic patients develop a foot ulcer at some point in their lives which is highly susceptible to infections and that spreads rapidly, leading to overwhelming tissue destruction and subsequent amputation. Infection with multidrug resistant organisms (MDRO) may increase the cost of management and may cause additional morbidity and mortality. Proper management of these infections requires appropriate antibiotic selection based on culture and antimicrobial susceptibility testing. Early diagnosis of microbial infections is aimed to institute the appropriate antibacterial therapy initiative to avoid further complications. A total of 200 Type 2 Diabetic Mellitus patients with infection were admitted at GD Hospital and Diabetes Institute, Kolkata. 60 of them who developed ulcer during the year 2013 were included in this study. A detailed clinical history and physical examination were carried out for every subject. Specimens for microbiological studies were obtained from ulcer region. Gram-negative bacilli were tested for extended spectrum Beta-lactamase (ESBL) production by double disc diffusion method. Staphylococcal isolates were tested for susceptibility to oxacillin by screen agar method and disc diffusion. Potential risk factors for MDRO-positive samples were explored. Gram-negative aerobes were most frequently isolated, followed by gram-positive aerobes. Males were predominant in the study and majority of the patients were in the age group of 41-60 years. The presence of neuropathy was observed in 80% cases followed by peripheral vascular disease (73%). Proteus spp. (22) was the most common pathogen isolated, followed by E.coli (17). Staphylococcus aureus was predominant amongst the gram-positive isolates. S.aureus showed a high rate of resistance to antibiotic tested (63.6%). Other gram-positive isolates were found to be highly resistant to erythromycin, tetracycline and ciprofloxacin, 40% each. All isolates were found to be sensitive to Vancomycin and Linezolid. ESBL production was noted in Proteus spp and E.coli. Approximately 70 % of the patients were positive for MDRO. MDRO-infected patients had poor glycemic control (HbA1c 11± 2). Infection with MDROs is common in diabetic foot ulcers and is associated with risk factors like inadequate glycemic control, the presence of neuropathy, osteomyelitis, ulcer size and increased the requirement for surgical treatment. There is a need for continuous surveillance of resistant bacteria to provide the basis for empirical therapy and reduce the risk of complications.Keywords: diabetic foot ulcer, bacterial infection, multidrug-resistant organism, extended spectrum beta-lactamase
Procedia PDF Downloads 337188 Typology of Fake News Dissemination Strategies in Social Networks in Social Events
Authors: Mohadese Oghbaee, Borna Firouzi
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The emergence of the Internet and more specifically the formation of social media has provided the ground for paying attention to new types of content dissemination. In recent years, Social media users share information, communicate with others, and exchange opinions on social events in this space. Many of the information published in this space are suspicious and produced with the intention of deceiving others. These contents are often called "fake news". Fake news, by disrupting the circulation of the concept and similar concepts such as fake news with correct information and misleading public opinion, has the ability to endanger the security of countries and deprive the audience of the basic right of free access to real information; Competing governments, opposition elements, profit-seeking individuals and even competing organizations, knowing about this capacity, act to distort and overturn the facts in the virtual space of the target countries and communities on a large scale and influence public opinion towards their goals. This process of extensive de-truthing of the information space of the societies has created a wave of harm and worries all over the world. The formation of these concerns has led to the opening of a new path of research for the timely containment and reduction of the destructive effects of fake news on public opinion. In addition, the expansion of this phenomenon has the potential to create serious and important problems for societies, and its impact on events such as the 2016 American elections, Brexit, 2017 French elections, 2019 Indian elections, etc., has caused concerns and led to the adoption of approaches It has been dealt with. In recent years, a simple look at the growth trend of research in "Scopus" shows an increasing increase in research with the keyword "false information", which reached its peak in 2020, namely 524 cases, reached, while in 2015, only 30 scientific-research contents were published in this field. Considering that one of the capabilities of social media is to create a context for the dissemination of news and information, both true and false, in this article, the classification of strategies for spreading fake news in social networks was investigated in social events. To achieve this goal, thematic analysis research method was chosen. In this way, an extensive library study was first conducted in global sources. Then, an in-depth interview was conducted with 18 well-known specialists and experts in the field of news and media in Iran. These experts were selected by purposeful sampling. Then by analyzing the data using the theme analysis method, strategies were obtained; The strategies achieved so far (research is in progress) include unrealistically strengthening/weakening the speed and content of the event, stimulating psycho-media movements, targeting emotional audiences such as women, teenagers and young people, strengthening public hatred, calling the reaction legitimate/illegitimate. events, incitement to physical conflict, simplification of violent protests and targeted publication of images and interviews were introduced.Keywords: fake news, social network, social events, thematic analysis
Procedia PDF Downloads 63187 Calculation of Pressure-Varying Langmuir and Brunauer-Emmett-Teller Isotherm Adsorption Parameters
Authors: Trevor C. Brown, David J. Miron
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Gas-solid physical adsorption methods are central to the characterization and optimization of the effective surface area, pore size and porosity for applications such as heterogeneous catalysis, and gas separation and storage. Properties such as adsorption uptake, capacity, equilibrium constants and Gibbs free energy are dependent on the composition and structure of both the gas and the adsorbent. However, challenges remain, in accurately calculating these properties from experimental data. Gas adsorption experiments involve measuring the amounts of gas adsorbed over a range of pressures under isothermal conditions. Various constant-parameter models, such as Langmuir and Brunauer-Emmett-Teller (BET) theories are used to provide information on adsorbate and adsorbent properties from the isotherm data. These models typically do not provide accurate interpretations across the full range of pressures and temperatures. The Langmuir adsorption isotherm is a simple approximation for modelling equilibrium adsorption data and has been effective in estimating surface areas and catalytic rate laws, particularly for high surface area solids. The Langmuir isotherm assumes the systematic filling of identical adsorption sites to a monolayer coverage. The BET model is based on the Langmuir isotherm and allows for the formation of multiple layers. These additional layers do not interact with the first layer and the energetics are equal to the adsorbate as a bulk liquid. This BET method is widely used to measure the specific surface area of materials. Both Langmuir and BET models assume that the affinity of the gas for all adsorption sites are identical and so the calculated adsorbent uptake at the monolayer and equilibrium constant are independent of coverage and pressure. Accurate representations of adsorption data have been achieved by extending the Langmuir and BET models to include pressure-varying uptake capacities and equilibrium constants. These parameters are determined using a novel regression technique called flexible least squares for time-varying linear regression. For isothermal adsorption the adsorption parameters are assumed to vary slowly and smoothly with increasing pressure. The flexible least squares for pressure-varying linear regression (FLS-PVLR) approach assumes two distinct types of discrepancy terms, dynamic and measurement for all parameters in the linear equation used to simulate the data. Dynamic terms account for pressure variation in successive parameter vectors, and measurement terms account for differences between observed and theoretically predicted outcomes via linear regression. The resultant pressure-varying parameters are optimized by minimizing both dynamic and measurement residual squared errors. Validation of this methodology has been achieved by simulating adsorption data for n-butane and isobutane on activated carbon at 298 K, 323 K and 348 K and for nitrogen on mesoporous alumina at 77 K with pressure-varying Langmuir and BET adsorption parameters (equilibrium constants and uptake capacities). This modeling provides information on the adsorbent (accessible surface area and micropore volume), adsorbate (molecular areas and volumes) and thermodynamic (Gibbs free energies) variations of the adsorption sites.Keywords: Langmuir adsorption isotherm, BET adsorption isotherm, pressure-varying adsorption parameters, adsorbate and adsorbent properties and energetics
Procedia PDF Downloads 234186 Application of Self-Efficacy Theory in Counseling Deaf and Hard of Hearing Students
Authors: Nancy A. Delich, Stephen D. Roberts
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This case study explores using self-efficacy theory in counseling deaf and hard of hearing students in one California school district. Self-efficacy is described as the confidence a student has for performing a set of skills required to succeed at a specific task. When students need to learn a skill, self-efficacy can be a major factor in influencing behavioral change. Self-efficacy is domain specific, meaning that students can have high confidence in their abilities to accomplish a task in one domain, while at the same time having low confidence in their abilities to accomplish another task in a different domain. The communication isolation experienced by deaf and hard of hearing children and adolescents can negatively impact their belief about their ability to navigate life challenges. There is a need to address issues that impact deaf and hard of hearing students’ social-emotional development. Failure to address these needs may result in depression, suicidal ideation, and anxiety among other mental health concerns. Self-efficacy training can be used to address these socio-emotional developmental issues with this population. Four sources of experiences are applied during an intervention: (a) enactive mastery experience, (b) vicarious experience, (c) verbal persuasion, and (d) physiological and affective states. This case study describes the use of self-efficacy training with a coed group of 12 deaf and hard of hearing high school students who experienced bullying at school. Beginning with enactive mastery experience, the counselor introduced the topic of bullying to the group. The counselor educated the students about the different types of bullying while teaching them the terminology, signs and their meanings. The most effective way to increase self-efficacy is through extensive practice. To better understand these concepts, the students practiced through role-playing with the goal of developing self-advocacy skills. Vicarious experience is the perception that students have about their capabilities. Viewing other students advocating for themselves, cognitively rehearsing what actions they will and will not take, and teaching each other how to stand up against bullying can strengthen their belief in successfully overcoming bullying. The third source of self-efficacy beliefs is verbal persuasion. It occurs when others express belief in the capabilities of the student. Didactic training and pedagogic materials on bullying were employed as part of the group counseling sessions. The fourth source of self-efficacy appraisals is physiological and affective states. Students expect positive emotions to be associated with successful skilled performance. When students practice new skills, the counselor can apply several strategies to enhance self-efficacy while reducing and controlling emotional and physical states. The intervention plan incorporated all four sources of self-efficacy training during several interactive group sessions regarding bullying. There was an increased understanding around the issues of bullying, resulting in the students’ belief of their ability to perform protective behaviors and deter future occurrences. The outcome of the intervention plan resulted in a reduction of reported bullying incidents. In conclusion, self-efficacy training can be an effective counseling and teaching strategy in addressing and enhancing the social-emotional functioning with deaf and hard of hearing adolescents.Keywords: counseling, self-efficacy, bullying, social-emotional development, mental health, deaf and hard of hearing students
Procedia PDF Downloads 352185 Tunable Graphene Metasurface Modeling Using the Method of Moment Combined with Generalised Equivalent Circuit
Authors: Imen Soltani, Takoua Soltani, Taoufik Aguili
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Metamaterials crossover classic physical boundaries and gives rise to new phenomena and applications in the domain of beam steering and shaping. Where electromagnetic near and far field manipulations were achieved in an accurate manner. In this sense, 3D imaging is one of the beneficiaries and in particular Denis Gabor’s invention: holography. But, the major difficulty here is the lack of a suitable recording medium. So some enhancements were essential, where the 2D version of bulk metamaterials have been introduced the so-called metasurface. This new class of interfaces simplifies the problem of recording medium with the capability of tuning the phase, amplitude, and polarization at a given frequency. In order to achieve an intelligible wavefront control, the electromagnetic properties of the metasurface should be optimized by means of solving Maxwell’s equations. In this context, integral methods are emerging as an important method to study electromagnetic from microwave to optical frequencies. The method of moment presents an accurate solution to reduce the problem of dimensions by writing its boundary conditions in the form of integral equations. But solving this kind of equations tends to be more complicated and time-consuming as the structural complexity increases. Here, the use of equivalent circuit’s method exhibits the most scalable experience to develop an integral method formulation. In fact, for allaying the resolution of Maxwell’s equations, the method of Generalised Equivalent Circuit was proposed to convey the resolution from the domain of integral equations to the domain of equivalent circuits. In point of fact, this technique consists in creating an electric image of the studied structure using discontinuity plan paradigm and taken into account its environment. So that, the electromagnetic state of the discontinuity plan is described by generalised test functions which are modelled by virtual sources not storing energy. The environmental effects are included by the use of an impedance or admittance operator. Here, we propose a tunable metasurface composed of graphene-based elements which combine the advantages of reflectarrays concept and graphene as a pillar constituent element at Terahertz frequencies. The metasurface’s building block consists of a thin gold film, a dielectric spacer SiO₂ and graphene patch antenna. Our electromagnetic analysis is based on the method of moment combined with generalised equivalent circuit (MoM-GEC). We begin by restricting our attention to study the effects of varying graphene’s chemical potential on the unit cell input impedance. So, it was found that the variation of complex conductivity of graphene allows controlling the phase and amplitude of the reflection coefficient at each element of the array. From the results obtained here, we were able to determine that the phase modulation is realized by adjusting graphene’s complex conductivity. This modulation is a viable solution compared to tunning the phase by varying the antenna length because it offers a full 2π reflection phase control.Keywords: graphene, method of moment combined with generalised equivalent circuit, reconfigurable metasurface, reflectarray, terahertz domain
Procedia PDF Downloads 176184 Application of Pedicled Perforator Flaps in Large Cavities of the Breast
Authors: Neerja Gupta
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Objective-Reconstruction of large cavities of the breast without contralateral symmetrisation Background- Reconstruction of breast includes a wide spectrum of procedures from displacement to regional and distant flaps. The pedicled Perforator flaps cover a wide spectrum of reconstruction surgery for all quadrants of the breast, especially in patients with comorbidities. These axial flaps singly or adjunct are based on a near constant perforator vessel, a ratio of 2:1 at its entry in a flap is good to maintain vascularity. The perforators of lateral chest wall viz LICAP, LTAP have overlapping perfurosomes without clear demarcation. LTAP is localized in the narrow zone between the lateral breast fold and anterior axillary line,2.5-3.8cm from the fold. MICAP are localized at 1-2 cm from sternum. Being 1-2mm in diameter, a Single perforator is good to maintain the flap. LICAP has a dominant perforator in 6th-11th spaces, while LTAP has higher placed dominant perforators in 4th and 5th spaces. Methodology-Six consecutive patients who underwent reconstruction of the breast with pedicled perforator flaps were retrospectively analysed. Selections of the flap was done based on the size and locations of the tumour, anticipated volume loss, willingness to undergo contralateral symmetrisation, cosmetic expectations, and finances available.3 patients underwent vertical LTAP, the distal limit of the flap being the inframammary crease. 3 patients underwent MICAP, oriented along the axis of rib, the distal limit being the anterior axillary line. Preoperative identification was done using a unidirectional hand held doppler. The flap was raised caudal to cranial, the pivot point of rotation being the vessel entry into the skin. The donor area is determined by the skin pinch. Flap harvest time was 20-25 minutes. Intra operative vascularity was assessed with dermal bleed. The patient immediate pre, post-operative and follow up pics were compared independently by two breast surgeons. Patients were given a breast Q questionnaire (licensed) for scoring. Results-The median age of six patients was 46. Each patient had a hospital stay of 24 hours. None of the patients was willing for contralateral symmetrisation. The specimen dimensions were from 8x6.8x4 cm to 19x16x9 cm. The breast volume reconstructed range was 30 percent to 45 percent. All wide excision had free margins on frozen. The mean flap dimensions were 12x5x4.5 cm. One LTAP underwent marginal necrosis and delayed wound healing due to seroma. Three patients were phyllodes, of which one was borderline, and 2 were benign on final histopathology. All other 3 patients were invasive ductal cancer and have completed their radiation. The median follow up is 7 months the satisfaction scores at median follow of 7 months are 90 for physical wellbeing and 85 for surgical results. Surgeons scored fair to good in Harvard score. Conclusion- Pedicled perforator flaps are a valuable option for 3/8th volume of breast defects. LTAP is preferred for tumours at the Central, upper, and outer quadrants of the breast and MICAP for the inner and lower quadrant. The vascularity of the flap is dependent on the angiosomalterritories; adequate venous and cavity drainage.Keywords: breast, oncoplasty, pedicled, perforator
Procedia PDF Downloads 187183 Learning-Teaching Experience about the Design of Care Applications for Nursing Professionals
Authors: A. Gonzalez Aguna, J. M. Santamaria Garcia, J. L. Gomez Gonzalez, R. Barchino Plata, M. Fernandez Batalla, S. Herrero Jaen
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Background: Computer Science is a field that transcends other disciplines of knowledge because it allows to support all kinds of physical and mental tasks. Health centres have a greater number and complexity of technological devices and the population consume and demand services derived from technology. Also, nursing education plans have included competencies related to and, even, courses about new technologies are offered to health professionals. However, nurses still limit their performance to the use and evaluation of products previously built. Objective: Develop a teaching-learning methodology for acquiring skills on designing applications for care. Methodology: Blended learning teaching with a group of graduate nurses through official training within a Master's Degree. The study sample was selected by intentional sampling without exclusion criteria. The study covers from 2015 to 2017. The teaching sessions included a four-hour face-to-face class and between one and three tutorials. The assessment was carried out by written test consisting of the preparation of an IEEE 830 Standard Specification document where the subject chosen by the student had to be a problem in the area of care. Results: The sample is made up of 30 students: 10 men and 20 women. Nine students had a degree in nursing, 20 diploma in nursing and one had a degree in Computer Engineering. Two students had a degree in nursing specialty through residence and two in equivalent recognition by exceptional way. Except for the engineer, no subject had previously received training in this regard. All the sample enrolled in the course received the classroom teaching session, had access to the teaching material through a virtual area and maintained at least one tutoring. The maximum of tutorials were three with an hour in total. Among the material available for consultation was an example of a document drawn up based on the IEEE Standard with an issue not related to care. The test to measure competence was completed by the whole group and evaluated by a multidisciplinary teaching team of two computer engineers and two nurses. Engineers evaluated the correctness of the characteristics of the document and the degree of comprehension in the elaboration of the problem and solution elaborated nurses assessed the relevance of the chosen problem statement, the foundation, originality and correctness of the proposed solution and the validity of the application for clinical practice in care. The results were of an average grade of 8.1 over 10 points, a range between 6 and 10. The selected topic barely coincided among the students. Examples of care areas selected are care plans, family and community health, delivery care, administration and even robotics for care. Conclusion: The applied methodology of learning-teaching for the design of technologies demonstrates the success in the training of nursing professionals. The role of expert is essential to create applications that satisfy the needs of end users. Nursing has the possibility, the competence and the duty to participate in the process of construction of technological tools that are going to impact in care of people, family and community.Keywords: care, learning, nursing, technology
Procedia PDF Downloads 136182 Pharmacokinetic Assessment of Antimicrobial Treatment of Acute Exacerbations of Chronic Obstructive Pulmonary Disease in Hospitalized Patients Colonized with Pseudomonas aeruginosa
Authors: Juliette Begin, Juliano Colapelle, Andrea Taratanu, Daniel Thirion, Amelie Marsot, Bryan A. Ross
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Chronic obstructive pulmonary disease (COPD), a leading cause of death globally, is characterized by chronic airflow obstruction and acute exacerbations (AECOPDs) that are often triggered by respiratory infections. Pseudomonas aeruginosa (P. aeruginosa), a potentially serious bacterial cause of AECOPDs, is treated with targeted anti-pseudomonal antibiotics. These select few antimicrobials are often used as first-line therapy in patients who are clinically unwell and/or in those suspected of P. aeruginosa-related infection prior to confirmation, potentially contributing to antimicrobial resistance. The present study evaluates prescribing practices in patients with a confirmed sputum history of P. aeruginosa admitted for AECOPD at the McGill University Health Centre (MUHC) and treated with anti-pseudomonal antibiotics. Serum antibiotic concentrations were measured from the same-day peak, trough, and mid-dose blood sampling intervals after reaching steady-state (on or after day 3) and were quantified using ultra-high-performance liquid chromatography (UHPLC). Demographic, clinical, and treatment outcomes were extracted from patient medical charts. Treatment failure was defined by respiratory-related death or mechanical ventilation after ≥3 days of antibiotics; antibiotic therapy extended beyond 2 weeks or a new antibiotic regimen started; or urgent care readmission within 30 days for AECOPD. To date, 9 of 30 planned participants have completed testing: seven received ciprofloxacin, one received meropenem, and one received piperacillin-tazobactam. Due to serum sample batching requirements, the serum ciprofloxacin concentration results for the first 2/8 participants are presented at the time of writing. The first participant had serum levels of 5.45mg/L (T₀), 4.74mg/L (T₅₀), and 4.49mg/L (T₁₀₀), while the second had serum levels of 5mg/L (T₀), 2.6mg/L (T₅₀), and 2.51mg/L (T₁₀₀). Pharmacokinetic parameters Cmax (5.18±0.43mg/L), T₁/₂ (23.56±18.94hours), and AUC (181.9±155.95mg*h/l) were higher than reported monograph values and met target AUC-to-MIC ratio of >125. The patients treated with meropenem and with piperacillin-tazobactam experienced treatment failure. Preliminary results suggest that standard ciprofloxacin dosing in patients experiencing an AECOPD and colonized with P. aeruginosa appears to achieve effective serum concentrations. Final cohort results will inform the pharmacokinetic appropriateness and clinical sufficiency of current AECOPD antimicrobial strategies in P. aeruginosa-colonized patients. This study will guide clinicians in determining the appropriate dosing for AECOPD treatment to achieve therapeutic levels, optimizing outcomes, and minimizing adverse effects. It could also highlight the value of routine antibiotic level monitoring in patients with treatment failure to ensure optimal serum concentrations.Keywords: acute exacerbation, antimicrobial resistance, chronic obstructive pulmonary disease, pharmacokinetics/pharmacodynamics, Pseudomonas aeruginosa
Procedia PDF Downloads 13181 Saline Aspiration Negative Intravascular Test: Mitigating Risk with Injectable Fillers
Authors: Marcelo Lopes Dias Kolling, Felipe Ferreira Laranjeira, Guilherme Augusto Hettwer, Pedro Salomão Piccinini, Marwan Masri, Carlos Oscar Uebel
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Introduction: Injectable fillers are among the most common nonsurgical cosmetic procedures, with significant growth yearly. Knowledge of rheological and mechanical characteristics of fillers, facial anatomy, and injection technique is essential for safety. Concepts such as the use of cannula versus needle, aspiration before injection, and facial danger zones have been well discussed. In case of an accidental intravascular puncture, the pressure inside the vessel may not be sufficient to push blood into the syringe due to the characteristics of the filler product; this is especially true for calcium hydroxyapatite (CaHA) or hyaluronic acid (HA) fillers with high G’. Since viscoelastic properties of normal saline are much lower than those of fillers, aspiration with saline prior to filler injection may decrease the risk of a false negative aspiration and subsequent catastrophic effects. We discuss a technique to add an additional safety step to the procedure with saline aspiration prior to injection, a ‘’reverse Seldinger’’ technique for intravascular access, which we term SANIT: Saline Aspiration Negative Intravascular Test. Objectives: To demonstrate the author’s (PSP) technique which adds an additional safety step to the process of filler injection, with both CaHA and HA, in order to decrease the risk of intravascular injection. Materials and Methods: Normal skin cleansing and topical anesthesia with prilocaine/lidocaine cream are performed; the facial subunits to be treated are marked. A 3mL Luer lock syringe is filled with 2mL of 0.9% normal saline and a 27G needle, which is turned one half rotation. When a cannula is to be used, the Luer lock syringe is attached to a 27G 4cm single hole disposable cannula. After skin puncture, the 3mL syringe is advanced with the plunger pulled back (negative pressure). Progress is made to the desired depth, all the while aspirating. Once the desired location of filler injection is reached, the syringe is exchanged for the syringe containing a filler, securely grabbing the hub of the needle and taking care to not dislodge the needle tip. Prior to this, we remove 0.1mL of filler to allow for space inside the syringe for aspiration. We again aspirate and inject retrograde. SANIT is especially useful for CaHA, since the G’ is much higher than HA, and thus reflux of blood into the syringe is less likely to occur. Results: The technique has been used safely for the past two years with no adverse events; the increase in cost is negligible (only the cost of 2mL of normal saline). Over 100 patients (over 300 syringes) have been treated with this technique. The risk of accidental intravascular puncture has been calculated to be between 1:6410 to 1:40882 syringes among expert injectors; however, the consequences of intravascular injection can be catastrophic even with board-certified physicians. Conclusions: While the risk of intravascular filler injection is low, the consequences can be disastrous. We believe that adding the SANIT technique can help further mitigate risk with no significant untoward effects and could be considered by all performing injectable fillers. Further follow-up is ongoing.Keywords: injectable fillers, safety, saline aspiration, injectable filler complications, hyaluronic acid, calcium hydroxyapatite
Procedia PDF Downloads 150180 A Quasi-Systematic Review on Effectiveness of Social and Cultural Sustainability Practices in Built Environment
Authors: Asif Ali, Daud Salim Faruquie
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With the advancement of knowledge about the utility and impact of sustainability, its feasibility has been explored into different walks of life. Scientists, however; have established their knowledge in four areas viz environmental, economic, social and cultural, popularly termed as four pillars of sustainability. Aspects of environmental and economic sustainability have been rigorously researched and practiced and huge volume of strong evidence of effectiveness has been founded for these two sub-areas. For the social and cultural aspects of sustainability, dependable evidence of effectiveness is still to be instituted as the researchers and practitioners are developing and experimenting methods across the globe. Therefore, the present research aimed to identify globally used practices of social and cultural sustainability and through evidence synthesis assess their outcomes to determine the effectiveness of those practices. A PICO format steered the methodology which included all populations, popular sustainability practices including walkability/cycle tracks, social/recreational spaces, privacy, health & human services and barrier free built environment, comparators included ‘Before’ and ‘After’, ‘With’ and ‘Without’, ‘More’ and ‘Less’ and outcomes included Social well-being, cultural co-existence, quality of life, ethics and morality, social capital, sense of place, education, health, recreation and leisure, and holistic development. Search of literature included major electronic databases, search websites, organizational resources, directory of open access journals and subscribed journals. Grey literature, however, was not included. Inclusion criteria filtered studies on the basis of research designs such as total randomization, quasi-randomization, cluster randomization, observational or single studies and certain types of analysis. Studies with combined outcomes were considered but studies focusing only on environmental and/or economic outcomes were rejected. Data extraction, critical appraisal and evidence synthesis was carried out using customized tabulation, reference manager and CASP tool. Partial meta-analysis was carried out and calculation of pooled effects and forest plotting were done. As many as 13 studies finally included for final synthesis explained the impact of targeted practices on health, behavioural and social dimensions. Objectivity in the measurement of health outcomes facilitated quantitative synthesis of studies which highlighted the impact of sustainability methods on physical activity, Body Mass Index, perinatal outcomes and child health. Studies synthesized qualitatively (and also quantitatively) showed outcomes such as routines, family relations, citizenship, trust in relationships, social inclusion, neighbourhood social capital, wellbeing, habitability and family’s social processes. The synthesized evidence indicates slight effectiveness and efficacy of social and cultural sustainability on the targeted outcomes. Further synthesis revealed that such results of this study are due weak research designs and disintegrated implementations. If architects and other practitioners deliver their interventions in collaboration with research bodies and policy makers, a stronger evidence-base in this area could be generated.Keywords: built environment, cultural sustainability, social sustainability, sustainable architecture
Procedia PDF Downloads 401