Search results for: hospital information system

Authors: Qin Zhu

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Under the background of accelerating the construction of Beautiful and Livable Park City in Chengdu, the Tianfu greenway system, as an important support system for the construction of parks in the whole region, its accessibility is one of the key indicators to measure the effectiveness of the greenway construction. In recent years, cycling has become an important transportation mode for residents to go to the greenways because of its low-carbon, healthy and convenient characteristics, and the study of greenway accessibility under cycling mode can provide reference suggestions for the optimization and improvement of greenways. Taking Jincheng Greenway in Chengdu City as an example, the Baidu Map Application Programming Interface (API) and questionnaire survey was used to improve the two-step floating catchment area (2SFCA) method from the three dimensions of search threshold, supply side and demand side, to calculate the cycling accessibility of the greenway and to explore the spatial matching relationship with the population density, the number of entrances and the comprehensive attractiveness. The results show that: 1) the distribution of greenway accessibility in Jincheng shows a pattern of "high in the south and low in the north, high in the west and low in the east", 2) the spatial match between greenway accessibility and population density of the residential area is imbalanced, and there is a significant positive correlation between accessibility and the number of selectable greenway access points in residential areas, as well as the overall attractiveness of greenways, with a high degree of match. On this basis, it is proposed to give priority to the mismatch area to alleviate the contradiction between supply and demand, optimize the greenway access points to improve the traffic connection, enhance the comprehensive quality of the greenway and strengthen the service capacity, to further improve the cycling accessibility of the Jincheng Greenway and improve the spatial allocation of greenway resources.

Keywords: accessibility, Baidu maps API, cycling, greenway, 2SFCA

Procedia PDF Downloads 64

Authors: Ramanpreet, Gursatej Gandhi

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Background: Dependence on electromagnetic radiations involved in communication and information technologies has incredibly increased in the personal and professional world. Among the numerous radiations, sources are fixed site transmitters, mobile phone base stations, and power lines beside indoor devices like cordless phones, WiFi, Bluetooth, TV, radio, microwave ovens, etc. Rather there is the continuous emittance of radiofrequency radiations (RFR) even to those not using the devices from mobile phone base stations. The consistent and widespread usage of wireless devices has build-up electromagnetic fields everywhere. In fact, the radiofrequency electromagnetic field (RF-EMF) has insidiously become a part of the environment and like any contaminant may pose to be health-hazardous requiring assessment. Materials and Methods: In the present study, cytogenetic damage was assessed using the Buccal Micronucleus Cytome (BMCyt) assay as a function of radiation exposure after Institutional Ethics Committee clearance of the study and written voluntary informed consent from the participants. On a pre-designed questionnaire, general information lifestyle patterns (diet, physical activity, smoking, drinking, use of mobile phones, internet, Wi-Fi usage, etc.) genetic, reproductive (pedigrees) and medical histories were recorded. For this, 24 hour-personal exposimeter measurements (PEM) were recorded for unrelated 60 healthy adults (40 cases residing in the vicinity of mobile phone base stations since their installation and 20 controls residing in areas with no base stations). The personal exposimeter collects information from all the sources generating EMF (TETRA, GSM, UMTS, DECT, and WLAN) as total RF-EMF uplink and downlink. Findings: The cases (n=40; 23-90 years) and the controls (n=20; 19-65 years) matched for alcohol drinking, smoking habits, and mobile and cordless phone usage. The PEM in cases (149.28 ± 8.98 mV/m) revealed significantly higher (p=0.000) electric field strength compared to the recorded value (80.40 ± 0.30 mV/m) in controls. The GSM 900 uplink (p=0.000), GSM 1800 downlink (p=0.000),UMTS (both uplink; p=0.013 and downlink; p=0.001) and DECT (p=0.000) electric field strength were significantly elevated in the cases as compared to controls. The electric field strength in the cases was significantly from GSM1800 (52.26 ± 4.49mV/m) followed by GSM900 (45.69 ± 4.98mV/m), UMTS (25.03 ± 3.33mV/m), DECT (18.02 ± 2.14mV/m) and was least from WLAN (8.26 ± 2.35mV/m). The higher significantly (p=0.000) increased exposure to the cases was from GSM (97.96 ± 6.97mV/m) in comparison to UMTS, DECT, and WLAN. The frequencies of micronuclei (1.86X, p=0.007), nuclear buds (2.95X, p=0.002) and cell death parameter (condensed chromatin cells) were significantly (1.75X, p=0.007) elevated in cases compared to that in controls probably as a function of radiofrequency radiation exposure. Conclusion: In the absence of other exposure(s), any cytogenetic damage if unrepaired is a cause of concern as it can cause malignancy. Larger sample size with the clinical assessment will prove more insightful of such an effect.

Keywords: Buccal micronucleus cytome assay, cytogenetic damage, electric field strength, personal exposimeter

Procedia PDF Downloads 146

Authors: Chao Wang

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Under rapid innovation of information technology, the media plays a very important role in the dissemination of information, and it has a totally different analogy generations face. However, the involvement of narrative images provides more possibilities of narrative text. "Images" through the process of aperture, a camera shutter and developable photosensitive processes are manufactured, recorded and stamped on paper, displayed on a computer screen-concretely saved. They exist in different forms of files, data, or evidence as the ultimate looks of events. By the interface of media and network platforms and special visual field of the viewer, class body space exists and extends out as thin as sebum layer, extremely soft and delicate with real full tension. The physical space of sebum layer of confuses the fact that physical objects exist, needs to be established under a perceived consensus. As at the scene, the existing concepts and boundaries of physical perceptions are blurred. Sebum layer physical simulation shapes the “Topical-Similarity" immersing, leading the contemporary social practice communities, groups, network users with a kind of illusion without the presence, i.e. a non-real illusion. From the investigation and discussion of literatures, digital movies editing manufacture and produce the variability characteristics of time (for example, slices, rupture, set, and reset) are analyzed. Interactive eBook has an unique interaction in "Waiting-Greeting" and "Expectation-Response" that makes the operation of image narrative structure more interpretations functionally. The works of digital editing and interactive technology are combined and further analyze concept and results. After digitization of Interventional Imaging and interactive technology, real events exist linked and the media handing cannot be cut relationship through movies, interactive art, practical case discussion and analysis. Audience needs more rational thinking about images carried by the authenticity of the text.

Keywords: sebum layer, topical and similarity, interactive technology, image narrative

Procedia PDF Downloads 378

Authors: Smruti Mahapatra, Dipankar Biswas, Richard Um, Michael Meggyesy, Riccardo Serra, Noah Gorelick, Steven Marra, Amir Manbachi, Mark G. Luciano

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Intracranial pressure (ICP) is profoundly regulated by the effects of cardiac pulsation and the volume of the incoming blood. Furthermore, these effects on ICP are incremented by the presence of a rigid skull that does not allow for changes in total volume during the cardiac cycle. These factors play a pivotal role in cerebrospinal fluid (CSF) dynamics and distribution, with consequences that are not well understood to this date and that may have a deep effect on the Central Nervous System (CNS) functioning. We designed this study with two specific aims: (a) To study how pulsatility influences local CSF flow, and (b) To study how modulating intracranial pressure affects drug distribution throughout the SAS globally. In order to achieve these aims, we built an elaborate in-vitro model of the SAS closely mimicking the dimensions and flow rates of physiological systems. To modulate intracranial pressure, we used an intracranially implanted, cardiac-gated, volume-oscillating balloon (CADENCE device). Commercially available dye was used to visualize changes in CSF flow. We first implemented two control cases, seeing how the tracer behaves in the presence of pulsations from the brain phantom and the balloon individually. After establishing the controls, we tested 2 cases, having the brain and the balloon pulsate together in sync and out of sync. We then analyzed the distribution area using image processing software. The in-sync case produced a significant increase, 5x times, in the tracer distribution area relative to the out-of-sync case. Assuming that the tracer fluid would mimic blood flow movement, a drug introduced in the SAS with such a system in place would enhance drug distribution and increase the bioavailability of therapeutic drugs to a wider spectrum of brain tissue.

Keywords: blood-brain barrier, cardiac-gated, cerebrospinal fluid, drug delivery, neurosurgery

Procedia PDF Downloads 170

Authors: Peter Amobi Chiamogu

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Communication has subsisted as the basis for mass mobilization and political education through history with the media as a generic concept. Revolutions in ICTs have occasioned a limitless environment for the dissemination of information and ideas especially with the use of a seemingly pervasive access, penetration and use of the internet which has engendered a connected society. This study seeks to analyze the prospects and challenges for the adaptation of social media for free election and how this process can enhance public policy making, implementation and evaluation in a developing state.

Keywords: social media, e-participation, political mobilization, public policy, electioneering

Procedia PDF Downloads 335

Authors: I. M. L. Nadeesha Jayaweera, Adao Alex Trindade

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In choosing a candidate model in likelihood-based modeling via an information criterion, the practitioner is often faced with the difficult task of deciding just how far up the ranked list to look. Motivated by this pragmatic necessity, we construct an uncertainty band for a generalized (model selection) information criterion (GIC), defined as a criterion for which the limit in probability is identical to that of the normalized log-likelihood. This includes common special cases such as AIC & BIC. The method starts from the asymptotic normality of the GIC for the joint distribution of the candidate models in an independent and identically distributed (IID) data framework and proceeds by deriving the (asymptotically) exact distribution of the minimum. The calculation of an upper quantile for its distribution then involves the computation of multivariate Gaussian integrals, which is amenable to efficient implementation via the R package "mvtnorm". The performance of the methodology is tested on simulated data by checking the coverage probability of nominal upper quantiles and compared to the bootstrap. Both methods give coverages close to nominal for large samples, but the bootstrap is two orders of magnitude slower. The methodology is subsequently extended to two other commonly used model structures: regression and time series. In the regression case, we derive the corresponding asymptotically exact distribution of the minimum GIC invoking Lindeberg-Feller type conditions for triangular arrays and are thus able to similarly calculate upper quantiles for its distribution via multivariate Gaussian integration. The bootstrap once again provides a default competing procedure, and we find that similar comparison performance metrics hold as for the IID case. The time series case is complicated by far more intricate asymptotic regime for the joint distribution of the model GIC statistics. Under a Gaussian likelihood, the default in most packages, one needs to derive the limiting distribution of a normalized quadratic form for a realization from a stationary series. Under conditions on the process satisfied by ARMA models, a multivariate normal limit is once again achieved. The bootstrap can, however, be employed for its computation, whence we are once again in the multivariate Gaussian integration paradigm for upper quantile evaluation. Comparisons of this bootstrap-aided semi-exact method with the full-blown bootstrap once again reveal a similar performance but faster computation speeds. One of the most difficult problems in contemporary statistical methodological research is to be able to account for the extra variability introduced by model selection uncertainty, the so-called post-model selection inference (PMSI). We explore ways in which the GIC uncertainty band can be inverted to make inferences on the parameters. This is being attempted in the IID case by pivoting the CDF of the asymptotically exact distribution of the minimum GIC. For inference one parameter at a time and a small number of candidate models, this works well, whence the attained PMSI confidence intervals are wider than the MLE-based Wald, as expected.

Keywords: model selection inference, generalized information criteria, post model selection, Asymptotic Theory

Procedia PDF Downloads 72

Authors: Gabriela Prins, Quinette Louw, Dawn Ernstzen

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Background: Access to rehabilitation services is a major challenge globally, especially in low-and-middle income countries (LMICs) where resources and infrastructure are extremely limited. Telerehabilitation (TR) has emerged in recent decades as a highly promising method to dramatically expand accessibility to rehabilitation services globally. TR provides rehabilitation care remotely using communication technologies such as video conferencing, smartphones, and internet-connected devices. This boosts accessibility to underprivileged regions and allows for greater flexibility for patients. Despite this, TR is hindered by several factors, including limited technological resources, high costs, lack of digital access, and the unavailability of healthcare systems, which are major barriers to widespread adoption among LMIC patients. These barriers have collectively hindered the potential implementation and adoption of TR services in LMICs healthcare settings. Adoption of TR will also require the buy-in of end users and limited information is known on the perspectives of the SA population. Aim: The study aimed to understand patients' perspectives regarding the use of digital technology as part of their OA rehabilitation at a public community healthcare centre in the Cape Metropole Area. Methods: A qualitative descriptive study design was used on 10 OA patients from a public community rehabilitation centre in South Africa. Data collection included semi-structured interviews and patient-reported outcome measures (PSFS, ASES-8, and EuroQol EQ-5D-5L) on functioning and quality of life. Transcribed interview data were coded in Atlas.ti. 22.2 and analyzed using thematic analysis. The results were narratively documented. Results: Four themes arose from the interviews. The themes were Telerehabilitation awareness (Use of Digital Technology Information Sources and Prior Experience with Technology /TR), Telerehabilitation Benefits (Access to healthcare providers, Access to educational information, Convenience, Time and Resource Efficiency and Facilitating Family Involvement), Telerehabilitation Implementation Considerations (Openness towards TR Implementation, Learning about TR and Technology, Therapeutic relationship, and Privacy) and Future use of Telerehabilitation (Personal Preference and TR for the next generation). The ten participants demonstrated limited awareness and exposure to TR, as well as minimal digital literacy and skills. Skepticism was shown when comparing the effectiveness of TR to in-person rehabilitation and valued physical interactions with health professionals. However, some recognized potential benefits of TR for accessibility, convenience, family involvement and improving community health in the long term. Willingness existed to try TR with sufficient training. Conclusion: With targeted efforts addressing identified barriers around awareness, technological literacy, clinician readiness and resource availability, perspectives on TR may shift positively from uncertainty towards endorsement of this expanding approach for simpler rehabilitation access in LMICs.

Keywords: digital technology, osteoarthritis, primary health care, telerehabilitation

Procedia PDF Downloads 58

Authors: Md. Mahamud Hassan, Shantanu Biswas Linkon, Nur Mohammad Khan

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Over the last three decades, the primary education system in Bangladesh has experienced significant improvement, but it has failed to cope with different social and cultural aspects, which present many challenges for children, families, and the public school system. Neglecting our own contextual learning environment, it is a matter of sorrow that much attention has been paid to the more physical outcome-focused model, which is nothing but mere infrastructural development, and less subtle to the environment that suits the child's psychology and improves their social, emotional, physical, and moral competency. In South Asia, the symbol of education was never the little red house of colonial architecture but “A Guru sitting under a tree", whereas a responsive and inclusive design approach could help to create more innovative learning environments. Such an approach incorporates how the built, natural, and cultural environment shapes the learner; in turn, learners shape the learning. This research will be conducted to, i) identify the major issues and drawbacks of government policy for primary education development programs; ii) explore and evaluate the morphology of the conventional model of school, and iii) propose an alternative model in a collaborative design process with the stakeholders for maximizing the relationship between the physical learning environments and learners by treating “the built environment” as “the third teacher.” Based on observation, this research will try to find out to what extent built, and natural environments can be utilized as a teaching tool for a more optimal learning environment. It should also be evident that there is a significant gap in the state policy, predetermined educational specifications, and implementation process in response to stakeholders’ involvement. The outcome of this research will contribute to a people-place sensitive design approach through a more thoughtful and responsive architectural process.

Keywords: built environment, conventional planning, indigenous learning space, responsive design

Procedia PDF Downloads 89

Authors: Zeinu Ahmed Rabba, Derek D Stretch

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Remote sensing contributes valuable information to streamflow estimates. Usually, stream flow is directly measured through ground-based hydrological monitoring station. However, in many developing countries like Ethiopia, ground-based hydrological monitoring networks are either sparse or nonexistent, which limits the manage water resources and hampers early flood-warning systems. In such cases, satellite remote sensing is an alternative means to acquire such information. This paper discusses the application of remotely sensed rainfall data for streamflow modeling in Gilgel Ghibe basin in Ethiopia. Ten years (2001-2010) of two satellite-based precipitation products (SBPP), TRMM and WaterBase, were used. These products were combined with the PyTOPKAPI hydrological model to generate daily stream flows. The results were compared with streamflow observations at Gilgel Ghibe Nr, Assendabo gauging station using four statistical tools (Bias, R², NS and RMSE). The statistical analysis indicates that the bias-adjusted SBPPs agree well with gauged rainfall compared to bias-unadjusted ones. The SBPPs with no bias-adjustment tend to overestimate (high Bias and high RMSE) the extreme precipitation events and the corresponding simulated streamflow outputs, particularly during wet months (June-September) and underestimate the streamflow prediction over few dry months (January and February). This shows that bias-adjustment can be important for improving the performance of the SBPPs in streamflow forecasting. We further conclude that the general streamflow patterns were well captured at daily time scales when using SBPPs after bias adjustment. However, the overall results demonstrate that the simulated streamflow using the gauged rainfall is superior to those obtained from remotely sensed rainfall products including bias-adjusted ones.

Keywords: Ethiopia, PyTOPKAPI model, remote sensing, streamflow, Tropical Rainfall Measuring Mission (TRMM), waterBase

Procedia PDF Downloads 265

Authors: Badli Shah Mohd Yusoff, Khairur Rijal Jamaludin, Rozetta Dollah

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The emerging of reverse logistics and product recovery management is an important concept in reconciling economic and environmental objectives through recapturing values of the end of life product returns. End of life products contains valuable modules, parts, residues and materials that can create value if recovered efficiently. The main objective of this study is to explore and develop a model to recover as much of the economic value as reasonably possible to find the optimality of return acquisition and sorting to meet demand and maximize profits over time. In this study, the benefits that can be obtained for remanufacturer is to develop demand forecasting of used products in the future with uncertainty of returns and quality of products. Formulated based on a generic disassembly tree, the proposed model focused on three reverse logistics activity, namely refurbish, remanufacture and disposal incorporating all plausible means quality levels of the returns. While stricter sorting policy, constitute to the decrease amount of products to be refurbished or remanufactured and increases the level of discarded products. Numerical experiments carried out to investigate the characteristics and behaviour of the proposed model with mathematical programming model using Lingo 16.0 for medium-term planning of return acquisition, disassembly (refurbish or remanufacture) and disposal activities. Moreover, the model seeks an analysis a number of decisions relating to trade off management system to maximize revenue from the collection of use products reverse logistics services through refurbish and remanufacture recovery options. The results showed that full utilization in the sorting process leads the system to obtain less quantity from acquisition with minimal overall cost. Further, sensitivity analysis provides a range of possible scenarios to consider in optimizing the overall cost of refurbished and remanufactured products.

Keywords: core acquisition, end of life, reverse logistics, quality uncertainty

Procedia PDF Downloads 283

Authors: Faishal Muhammad, Erlinda Muslim, Nadia Faradilla, Sayidul Fikri

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To deal with the increase of mass transportation needs problem, PT. Kereta Commuter Jabodetabek (KCJ) implements Commuter Vending Machine (C-VIM) as the solution. For that background, C-VIM is implemented as a substitute to the conventional ticket windows with the purposes to make transaction process more efficient and to introduce self-service technology to the commuter line user. However, this implementation causing problems and long queues when the user is not accustomed to using the machine. The objective of this research is to evaluate user experience after using the commuter vending machine. The goal is to analyze the existing user experience problem and to achieve a better user experience design. The evaluation method is done by giving task scenario according to the features offered by the machine. The features are daily insured ticket sales, ticket refund, and multi-trip card top up. There 20 peoples that separated into two groups of respondents involved in this research, which consist of 5 males and 5 females each group. The experienced and inexperienced user to prove that there is a significant difference between both groups in the measurement. The user experience is measured by both quantitative and qualitative measurement. The quantitative measurement includes the user performance metrics such as task success, time on task, error, efficiency, and learnability. The qualitative measurement includes system usability scale questionnaire (SUS), questionnaire for user interface satisfaction (QUIS), and retrospective think aloud (RTA). Usability performance metrics shows that 4 out of 5 indicators are significantly different in both group. This shows that the inexperienced group is having a problem when using the C-VIM. Conventional ticket windows also show a better usability performance metrics compared to the C-VIM. From the data processing, the experienced group give the SUS score of 62 with the acceptability scale of 'marginal low', grade scale of “D”, and the adjective ratings of 'good' while the inexperienced group gives the SUS score of 51 with the acceptability scale of 'marginal low', grade scale of 'F', and the adjective ratings of 'ok'. This shows that both groups give a low score on the system usability scale. The QUIS score of the experienced group is 69,18 and the inexperienced group is 64,20. This shows the average QUIS score below 70 which indicate a problem with the user interface. RTA was done to obtain user experience issue when using C-VIM through interview protocols. The issue obtained then sorted using pareto concept and diagram. The solution of this research is interface redesign using activity relationship chart. This method resulted in a better interface with an average SUS score of 72,25, with the acceptable scale of 'acceptable', grade scale of 'B', and the adjective ratings of 'excellent'. From the time on task indicator of performance metrics also shows a significant better time by using the new interface design. Result in this study shows that C-VIM not yet have a good performance and user experience.

Keywords: activity relationship chart, commuter line vending machine, system usability scale, usability performance metrics, user experience evaluation

Procedia PDF Downloads 247

Authors: Sujit K. Basak

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This paper presents a comparison of reference management software between RefWorks and Zotero. The results were drawn by comparing two software and the novelty of this paper is the comparative analysis of software and it has shown that ReftWorks can import more information from the Google Scholar for the researchers. This finding could help to know researchers to use the reference management software.

Keywords: analysis, comparative analysis, reference management software, researchers

Procedia PDF Downloads 527

Authors: Somayeh Pashaee

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The ever-increasing growth of the Internet and the development of information and communication technology have prompted the politicians of different countries to use virtual networks as an efficient tool for their foreign policy. The communication of governments and countries, even in the farthest places from each other, through electronic networks, has caused vast changes in the way of statecraft and governance. Importantly, in the meantime, diplomacy, which is always based on information and communication, has been affected by the new prevailing conditions and new technologies more than other areas and has faced greater changes. The emergence of virtual space and the formation of new communication tools in the field of public diplomacy has led to the redefinition of the framework of diplomacy and politics in the international arena and the appearance of a new aspect of diplomacy called digital diplomacy. Digital diplomacy is in the concept of changing relations from a face-to-face and traditional way to a non-face-to-face and new way, and its purpose is to solve foreign policy issues using virtual space. Digital diplomacy, by affecting diplomatic procedures and its change, explains the role of technology in the visualization and implementation of diplomacy in different ways. The purpose of this paper is to investigate the position of digital diplomacy in the public diplomacy of the Islamic Republic of Iran. The paper tries to answer these two questions in a descriptive-analytical way, considering the progress of communication and the role of virtual space in the service of diplomacy, what is the approach of the Islamic Republic of Iran towards digital diplomacy and the use of a new way of establishing foreign relations in public diplomacy? What capacities and damages are facing the country after the use of this type of new diplomacy? In this paper, various theoretical concepts in the field of public diplomacy and modern diplomacy, including Geoff Berridge, Charles Kegley, Hans Tuch and Ronald Peter Barston, as well as the theoretical framework of Marcus Holmes on digital diplomacy, will be used as a conceptual basis to support the analysis. As a result, in order to better achieve the political goals of the country, especially in foreign policy, the approach of the Islamic Republic of Iran to public diplomacy with a focus on digital diplomacy should be strengthened and revised. Today, only emphasizing on advancing diplomacy through traditional methods may weaken Iran's position in the public opinion level from other countries.

Keywords: digital diplomacy, public diplomacy, islamic republic of Iran, foreign policy, opportunities and challenges

Procedia PDF Downloads 100

Authors: Arpita Mondal, Aurobinda Routray, Sreeraj Puravankara, Rajashree Biswas

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The most difficult part of designing a battery management system (BMS) is battery modeling. A good battery model can capture the dynamics which helps in energy management, by accurate model-based state estimation algorithms. So far the most suitable and fruitful model is the equivalent circuit model (ECM). However, in real-time applications, the model parameters are time-varying, changes with current, temperature, state of charge (SOC), and aging of the battery and this make a great impact on the performance of the model. Therefore, to increase the equivalent circuit model performance, the parameter estimation has been carried out in the frequency domain. The battery is a very complex system, which is associated with various chemical reactions and heat generation. Therefore, it’s very difficult to select the optimal model structure. As we know, if the model order is increased, the model accuracy will be improved automatically. However, the higher order model will face the tendency of over-parameterization and unfavorable prediction capability, while the model complexity will increase enormously. In the time domain, it becomes difficult to solve higher order differential equations as the model order increases. This problem can be resolved by frequency domain analysis, where the overall computational problems due to ill-conditioning reduce. In the frequency domain, several dominating frequencies can be found in the input as well as output data. The selective frequency domain estimation has been carried out, first by estimating the frequencies of the input and output by subspace decomposition, then by choosing the specific bands from the most dominating to the least, while carrying out the least-square, recursive least square and Kalman Filter based parameter estimation. In this paper, a second order battery model consisting of three resistors, two capacitors, and one SOC controlled voltage source has been chosen. For model identification and validation hybrid pulse power characterization (HPPC) tests have been carried out on a 2.6 Ah LiFePO₄ battery.

Keywords: equivalent circuit model, frequency estimation, parameter estimation, subspace decomposition

Procedia PDF Downloads 133

Authors: Ameer Alalwan

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Summary: The aim of this research is to identify trends of municipal council member in practicing his administrative control, decision-making, and counsultive role on municipalities' main municipal activities in the kingdom of Saudi Arabia. This research is conducted after the implementation of the new municipal system resolution no. (M\61) in 1435 in the work of municipal councils for the third session. To achieve the goal of this research, a questionnaire has been designed to obtain the opinion of municipal councils on this matter. This questionnaire has been tested for reliability and validity. The results of this research show that in general performance of municipal council is moderate after the implementation of the new municipal system resolution no. (M\61) in 1435 in the work of municipal councils for the third session. Also, extend that municipal council member practice his roles on the main municipality activities is moderate and weak. In addition, results show that municipal council member practice big role in decision-making, and moderate role in administrative control, and weaker role in giving opinion on municipality main issues. Furthermore, the results show that there is a significant difference between municipal council member's responses by the change of their Personal characteristics. Educated and appointed municipal council members practicing their role more than others do. In addition, municipal council presidents, and vice presidents, and in regional and sub-regional municipalities practice their role more than others do. Finally, this research in general recommened that muincialty council member must be empowered, so that he can practice his role on muicipality main activities. In addition, research suggest, granting municipal council member the authority, resources needed, training and appointment of qualified members, so that they will be able to practice their roles. Furthermore, this research suggest for the time being maintain certain percent of municipal council's appointed until this experience mature in the kingdom.

Keywords: municipal council, municipal council member, municipality, decision-making role

Procedia PDF Downloads 116

Authors: Matthew Heidman, Susan Dallabrida, Analice Costa

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Background:Accuracy of caregiver reported outcomes is essential for infant growth and tolerability study success. Crying/fussiness, stool consistencies, and other gastrointestinal characteristics are important parameters regarding tolerability, and inter-caregiver reporting can see a significant amount of subjectivity and vary greatly within a study, compromising data. This study sought to elucidate how caregiver reported questions related to stool frequency are answered before and after a short amount of training and how training impacts caregivers’ understanding, and how they would answer the question. Methods:A digital survey was issued for 90 daysin the US (n=121) and 30 days in Mexico (n=88), targeting respondents with children ≤4 years of age. Respondents were asked a question in two formats, first without a line of training text and second with a line of training text. The question set was as follows, “If your baby had stool in his/her diaper and you changed the diaper and 10 min later there was more stool in the diaper, how many stools would you report this as?” followed by the same question beginning with “If you were given the instruction that IF there are at least 5 minutes in between stools, then it counts as two (2) stools…”.Four response items were provided for both questions, 1) 2 stools, 2) 1stool, 3) it depends on how much stool was in the first versus the second diaper, 4) There is not enough information to be able to answer the question. Response frequencies between questions were compared. Results: Responses to the question without training saw some variability in the US, with 69% selecting “2 stools”,11% selecting “1 stool”, 14% selecting “it depends on how much stool was in the first versus the second diaper”, and 7% selecting “There is not enough information to be able to answer the question” and in Mexico respondents selected 9%, 78%, 13%, and 0% respectively. However, responses to the question after training saw more consolidation in the US, with 85% of respondents selecting“2 stools,” representing an increase in those selecting the correct answer. Additionally in Mexico, with 84% of respondents selecting “1 episode” representing an increase in the those selecting the correct response. Conclusions: Caregiver reported outcomes are critical for infant growth and tolerability studies, however, they can be highly subjective and see a high variability of responses without guidance. Training is critical to standardize all caregivers’ perspective regarding how to answer questions accurately in order to provide an accurate dataset.

Keywords: infant nutrition, clinical trial optimization, stool reporting, decentralized clinical trials

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Authors: Camila Lozano-Vivas, Camila Quevedo-Villamil, Ingrid Munoz-Quijano, Diego Loaiza

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Colombia's limited oil reserves make the finding of new fields of extraction or the potentiate of the existing ones a more important task to do every day; the exploration projects that allow to have a better knowledge of the oil basins are essential. The upper Magdalena Valley basin - VSM, whose reserves are limited, has been one of the first basins for the exploration and production of hydrocarbons in Colombia. The Hondita and Lomagorda formations were deposited in the Late Cretaceous Middle Albian to the Coniacian and are characterized by being the hydrocarbon-generating rocks in the VSM basin oil system along with the Shale de Bambucá; therefore multiple studies have been made. In the oil industry, geochemical properties are used to understand the origin, migration, accumulation, and alteration of hydrocarbons and, in general, the evolution of the basin containing them. One of the most important parameters to understand this evolution is the formation temperature of the oil system. For this reason, a microthermometric study of fluid inclusions was carried out to recognize formation temperatures and to determine certain basic physicochemical variables, homogenization temperature, pressure, density and salinity of the fluid at the time of entrapment, providing evidence on the history of different events in different geological environments in the evolution of a sedimentary basin. Prior to this study, macroscopic and microscopic petrographic analyses of the samples collected in the field were performed. The results of the mentioned properties of the fluid inclusions in the different samples analyzed have salinities ranging from 20.22% to 26.37% eq. by weight NaCl, similar densities found in the ranges of 1.05 to 1.16 g/cc and an average homogenization temperature at 142.92°C, indicating that, at the time of their entanglement, the rock was in the window of generation of medium hydrocarbons –light with fragile characteristics of the rock that would make it useful to treat them as naturally fractured reservoirs.

Keywords: homogenization temperature, fluid inclusions, microthermometry, salinity

Procedia PDF Downloads 141

Authors: Anusha P. Wijesundara, Dulap I. Rathnayake, Nihal D. Perera

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Bathymetric information is fundamental importance to coastal and marine planning and management, nautical navigation, and scientific studies of marine environments. Satellite-derived bathymetry data provide detailed information in areas where conventional sounding data is lacking and conventional surveys are inaccessible. The two empirical approaches of log-linear bathymetric inversion model and non-linear bathymetric inversion model are applied for deriving bathymetry from high-resolution multispectral satellite imagery. This study compares these two approaches by means of geographical error analysis for the site Kankesanturai using WorldView-2 satellite imagery. Based on the Levenberg-Marquardt method calibrated the parameters of non-linear inversion model and the multiple-linear regression model was applied to calibrate the log-linear inversion model. In order to calibrate both models, Single Beam Echo Sounding (SBES) data in this study area were used as reference points. Residuals were calculated as the difference between the derived depth values and the validation echo sounder bathymetry data and the geographical distribution of model residuals was mapped. The spatial autocorrelation was calculated by comparing the performance of the bathymetric models and the results showing the geographic errors for both models. A spatial error model was constructed from the initial bathymetry estimates and the estimates of autocorrelation. This spatial error model is used to generate more reliable estimates of bathymetry by quantifying autocorrelation of model error and incorporating this into an improved regression model. Log-linear model (R²=0.846) performs better than the non- linear model (R²=0.692). Finally, the spatial error models improved bathymetric estimates derived from linear and non-linear models up to R²=0.854 and R²=0.704 respectively. The Root Mean Square Error (RMSE) was calculated for all reference points in various depth ranges. The magnitude of the prediction error increases with depth for both the log-linear and the non-linear inversion models. Overall RMSE for log-linear and the non-linear inversion models were ±1.532 m and ±2.089 m, respectively.

Keywords: log-linear model, multi spectral, residuals, spatial error model

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Authors: Mane Varosyan, Diana Tumanyan, Agnesa Martirosyan

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There are many catastrophic events that end with dire consequences, and to avoid them, people should be well-armed with the necessary information about these situations. During the last years, Serious Games have increasingly gained popularity for training people for different types of emergencies. The major discussed problem is the usage of gamification in education. Moreover, it is mandatory to understand how and what kind of gamified e-learning modules promote engagement. As the theme is emergency, we also find out people’s behavior for creating the final approach. Our proposed solution is an educational video game, “EZZRA”.

Keywords: gamification, education, emergency, serious games, game design, virtual reality, digitalisation

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Authors: Richa Soni, Vibha Bhatnagar, N. K. Jain

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This study was conducted to develop a computer mediated programme for weight management and physical fitness and examining its efficacy in reducing weight and improving physical fitness in obese adults. A user friendly, computer based programme was developed to provide a simple, quick, easy and user-friendly method of assessing energy balance at individual level. The programme had four main sections viz. personal Profile, know about your weight, fitness and food exchange list. The computer programme was developed to provide facilities of creating individual profile, tracking meal and physical activities, suggesting nutritional and exercise requirements, planning calorie specific menus, keeping food diaries and revising the diet and exercise plans if needed. The programme was also providing information on obesity, underweight, physical fitness. An exhaustive food exchange list was also given in the programme to assist user to make right food choice decisions. The developed programme was evaluated by a panel of 15 experts comprising endocrinologists, nutritionists and diet counselors. Suggestions given by the experts were paned down and the entire programme was modified in light of suggestions given by the panel members and was reevaluated by the same panel of experts. For assessing the impact of the programme 22 obese subjects were selected purposively and randomly assigned to intervention group (n=12) and no information control group. (n=10). The programme group was asked to strictly follow the programme for one month. Significant reduction in the intake of energy, fat and carbohydrates was observed while intake of fruits, green leafy vegetables was increased. The programme was also found to be effective in reducing body weight, body fat percent and body fat mass whereas total body water and physical fitness scores improved significantly. There was no significant alteration observed in any parameters in the control group.

Keywords: body composition, body weight, computer programme, physical fitness

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Authors: Saruda Nitiworakarn

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This research aims to identify traditional Mon cuisines as well as gather and classify traditional cuisines of Mon communities in Bangkok. The studying of this research is used by methodology of the quantitative research. Using the questionnaire as the method in collecting information from sampling totally amount of 450 persons analyzed via frequency, percentage and mean value. The results showed that a variety of traditional Mon cuisines of Bangkok could split into 6 categories of meat diet with 54 items and 6 categories of desserts with 19 items.

Keywords: cultural identity, traditional food, Mon cuisine, Thailand

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Authors: Jana Andzane, Gunta Kunakova, Margarita Baitimirova, Mikelis Marnauza, Floriana Lombardi, Donats Erts

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Bismuth selenide (Bi₂Se₃) is known as a narrow band gap semiconductor with pronounced thermoelectric (TE) and topological insulator (TI) properties. Unique TI properties offer exciting possibilities for fundamental research as observing the exciton condensate and Majorana fermions, as well as practical application in spintronic and quantum information. In turn, TE properties of this material can be applied for wide range of thermoelectric applications, as well as for broadband photodetectors and near-infrared sensors. Nanostructuring of this material results in improvement of TI properties due to suppression of the bulk conductivity, and enhancement of TE properties because of increased phonon scattering at the nanoscale grains and interfaces. Regarding TE properties, crystallographic growth direction, as well as orientation of the nanostructures relative to the growth substrate, play significant role in improvement of TE performance of nanostructured material. For instance, Bi₂Se₃ layers consisting of randomly oriented nanostructures and/or of combination of them with planar nanostructures show significantly enhanced in comparison with bulk and only planar Bi₂Se₃ nanostructures TE properties. In this work, a catalyst-free vapour-solid deposition technique was applied for controlled obtaining of different types of Bi₂Se₃ nanostructures and continuous nanostructured layers for targeted applications. For example, separated Bi₂Se₃ nanoplates, nanobelts and nanowires can be used for investigations of TI properties; consisting from merged planar and/or randomly oriented nanostructures Bi₂Se₃ layers are useful for applications in heat-to-power conversion devices and infrared detectors. The vapour-solid deposition was carried out using quartz tube furnace (MTI Corp), equipped with an inert gas supply and pressure/temperature control system. Bi₂Se₃ nanostructures/nanostructured layers of desired type were obtained by adjustment of synthesis parameters (process temperature, deposition time, pressure, carrier gas flow) and selection of deposition substrate (glass, quartz, mica, indium-tin-oxide, graphene and carbon nanotubes). Morphology, structure and composition of obtained Bi₂Se₃ nanostructures and nanostructured layers were inspected using SEM, AFM, EDX and HRTEM techniques, as well as home-build experimental setup for thermoelectric measurements. It was found that introducing of temporary carrier gas flow into the process tube during the synthesis and deposition substrate choice significantly influence nanostructures formation mechanism. Electrical, thermoelectric, and topological insulator properties of different types of deposited Bi₂Se₃ nanostructures and nanostructured coatings are characterized as a function of thickness and discussed.

Keywords: bismuth seleinde, nanostructures, topological insulator, vapour-solid deposition

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Authors: V. Mantey, N. Findlay, I. Maddox

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The quality and quantity of global satellite data have been increasing exponentially in recent years as spaceborne systems become more affordable and the sensors themselves become more sophisticated. This is a valuable resource for many applications, including disaster management and relief. However, while more information can be valuable, the volume of data available is impossible to manually examine. Therefore, the question becomes how to extract as much information as possible from the data with limited manpower. Buildings are a key feature of interest in satellite imagery with applications including telecommunications, population models, and disaster relief. Machine learning tools are fast becoming one of the key resources to solve this problem, and models have been developed to detect buildings in optical satellite imagery. However, by and large, most models focus on affluent regions where buildings are generally larger and constructed further apart. This work is focused on the more difficult problem of detection in populated regions. The primary challenge with detecting small buildings in densely populated regions is both the spatial and spectral resolution of the optical sensor. Densely packed buildings with similar construction materials will be difficult to separate due to a similarity in color and because the physical separation between structures is either non-existent or smaller than the spatial resolution. This study finds that training models until they are overfitting the input sample can perform better in these areas than a more robust, generalized model. An overfitted model takes less time to fine-tune from a generalized pre-trained model and requires fewer input data. The model developed for this study has also been fine-tuned using existing, open-source, building vector datasets. This is particularly valuable in the context of disaster relief, where information is required in a very short time span. Leveraging existing datasets means that little to no manpower or time is required to collect data in the region of interest. The training period itself is also shorter for smaller datasets. Requiring less data means that only a few quality areas are necessary, and so any weaknesses or underpopulated regions in the data can be skipped over in favor of areas with higher quality vectors. In this study, a landcover classification model was developed in conjunction with the building detection tool to provide a secondary source to quality check the detected buildings. This has greatly reduced the false positive rate. The proposed methodologies have been implemented and integrated into a configurable production environment and have been employed for a number of large-scale commercial projects, including continent-wide DEM production, where the extracted building footprints are being used to enhance digital elevation models. Overfitted machine learning models are often considered too specific to have any predictive capacity. However, this study demonstrates that, in cases where input data is scarce, overfitted models can be judiciously applied to solve time-sensitive problems.

Keywords: building detection, disaster relief, mask-RCNN, satellite mapping

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Authors: Yasser F. Hassan

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In this paper, a proposed model of cellular automata is studied by means of fractional integral function. A cellular automaton is a decentralized computing model providing an excellent platform for performing complex computation with the help of only local information. The paper discusses how using fractional integral function for representing cellular automata memory or state. The architecture of computing and learning model will be given and the results of calibrating of approach are also given.

Keywords: fractional integral, cellular automata, memory, learning

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Authors: Stefanie M. Vanneste, Stijn Goeminne

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This paper studies the effect of political characteristics of 308 Flemish municipalities on their budget balance in the period 1995-2011. All local governments experience the same economic and financial setting, however some governments have high budget balances, while others have low budget balances. The aim of this paper is to explain the differences in municipal budget balances by a number of economic, socio-demographic and political variables. The economic and socio-demographic variables will be used as control variables, while the focus of this paper will be on the political variables. We test four hypotheses resulting from the literature, namely (i) the partisan hypothesis tests if left wing governments have lower budget balances, (ii) the fragmentation hypothesis stating that more fragmented governments have lower budget balances, (iii) the hypothesis regarding the power of the government, higher powered governments would resolve in higher budget balances, and (iv) the opportunistic budget cycle to test whether politicians manipulate the economic situation before elections in order to maximize their reelection possibilities and therefore have lower budget balances before elections. The contributions of our paper to the existing literature are multiple. First, we use the whole array of political variables and not just a selection of them. Second, we are dealing with a homogeneous database with the same budget and election rules, making it easier to focus on the political factors without having to control for the impact of differences in the political systems. Third, our research extends the existing literature on Flemish municipalities as this is the first dynamic research on local budget balances. We use a dynamic panel data model. Because of the two lagged dependent variables as explanatory variables, we employ the system GMM (Generalized Method of Moments) estimator. This is the best possible estimator as we are dealing with political panel data that is rather persistent. Our empirical results show that the effect of the ideological position and the power of the coalition are of less importance to explain the budget balance. The political fragmentation of the government on the other hand has a negative and significant effect on the budget balance. The more parties in a coalition the worse the budget balance is ceteris paribus. Our results also provide evidence of an opportunistic budget cycle, the budget balances are lower in pre-election years relative to the other years to try and increase the incumbents reelection possibilities. An additional finding is that the incremental effect of the budget balance is very important and should not be ignored like is being done in a lot of empirical research. The coefficients of the lagged dependent variables are always positive and very significant. This proves that the budget balance is subject to incrementalism. It is not possible to change the entire policy from one year to another so the actions taken in recent past years still have an impact on the current budget balance. Only a relatively small amount of research concerning the budget balance takes this considerable incremental effect into account. Our findings survive several robustness checks.

Keywords: budget balance, fragmentation, ideology, incrementalism, municipalities, opportunistic budget cycle, panel data, political characteristics, power, system GMM

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Authors: Hikari Ryu, Yuki Fukuda, Kento Oishi, Chiharu Igarashi, Shogo Kiryu

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Recently, wireless power transfer has been developed in various fields. Magnetic coupling is popular for feeding power at a relatively short distance and at a lower frequency. Electro-magnetic wave coupling at a high frequency is used for long-distance power transfer. The wireless power transfer has attracted attention in e-textile fields. Rigid batteries are required for many body-worn electric systems at the present time. The technology enables such batteries to be removed from the systems. Flexible coils have been studied for such applications. Coils with a high Q factor are required in the magnetic-coupling power transfer. Antennas with low return loss are needed for the electro-magnetic coupling. Litz wire is so flexible to fabricate coils and antennas sewn on fabric and has low resistivity. In this study, the electric characteristics of some coils and antennas fabricated with the Litz wire by using two sewing techniques are investigated. As examples, a coil and an antenna are described. Both were fabricated with 330/0.04 mm Litz wire. The coil was a planar coil with a square shape. The outer side was 150 mm, the number of turns was 15, and the pitch interval between each turn was 5 mm. The Litz wire of the coil was overstitched with a sewing machine. The coil was fabricated as a receiver coil for a magnetic coupled wireless power transfer. The Q factor was 200 at a frequency of 800 kHz. A wireless power system was constructed by using the coil. A power oscillator was used in the system. The resonant frequency of the circuit was set to 123 kHz, where the switching loss of power FETs was small. The power efficiencies were 0.44 – 0.99, depending on the distance between the transmitter and receiver coils. As an example of an antenna with a sewing technique, a fractal pattern antenna was stitched on a 500 mm x 500 mm fabric by using a needle punch method. The pattern was the 2nd-oder Vicsec fractal. The return loss of the antenna was -28 dB at a frequency of 144 MHz.

Keywords: e-textile, flexible coils and antennas, Litz wire, wireless power transfer

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Authors: Anna Stepien

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The paper presents the results of research on modifications of sand-lime bricks, especially using glass additives (glass fiber and glass sand) and other additives (e.g.:basalt&barite aggregate, lithium silicate and microsilica) as well. The main goal of this paper is to answer the question ‘How to use glass additives in the sand-lime mass and get a better bricks?’ The article contains information on modification of sand-lime bricks using glass fiber, glass sand, microsilica (different structure of silica). It also presents the results of the conducted compression tests, which were focused on compressive strength, water absorption, bulk density, and their microstructure. The Scanning Electron Microscope, spectrum EDS, X-ray diffractometry and DTA analysis helped to define the microstructural changes of modified products. The interpretation of the products structure revealed the existence of diversified phases i.e.the C-S-H and tobermorite. CaO-SiO2-H2O system is the object of intensive research due to its meaning in chemistry and technologies of mineral binding materials. Because the blocks are the autoclaving materials, the temperature of hydrothermal treatment of the products is around 200°C, the pressure - 1,6-1,8 MPa and the time - up to 8hours (it means: 1h heating + 6h autoclaving + 1h cooling). The microstructure of the products consists mostly of hydrated calcium silicates with a different level of structural arrangement. The X-ray diffraction indicated that the type of used sand is an important factor in the manufacturing of sand-lime elements. Quartz sand of a high hardness is also a substrate hardly reacting with other possible modifiers, which may cause deterioration of certain physical and mechanical properties. TG and DTA curves show the changes in the weight loss of the sand-lime bricks specimen against time as well as the endo- and exothermic reactions that took place. The endothermic effect with the maximum at T=573°C is related to isomorphic transformation of quartz. This effect is not accompanied by a change of the specimen weight. The next endothermic effect with the maximum at T=730-760°C is related to the decomposition of the calcium carbonates. The bulk density of the brick it is 1,73kg/dm3, the presence of xonotlite in the microstructure and significant weight loss during DTA and TG tests (around 0,6% after 70 minutes) have been noticed. Silicate elements were assessed on the basis of their compressive property. Orthogonal compositional plan type 3k (with k=2), i.e.full two-factor experiment was applied in order to carry out the experiments both, in the compression strength test and bulk density test. Some modification (e.g.products with barite and basalt aggregate) have improved the compressive strength around 41.3 MPa and water absorption due to capillary raising have been limited to 12%. The next modification was adding glass fiber to sand-lime mass, then glass sand. The results show that the compressive strength was higher than in the case of traditional bricks, while modified bricks were lighter.

Keywords: bricks, fiber, glass, microstructure

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Authors: Himanshu Shekhar Maharana, S. K .Dash

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Economic Load Dispatch (ELD) proves to be a vital optimization process in electric power system for allocating generation amongst various units to compute the cost of generation, the cost of emission involving global warming gases like sulphur dioxide, nitrous oxide and carbon monoxide etc. In this dissertation, we emphasize ramp rate constriction factor based particle swarm optimization (RRCPSO) for analyzing various performance objectives, namely cost of generation, cost of emission, and a dual objective function involving both these objectives through the experimental simulated results. A 6-unit 30 bus IEEE test case system has been utilized for simulating the results involving improved weight factor advanced ramp rate limit constraints for optimizing total cost of generation and emission. This method increases the tendency of particles to venture into the solution space to ameliorate their convergence rates. Earlier works through dispersed PSO (DPSO) and constriction factor based PSO (CPSO) give rise to comparatively higher computational time and less good optimal solution at par with current dissertation. This paper deals with ramp rate and constriction factor based well defined ramp rate PSO to compute various objectives namely cost, emission and total objective etc. and compares the result with DPSO and weight improved PSO (WIPSO) techniques illustrating lesser computational time and better optimal solution. 

Keywords: economic load dispatch (ELD), constriction factor based particle swarm optimization (CPSO), dispersed particle swarm optimization (DPSO), weight improved particle swarm optimization (WIPSO), ramp rate and constriction factor based particle swarm optimization (RRCPSO)

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Authors: Nam-Hee Kim, Jang-Hoon Ko, Kwon-Hee Lee

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A relief valve is a mechanical element to keep safety by controlling high pressure. Usually, the high pressure is relieved by using the spring force and letting the fluid to flow from another way out of system. When its normal pressure is reached, the relief valve can return to initial state. The relief valve in this study has been applied for pressure vessel, evaporator, piping line, etc. The relief valve should be designed for smooth operation and should satisfy the structural safety requirement under operating condition. In general, the structural analysis is performed by following fluid flow analysis. In this process, the FSI (Fluid-Structure Interaction) is required to input the force obtained from the output of the flow analysis. Firstly, this study predicts the velocity profile and the pressure distribution in the given system. In this study, the assumptions for flow analysis are as follows: • The flow is steady-state and three-dimensional. • The fluid is Newtonian and incompressible. • The walls of the pipe and valve are smooth. The flow characteristics in this relief valve does not induce any problem. The commercial software ANSYS/CFX is utilized for flow analysis. On the contrary, very high pressure may cause structural problem due to severe stress. The relief valve is made of body, bonnet, guide, piston and nozzle, and its material is stainless steel. To investigate its structural safety, the worst case loading is considered as the pressure of 700 bar. The load is applied to inside the valve, which is greater than the load obtained from FSI. The maximum stress is calculated as 378 MPa by performing the finite element analysis. However, the value is greater than its allowable value. Thus, an alternative design is suggested to improve the structural performance through case study. We found that the sensitive design variable to the strength is the shape of the nozzle. The case study is to vary the size of the nozzle. Finally, it can be seen that the suggested design satisfy the structural design requirement. The FE analysis is performed by using the commercial software ANSYS/Workbench.

Keywords: relief valve, structural analysis, structural design, strength, safety factor

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Authors: Fayez Hanna, Viet Tran

Abstract:

A 20 years old lady- primigravida 6 weeks pregnant with unremarkable past history, presented to the emergency department at the Royal Hobart Hospital, Tasmania, Australia, with hyperemesis gravidarum associated with, dehydration and complicated with hematemesis and chest pain resistant. Accordingly, we conducted laboratory investigations which revealed: FBC: WBC 23.9, unremarkable U&E, LFT, lipase and her VBG showed a pH 7.4, pCo2 36.7, cK+ 3.2, cNa+ 142. The decision was made to do a chest X-ray (CXR) after explaining the risks/benefit of performing radiographic investigations during pregnancy and considering the patient's plan for the termination of the pregnancy as she was not ready for motherhood for shared decision-making and consent to look for pneumoperitoneum to suggest perforated viscus that might cause the hematemesis. However, the CXR showed pneumomediastinum but no evidence of pneumoperitoneum or pneumothorax. Consequently, a decision was made to proceed with CT oesophagography with imaging pre and post oral contrast administration to identify a potential oesophageal tear since it could not be excluded using a plain film of the CXR. The CT oesophagography could not find a leak for the administered oral contrast and thus, no oesophageal tear could be confirmed but could not exclude the Mallory-Weiss tear (lower oesophageal tear). Further, the CT oesophagography showed an extensive pneumomediastinum that could not be confirmed to be pulmonary in origin noting the presence of bilateral pulmonary interstitial emphysema and pneumothorax in the apex of the right lung that was small. The patient was admitted to the Emergency Department Inpatient Unit for monitoring, supportive therapy, and symptomatic management. Her hyperemesis was well controlled with ondansetron 8mg IV, metoclopramide 10mg IV, doxylamine 25mg PO, pyridoxine 25mg PO, esomeprazole 40mg IV and oxycodone 5mg PO was given for pain control and 2 litter of IV fluid. The patient was stabilized after 24 hours and discharged home on ondansetron 8mg every 8 hours whereas the patient had a plan for medical termination of pregnancy. Three weeks later, the patient represented with nausea and vomiting complicated by a frank hematemesis. Her observation chart showed HR 117- other vital signs were normal. Pathology showed WBC 14.3 with normal U&E and Hb. The patient was managed in the Emergency Department with the same previous regimen and was discharged home on same previous regimes. Five days later, she presented again with nausea, vomiting and hematemesis and was admitted under obstetrics and gynaecology for stabilization then discharged home with a plan for surgical termination of pregnancy after 3-days rather than the previously planned medical termination of pregnancy to avoid extension of potential oesophageal tear. The surgical termination and follow up period were uneventful. The case is considered rare as pneumomediastinum is a very rare complication of hyperemesis gravidarum where vomiting-induced barotrauma leads to a ruptured oesophagus and air leak into the mediastinum. However no rupture oesophagus in our case. Although the combination of pneumothorax and pneumomediastinum without oesophageal tear was reported only 8 times in the literature, but none of them was due to hyperemesis gravidarum.

Keywords: Pneumothorax, pneumomediastinum, hyperemesis gravidarum, pneumopericardium

Procedia PDF Downloads 81