Search results for: discharge rating
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1464

Search results for: discharge rating

174 Groundwater Numerical Modeling, an Application of Remote Sensing, and GIS Techniques in South Darb El Arbaieen, Western Desert, Egypt

Authors: Abdallah M. Fayed

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The study area is located in south Darb El Arbaieen, western desert of Egypt. It occupies the area between latitudes 22° 00/ and 22° 30/ North and Longitudes 29° 30/ and 30° 00/ East, from southern border of Egypt to the area north Bir Kuraiym and from the area East of East Owienat to the area west Tushka district, its area about 2750 Km2. The famous features; southern part of Darb El Arbaieen road, G Baraqat El Scab El Qarra, Bir Dibis, Bir El Shab and Bir Kuraiym, Interpretation of soil stratification shows layers that are related to Quaternary and Upper-Lower Cretaceous eras. It is dissected by a series of NE-SW striking faults. The regional groundwater flow direction is in SW-NE direction with a hydraulic gradient is 1m / 2km. Mathematical model program has been applied for evaluation of groundwater potentials in the main Aquifer –Nubian Sandstone- in the area of study and Remote sensing technique is considered powerful, accurate and saving time in this respect. These techniques are widely used for illustrating and analysis different phenomenon such as the new development in the desert (land reclamation), residential development (new communities), urbanization, etc. The major issues concerning water development objective of this work is to determine the new development areas in western desert of Egypt during the period from 2003 to 2015 using remote sensing technique, the impacts of the present and future development have been evaluated by using the two-dimensional numerical groundwater flow Simulation Package (visual modflow 4.2). The package was used to construct and calibrate a numerical model that can be used to simulate the response of the aquifer in the study area under implementing different management alternatives in the form of changes in piezometric levels and salinity. Total period of simulation is 100 years. After steady state calibration, two different scenarios are simulated for groundwater development. 21 production wells are installed at the study area and used in the model, with the total discharge for the two scenarios were 105000 m3/d, 210000 m3/d. The drawdown was 11.8 m and 23.7 m for the two scenarios in the end of 100 year. Contour maps for water heads and drawdown and hydrographs for piezometric head are represented. The drawdown was less than the half of the saturated thickness (the safe yield case).

Keywords: remote sensing, management of aquifer systems, simulation modeling, western desert, South Darb El Arbaieen

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173 Factors Contributing to Adverse Maternal and Fetal Outcome in Patients with Eclampsia

Authors: T. Pradhan, P. Rijal, M. C. Regmi

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Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.

Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors

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172 Interpersonal Competence Related to the Practice Learning of Occupational Therapy Students in Hong Kong

Authors: Lik Hang Gary Wong

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Background: Practice learning is crucial for preparing the healthcare profession to meet the real challenge upon graduation. Students are required to demonstrate their competence in managing interpersonal challenges, such as teamwork with other professionals and communicating well with the service users, during the placement. Such competence precedes clinical practice, and it may eventually affect students' actual performance in a clinical context. Unfortunately, there were limited studies investigating how such competence affects students' performance in practice learning. Objectives: The aim of this study is to investigate how self-rated interpersonal competence affects students' actual performance during clinical placement. Methods: 40 occupational therapy students from Hong Kong were recruited in this study. Prior to the clinical placement (level two or above), they completed an online survey that included the Interpersonal Communication Competence Scale (ICCS) measuring self-perceived competence in interpersonal communication. Near the end of their placement, the clinical educator rated students’ performance with the Student Practice Evaluation Form - Revised edition (SPEF-R). The SPEF-R measures the eight core competency domains required for an entry-level occupational therapist. This study adopted the cross-sectional observational design. Pearson correlation and multiple regression are conducted to examine the relationship between students' interpersonal communication competence and their actual performance in clinical placement. Results: The ICCS total scores were significantly correlated with all the SPEF-R domains, with correlation coefficient r ranging from 0.39 to 0.51. The strongest association was found with the co-worker communication domain (r = 0.51, p < 0.01), followed by the information gathering domain (r = 0.50, p < 0.01). Regarding the ICCS total scores as the independent variable and the rating in various SPEF-R domains as the dependent variables in the multiple regression analyses, the interpersonal competence measures were identified as a significant predictor of the co-worker communication (R² = 0.33, β = 0.014, SE = 0.006, p = 0.026), information gathering (R² = 0.27, β = 0.018, SE = 0.007, p = 0.011), and service provision (R² = 0.17, β = 0.017, SE = 0.007, p = 0.020). Moreover, some specific communication skills appeared to be especially important to clinical practice. For example, immediacy, which means whether the students were readily approachable on all social occasions, correlated with all the SPEF-R domains, with r-values ranging from 0.45 to 0.33. Other sub-skills, such as empathy, interaction management, and supportiveness, were also found to be significantly correlated to most of the SPEF-R domains. Meanwhile, the ICCS scores correlated differently with the co-worker communication domain (r = 0.51, p < 0.01) and the communication with the service user domain (r = 0.39, p < 0.05). It suggested that different communication skill sets would be required for different interpersonal contexts within the workplace. Conclusion: Students' self-perceived interpersonal communication competence could predict their actual performance during clinical placement. Moreover, some specific communication skills were more important to the co-worker communication but not to the daily interaction with the service users. There were implications on how to better prepare the students to meet the future challenge upon graduation.

Keywords: interpersonal competence, clinical education, healthcare professional education, occupational therapy, occupational therapy students

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171 Analysis of Waterjet Propulsion System for an Amphibious Vehicle

Authors: Nafsi K. Ashraf, C. V. Vipin, V. Anantha Subramanian

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This paper reports the design of a waterjet propulsion system for an amphibious vehicle based on circulation distribution over the camber line for the sections of the impeller and stator. In contrast with the conventional waterjet design, the inlet duct is straight for water entry parallel and in line with the nozzle exit. The extended nozzle after the stator bowl makes the flow more axial further improving thrust delivery. Waterjet works on the principle of volume flow rate through the system and unlike the propeller, it is an internal flow system. The major difference between the propeller and the waterjet occurs at the flow passing the actuator. Though a ducted propeller could constitute the equivalent of waterjet propulsion, in a realistic situation, the nozzle area for the Waterjet would be proportionately larger to the inlet area and propeller disc area. Moreover, the flow rate through impeller disk is controlled by nozzle area. For these reasons the waterjet design is based on pump systems rather than propellers and therefore it is important to bring out the characteristics of the flow from this point of view. The analysis is carried out using computational fluid dynamics. Design of waterjet propulsion is carried out adapting the axial flow pump design and performance analysis was done with three-dimensional computational fluid dynamics (CFD) code. With the varying environmental conditions as well as with the necessity of high discharge and low head along with the space confinement for the given amphibious vehicle, an axial pump design is suitable. The major problem of inlet velocity distribution is the large variation of velocity in the circumferential direction which gives rise to heavy blade loading that varies with time. The cavitation criteria have also been taken into account as per the hydrodynamic pump design. Generally, waterjet propulsion system can be parted into the inlet, the pump, the nozzle and the steering device. The pump further comprises an impeller and a stator. Analytical and numerical approaches such as RANSE solver has been undertaken to understand the performance of designed waterjet propulsion system. Unlike in case of propellers the analysis was based on head flow curve with efficiency and power curves. The modeling of the impeller is performed using rigid body motion approach. The realizable k-ϵ model has been used for turbulence modeling. The appropriate boundary conditions are applied for the domain, domain size and grid dependence studies are carried out.

Keywords: amphibious vehicle, CFD, impeller design, waterjet propulsion

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170 Brief Cognitive Behavior Therapy (BCBT) in a Japanese School Setting: Preliminary Outcomes on a Single Arm Study

Authors: Yuki Matsumoto, Yuma Ishimoto

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Cognitive Behavior Therapy (CBT) with children has shown effective application to various problems such as anxiety and depression. Although there are barriers to access to mental health services including lack of professional services in communities and parental concerns about stigma, school has a significant role to address children’s health problems. Schools are regarded as a suitable arena for prevention and early intervention of mental health problems. In this line, CBT can be adaptable to school education and useful to enhance students’ social and emotional skills. However, Japanese school curriculum is rigorous so as to limit available time for implementation of CBT in schools. This paper describes Brief Cognitive Behavior Therapy (BCBT) with children in a Japanese school setting. The program has been developed in order to facilitate acceptability of CBT in schools and aimed to enhance students’ skills to manage anxiety and difficult behaviors. The present research used a single arm design in which 30 students aged 9-10 years old participated. The authors provided teachers a CBT training workshop (two hours) at two primary schools in Tokyo metropolitan area and recruited participants in the research. A homeroom teacher voluntarily delivered a 6-session BCBT program (15 minutes each) in classroom periods which is called as Kaerinokai, a meeting before leaving school. Students completed a questionnaire sheet at pre- and post-periods under the supervision of the teacher. The sheet included the Spence Child Anxiety Scale (SCAS), the Depression Self-Rating Scale for Children (DSRS), and the Strengths and Difficulties Questionnaire (SDQ). The teacher was asked for feedback after the completion. Significant positive changes were found in the total and five of six sub-scales of the SCAS and the total difficulty scale of the SDQ. However, no significant changes were seen in Physical Injury Fear sub-scale of the SCAS, in the DSRS or the Prosocial sub-scale of the SDQ. The effect sizes are mostly between small and medium. The teacher commented that the program was easy to use and found positive changes in classroom activities and personal relationships. This preliminary research showed the feasibility of the BCBT in a school setting. The results suggest that the BCBT offers effective treatment for reduction in anxiety and in difficult behaviors. There is a good prospect of the BCBT suggesting that BCBT may be easier to be delivered than CBT by Japanese teachers to promote child mental health. The study has limitations including no control group, small sample size, or a short teacher training. Future research should address these limitations.

Keywords: brief cognitive behavior therapy, cognitive behavior therapy, mental health services in schools, teacher training workshop

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169 Transient Heat Transfer: Experimental Investigation near the Critical Point

Authors: Andreas Kohlhepp, Gerrit Schatte, Wieland Christoph, Spliethoff Hartmut

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In recent years the research of heat transfer phenomena of water and other working fluids near the critical point experiences a growing interest for power engineering applications. To match the highly volatile characteristics of renewable energies, conventional power plants need to shift towards flexible operation. This requires speeding up the load change dynamics of steam generators and their heating surfaces near the critical point. In dynamic load transients, both a high heat flux with an unfavorable ratio to the mass flux and a high difference in fluid and wall temperatures, may cause problems. It may lead to deteriorated heat transfer (at supercritical pressures), dry-out or departure from nucleate boiling (at subcritical pressures), all cases leading to an extensive rise of temperatures. For relevant technical applications, the heat transfer coefficients need to be predicted correctly in case of transient scenarios to prevent damage to the heated surfaces (membrane walls, tube bundles or fuel rods). In transient processes, the state of the art method of calculating the heat transfer coefficients is using a multitude of different steady-state correlations for the momentarily existing local parameters for each time step. This approach does not necessarily reflect the different cases that may lead to a significant variation of the heat transfer coefficients and shows gaps in the individual ranges of validity. An algorithm was implemented to calculate the transient behavior of steam generators during load changes. It is used to assess existing correlations for transient heat transfer calculations. It is also desirable to validate the calculation using experimental data. By the use of a new full-scale supercritical thermo-hydraulic test rig, experimental data is obtained to describe the transient phenomena under dynamic boundary conditions as mentioned above and to serve for validation of transient steam generator calculations. Aiming to improve correlations for the prediction of the onset of deteriorated heat transfer in both, stationary and transient cases the test rig was specially designed for this task. It is a closed loop design with a directly electrically heated evaporation tube, the total heating power of the evaporator tube and the preheater is 1MW. To allow a big range of parameters, including supercritical pressures, the maximum pressure rating is 380 bar. The measurements contain the most important extrinsic thermo-hydraulic parameters. Moreover, a high geometric resolution allows to accurately predict the local heat transfer coefficients and fluid enthalpies.

Keywords: departure from nucleate boiling, deteriorated heat transfer, dryout, supercritical working fluid, transient operation of steam generators

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168 Effect of Manure Treatment on Furrow Erosion: A Case Study of Sagawika Irrigation Scheme in Kasungu, Malawi

Authors: Abel Mahowe

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Furrow erosion is the major problem menacing sustainability of irrigation in Malawi and polluting water bodies resulting in death of many aquatic animals. Many rivers in Malawi are drying due to some poor practices that are being practiced around these water bodies, furrow erosion is one of the cause of sedimentation in these rivers although it has gradual effect on deteriorating of these rivers hence neglected, but has got long term disastrous effect on water bodies. Many aquatic animals also suffer when these sediments are taken into these water bodies. An assessment of effect of manure treatment on furrow erosion was carried out in Sagawika irrigation scheme located in Kasungu District north part of Malawi. The soil on the field was clay loam and had just been tilled. The average furrow slope of 0.2% and was divided into two blocks, A and B. Each block had 20V-shaped furrow having a length of 10 m. Three different manure were used to construct these furrows by mixing it with soil which was moderately moist and 5 furrows from each block were constructed without manure. In each block 5furrow were made using a specific type of manure, and one set of five furrows in each block was made without manure treatment. The types of manure that were used were goat manure, pig manure, and manure from crop residuals. The manure application late was 5 kg/m. The furrow was constructed at a spacing of 0.6 m. Tomato was planted in the two blocks at spacing of 0.15 m between rows and 0.15 m between planting stations. Irrigation water was led from feeder canal into the irrigation furrows using siphons. The siphons discharge into each furrow was set at 1.86 L/S. The ¾ rule was used to determine the cut-off time for the irrigation cycles in order to reduce the run-off at the tail end. During each irrigation cycle, samples of the runoff water were collected at one-minute intervals and analyzed for total sediment concentration for use in estimating the total soil sediment loss. The results of the study have shown that a significant amount of soil is lost in soils without many organic matters, there was a low level of erosion in furrows that were constructed using manure treatment within the blocks. In addition, the results have shown that manure also differs in their ability to control erosion since pig manure proved to have greater abilities in binding the soil together than other manure since they were reduction in the amount of sediments at the tail end of furrows constructed by this type of manure. The results prove that manure contains organic matters which helps soil particles to bind together hence resisting the erosive force of water. The use of manure when constructing furrows in soil with less organic matter can highly reduce erosion hence reducing also pollution of water bodies and improve the conditions of aquatic animals.

Keywords: aquatic, erosion, furrow, soil

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167 Best Practice for Post-Operative Surgical Site Infection Prevention

Authors: Scott Cavinder

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Surgical site infections (SSI) are a known complication to any surgical procedure and are one of the most common nosocomial infections. Globally it is estimated 300 million surgical procedures take place annually, with an incidence of SSI’s estimated to be 11 of 100 surgical patients developing an infection within 30 days after surgery. The specific purpose of the project is to address the PICOT (Problem, Intervention, Comparison, Outcome, Time) question: In patients who have undergone cardiothoracic or vascular surgery (P), does implementation of a post-operative care bundle based on current EBP (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period (T)? Synthesis of Supporting Evidence: A literature search of five databases, including citation chasing, was performed, which yielded fourteen pieces of evidence ranging from high to good quality. Four common themes were identified for the prevention of SSI’s including use and removal of surgical dressings; use of topical antibiotics and antiseptics; implementation of evidence-based care bundles, and implementation of surveillance through auditing and feedback. The Iowa Model was selected as the framework to help guide this project as it is a multiphase change process which encourages clinicians to recognize opportunities for improvement in healthcare practice. Practice/Implementation: The process for this project will include recruiting postsurgical participants who have undergone cardiovascular or thoracic surgery prior to discharge at a Northwest Indiana Hospital. The patients will receive education, verbal instruction, and return demonstration. The patients will be followed for 12 weeks, and wounds assessed utilizing the National Healthcare Safety Network//Centers for Disease Control (NHSN/CDC) assessment tool and compared to the SSI rate of 2021. Key stakeholders will include two cardiovascular surgeons, four physician assistants, two advance practice nurses, medical assistant and patients. Method of Evaluation: Chi Square analysis will be utilized to establish statistical significance and similarities between the two groups. Main Results/Outcomes: The proposed outcome is the prevention of SSIs in the post-op cardiothoracic and vascular patient. Implication/Recommendation(s): Implementation of standardized post operative care bundles in the prevention of SSI in cardiovascular and thoracic surgical patients.

Keywords: cardiovascular, evidence based practice, infection, post-operative, prevention, thoracic, surgery

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166 Effect of Malnutrition at Admission on Length of Hospital Stay among Adult Surgical Patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia: Prospective Cohort Study, 2022

Authors: Yoseph Halala Handiso, Zewdi Gebregziabher

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Background: Malnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Despite the fact that malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical patients in Ethiopia, while nutritional assessment is also often a neglected component of the health service practice. Objective: This study aimed to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022. Methods: A facility-based prospective cohort study was conducted among 398 adult surgical patients admitted to the hospital. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 hours within 48 hours after admission (SGA). Data were collected using the open data kit (ODK) version 2022.3.3 software, while Stata version 14.1 software was employed for statistical analysis. The Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusting for several potential confounders taken at admission. Adjusted hazard ratio (HR) with a 95% confidence interval was used to show the effect of malnutrition. Results: The prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59%-69%) according to the SGA classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11-13) as compared to well-nourished patients (8 days: 95% CI: 8-9), means adult surgical patients who were malnourished at admission were at higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29-0.47) as compared to well-nourished patients. Presence of comorbidity (AHR: 0.68, 95% CI: 0.50-90), poly medication (AHR: 0.69, 95% CI: 0.55-0.86), and history of admission (AHR: 0.70, 95% CI: 0.55-0.87) within the previous five years were found to be the significant covariates of the length of hospital stay (LOS). Conclusion: The magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, polymedication, and history of admission were found to be the significant covariates of LOS. All stakeholders should give attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.

Keywords: effect of malnutrition, length of hospital stay, surgical patients, Ethiopia

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165 Impact of 6-Week Brain Endurance Training on Cognitive and Cycling Performance in Highly Trained Individuals

Authors: W. Staiano, S. Marcora

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Introduction: It has been proposed that acute negative effect of mental fatigue (MF) could potentially become a training stimulus for the brain (Brain endurance training (BET)) to adapt and improve its ability to attenuate MF states during sport competitions. Purpose: The aim of this study was to test the efficacy of 6 weeks of BET on cognitive and cycling tests in a group of well-trained subjects. We hypothesised that combination of BET and standard physical training (SPT) would increase cognitive capacity and cycling performance by reducing rating of perceived exertion (RPE) and increase resilience to fatigue more than SPT alone. Methods: In a randomized controlled trial design, 26 well trained participants, after a familiarization session, cycled to exhaustion (TTE) at 80% peak power output (PPO) and, after 90 min rest, at 65% PPO, before and after random allocation to a 6 week BET or active placebo control. Cognitive performance was measured using 30 min of STROOP coloured task performed before cycling performance. During the training, BET group performed a series of cognitive tasks for a total of 30 sessions (5 sessions per week) with duration increasing from 30 to 60 min per session. Placebo engaged in a breathing relaxation training. Both groups were monitored for physical training and were naïve to the purpose of the study. Physiological and perceptual parameters of heart rate, lactate (LA) and RPE were recorded during cycling performances, while subjective workload (NASA TLX scale) was measured during the training. Results: Group (BET vs. Placebo) x Test (Pre-test vs. Post-test) mixed model ANOVA’s revealed significant interaction for performance at 80% PPO (p = .038) or 65% PPO (p = .011). In both tests, groups improved their TTE performance; however, BET group improved significantly more compared to placebo. No significant differences were found for heart rate during the TTE cycling tests. LA did not change significantly at rest in both groups. However, at completion of 65% TTE, it was significantly higher (p = 0.043) in the placebo condition compared to BET. RPE measured at ISO-time in BET was significantly lower (80% PPO, p = 0.041; 65% PPO p= 0.021) compared to placebo. Cognitive results in the STROOP task showed that reaction time in both groups decreased at post-test. However, BET decreased significantly (p = 0.01) more compared to placebo despite no differences accuracy. During training sessions, participants in the BET showed, through NASA TLX questionnaires, constantly significantly higher (p < 0.01) mental demand rates compared to placebo. No significant differences were found for physical demand. Conclusion: The results of this study provide evidences that combining BET and SPT seems to be more effective than SPT alone in increasing cognitive and cycling performance in well trained endurance participants. The cognitive overload produced during the 6-week training of BET can induce a reduction in perception of effort at a specific power, and thus improving cycling performance. Moreover, it provides evidence that including neurocognitive interventions will benefit athletes by increasing their mental resilience, without affecting their physical training load and routine.

Keywords: cognitive training, perception of effort, endurance performance, neuro-performance

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164 A Preliminary Study on the Effects of Equestrian and Basketball Exercises in Children with Autism

Authors: Li Shuping, Shu Huaping, Yi Chaofan, Tao Jiang

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Equestrian practice is often considered having a unique effect on improving symptoms in children with autism. This study evaluated and measured the changes in daily behavior, morphological, physical function, and fitness indexes of two group children with autism by means of 12 weeks of equestrian and basketball exercises. 19 clinically diagnosed children with moderate/mild autism were randomly divided into equestrian group (9 children, age=10.11±1.90y) and basketball group (10 children, age=10.70±2.16y). Both the equestrian and basketball groups practiced twice a week for 45 to 60 minutes each time. Three scales, the Autism Behavior Checklist (ABC), the Childhood Autism Rating Scale (CARS) and the Clancy Autism Behavior Scale (CABS) were used to assess their human behavior and psychology. Four morphological, seven physical function and fitness indicators were measured to evaluate the effects of the two exercises on the children’s body. The evaluations were taken by every four weeks ( pre-exercise, the 4th week, the 8th week and 12th week (post exercise). The result showed that the total scores of ABC, CARS and CABS, the dimension scores of ABC on the somatic motor, language and life self-care obtained after exercise were significantly lower than those obtained before 12 week exercises in both groups. The ABC feeling dimension scores of equestrian group and ABC communication dimension score of basketball group were significantly lower,and The upper arm circumference, sitting forward flexion, 40 second sit-up, 15s lateral jump, vital capacity, and single foot standing of both groups were significantly higher than that of before exercise.. The BMI of equestrian group was significantly reduced. The handgrip strength of basketball group was significantly increased. In conclusion, both types of exercises could improve daily behavior, morphological, physical function, and fitness indexes of the children with autism. However, the behavioral psychological scores, body morphology and function indicators and time points were different in the middle and back of the two interventions.But the indicators and the timing of the improvement were different. To the group of equestrian, the improvement of the flexibility occurred at week 4, the improvement of the sensory perception, control and use their own body, and promote the development of core strength endurance, coordination and cardiopulmonary function occurred at week 8,and the improvement of core strength endurance, coordination and cardiopulmonary function occurred at week 12. To the group of basketball, the improvement of the hand strength, balance, flexibility and cardiopulmonary function occurred at week 4, the improvement of the self-care ability and language expression ability, and core strength endurance and coordination occurred at week 8, the improvement of the control and use of their own body and social interaction ability occurred at week 12. In comparison of the exercise effects, the equestrian exercise improved the physical control and application ability appeared earlier than that of basketball group. Basketball exercise improved the language expression ability, self-care ability, balance ability and cardiopulmonary function of autistic children appeared earlier than that of equestrian group.

Keywords: intervention, children with autism, equestrain, basketball

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163 Urogenital Myiasis in Pregnancy - A Rare Presentation

Authors: Madeleine Elder, Aye Htun

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Background: Myiasis is the parasitic infestation of body tissues by fly larvae. It predominantly occurs in poor socioeconomic regions of tropical and subtropical countries where it is associated with poor hygiene and sanitation. Cutaneous and wound myiasis are the most common presentations whereas urogenital myiasis is rare, with few reported cases. Case: a 26-year-old primiparous woman with a low-risk pregnancy presented to the emergency department at 37+3-weeks’ gestation after passing a 2cm black larva during micturition, with 2 weeks of mild vulvar pruritus and dysuria. She had travelled to India 9-months prior. Examination of the external genitalia showed small white larvae over the vulva and anus and a mildly inflamed introitus. Speculum examination showed infiltration into the vagina and heavy white discharge. High vaginal swab reported Candida albicans. Urine microscopy reported bacteriuria with Enterobacter cloacae. Urine parasite examination showed myiasis caused by Clogmia albipunctata species of fly larvae from the family Psychodidae. Renal tract ultrasound and inflammatory markers were normal. Infectious diseases, urology and paediatric teams were consulted. The woman received treatment for her urinary tract infection (which was likely precipitated by bladder irritation from local parasite infestation) and vaginal candidiasis. She underwent daily physical removal of parasites with cleaning, speculum examination and removal, and hydration to promote bladder emptying. Due to the risk of neonatal exposure, aspiration pneumonitis and facial infestation, the woman was steroid covered and proceeded to have an elective caesarean section at 38+3-weeks’ gestation, with delivery of a healthy infant. She then proceeded to have a rigid cystoscopy and washout, which was unremarkable. Placenta histopathology revealed focal eosinophilia in keeping with the history of maternal parasites. Conclusion: Urogenital myiasis is very rare, especially in the developed world where it is seen in returned travellers. Treatment may include systemic therapy with ivermectin and physical removal of parasites. During pregnancy, physical removal is considered the safest treatment option, and discussion around the timing and mode of delivery should consider the risk of harm to the foetus.

Keywords: urogenital myiasis, parasitic infection, infection in pregnancy, returned traveller

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162 Dry Modifications of PCL/Chitosan/PCL Tissue Scaffolds

Authors: Ozan Ozkan, Hilal Turkoglu Sasmazel

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Natural polymers are widely used in tissue engineering applications, because of their biocompatibility, biodegradability and solubility in the physiological medium. On the other hand, synthetic polymers are also widely utilized in tissue engineering applications, because they carry no risk of infectious diseases and do not cause immune system reaction. However, the disadvantages of both polymer types block their individual usages as tissue scaffolds efficiently. Therefore, the idea of usage of natural and synthetic polymers together as a single 3D hybrid scaffold which has the advantages of both and the disadvantages of none has been entered to the literature. On the other hand, even though these hybrid structures support the cell adhesion and/or proliferation, various surface modification techniques applied to the surfaces of them to create topographical changes on the surfaces and to obtain reactive functional groups required for the immobilization of biomolecules, especially on the surfaces of synthetic polymers in order to improve cell adhesion and proliferation. In a study presented here, to improve the surface functionality and topography of the layer by layer electrospun 3D poly-epsilon-caprolactone/chitosan/poly-epsilon-caprolactone hybrid tissue scaffolds by using atmospheric pressure plasma method, thus to improve cell adhesion and proliferation of these tissue scaffolds were aimed. The formation/creation of the functional hydroxyl and amine groups and topographical changes on the surfaces of scaffolds were realized by using two different atmospheric pressure plasma systems (nozzle type and dielectric barrier discharge (DBD) type) carried out under different gas medium (air, Ar+O2, Ar+N2). The plasma modification time and distance for the nozzle type plasma system as well as the plasma modification time and the gas flow rate for DBD type plasma system were optimized with monitoring the changes in surface hydrophilicity by using contact angle measurements. The topographical and chemical characterizations of these modified biomaterials’ surfaces were carried out with SEM and ESCA, respectively. The results showed that the atmospheric pressure plasma modifications carried out with both nozzle type plasma and DBD plasma caused topographical and functionality changes on the surfaces of the layer by layer electrospun tissue scaffolds. However, the shelf life studies indicated that the hydrophilicity introduced to the surfaces was mainly because of the functionality changes. Therefore, according to the optimized results, samples treated with nozzle type air plasma modification applied for 9 minutes from a distance of 17 cm and Ar+O2 DBD plasma modification applied for 1 minute under 70 cm3/min O2 flow rate were found to have the highest hydrophilicity compared to pristine samples.

Keywords: biomaterial, chitosan, hybrid, plasma

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161 Heat Transfer Performance of a Small Cold Plate with Uni-Directional Porous Copper for Cooling Power Electronics

Authors: K. Yuki, R. Tsuji, K. Takai, S. Aramaki, R. Kibushi, N. Unno, K. Suzuki

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A small cold plate with uni-directional porous copper is proposed for cooling power electronics such as an on-vehicle inverter with the heat generation of approximately 500 W/cm2. The uni-directional porous copper with the pore perpendicularly orienting the heat transfer surface is soldered to a grooved heat transfer surface. This structure enables the cooling liquid to evaporate in the pore of the porous copper and then the vapor to discharge through the grooves. In order to minimize the cold plate, a double flow channel concept is introduced for the design of the cold plate. The cold plate consists of a base plate, a spacer, and a vapor discharging plate, totally 12 mm in thickness. The base plate has multiple nozzles of 1.0 mm in diameter for the liquid supply and 4 slits of 2.0 mm in width for vapor discharging, and is attached onto the top surface of the porous copper plate of 20 mm in diameter and 5.0 mm in thickness. The pore size is 0.36 mm and the porosity is 36 %. The cooling liquid flows into the porous copper as an impinging jet flow from the multiple nozzles, and then the vapor, which is generated in the pore, is discharged through the grooves and the vapor slits outside the cold plate. A heated test section consists of the cold plate, which was explained above, and a heat transfer copper block with 6 cartridge heaters. The cross section of the heat transfer block is reduced in order to increase the heat flux. The top surface of the block is the grooved heat transfer surface of 10 mm in diameter at which the porous copper is soldered. The grooves are fabricated like latticework, and the width and depth are 1.0 mm and 0.5 mm, respectively. By embedding three thermocouples in the cylindrical part of the heat transfer block, the temperature of the heat transfer surface ant the heat flux are extrapolated in a steady state. In this experiment, the flow rate is 0.5 L/min and the flow velocity at each nozzle is 0.27 m/s. The liquid inlet temperature is 60 °C. The experimental results prove that, in a single-phase heat transfer regime, the heat transfer performance of the cold plate with the uni-directional porous copper is 2.1 times higher than that without the porous copper, though the pressure loss with the porous copper also becomes higher than that without the porous copper. As to the two-phase heat transfer regime, the critical heat flux increases by approximately 35% by introducing the uni-directional porous copper, compared with the CHF of the multiple impinging jet flow. In addition, we confirmed that these heat transfer data was much higher than that of the ordinary single impinging jet flow. These heat transfer data prove high potential of the cold plate with the uni-directional porous copper from the view point of not only the heat transfer performance but also energy saving.

Keywords: cooling, cold plate, uni-porous media, heat transfer

Procedia PDF Downloads 292
160 Dynamic Simulation of Disintegration of Wood Chips Caused by Impact and Collisions during the Steam Explosion Pre-Treatment

Authors: Muhammad Muzamal, Anders Rasmuson

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Wood material is extensively considered as a raw material for the production of bio-polymers, bio-fuels and value-added chemicals. However, the shortcoming in using wood as raw material is that the enzymatic hydrolysis of wood material is difficult because the accessibility of enzymes to hemicelluloses and cellulose is hindered by complex chemical and physical structure of the wood. The steam explosion (SE) pre-treatment improves the digestion of wood material by creating both chemical and physical modifications in wood. In this process, first, wood chips are treated with steam at high pressure and temperature for a certain time in a steam treatment vessel. During this time, the chemical linkages between lignin and polysaccharides are cleaved and stiffness of material decreases. Then the steam discharge valve is rapidly opened and the steam and wood chips exit the vessel at very high speed. These fast moving wood chips collide with each other and with walls of the equipment and disintegrate to small pieces. More damaged and disintegrated wood have larger surface area and increased accessibility to hemicelluloses and cellulose. The energy required for an increase in specific surface area by same value is 70 % more in conventional mechanical technique, i.e. attrition mill as compared to steam explosion process. The mechanism of wood disintegration during the SE pre-treatment is very little studied. In this study, we have simulated collision and impact of wood chips (dimension 20 mm x 20 mm x 4 mm) with each other and with walls of the vessel. The wood chips are simulated as a 3D orthotropic material. Damage and fracture in the wood material have been modelled using 3D Hashin’s damage model. This has been accomplished by developing a user-defined subroutine and implementing it in the FE software ABAQUS. The elastic and strength properties used for simulation are of spruce wood at 12% and 30 % moisture content and at 20 and 160 OC because the impacted wood chips are pre-treated with steam at high temperature and pressure. We have simulated several cases to study the effects of elastic and strength properties of wood, velocity of moving chip and orientation of wood chip at the time of impact on the damage in the wood chips. The disintegration patterns captured by simulations are very similar to those observed in experimentally obtained steam exploded wood. Simulation results show that the wood chips moving with higher velocity disintegrate more. Moisture contents and temperature decreases elastic properties and increases damage. Impact and collision in specific directions cause easy disintegration. This model can be used to efficiently design the steam explosion equipment.

Keywords: dynamic simulation, disintegration of wood, impact, steam explosion pretreatment

Procedia PDF Downloads 399
159 A Comparative Analysis of Liberation and Contemplation in Sankara and Aquinas

Authors: Zeite Shumneiyang Koireng

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Liberation is the act of liberating or the state of being liberated. Indian philosophy, in general, understands liberation as moksa, which etymological is derived from the Sanskrit root muc+ktin meaning to loose, set free, to let go, discharge, release, liberate, deliver, etc. According to Indian schools of thought, moksa is the highest value on realizing which nothing remains to be realized. It is the cessation of birth and death, all kinds of pain and at the same time, it is the realization of one’s own self. Sankara’s Advaita philosophy is based on the following propositions: Brahman is the only Reality; the world has apparent reality, and the soul is not different from Brahman. According to Sankara, Brahman is the basis on which the world form appears; it is the sustaining ground of all various modification. It is the highest self and the self of all reveals himself by dividing himself [ as it was in the form of various objects] in multiple ways. The whole world is the manifestation of the Supreme Being. Brahman modifying itself into the Atman or internal self of all things is the world. Since Brahman is the Upadhana karana of the world, the sruti speaks of the world as the modification of Brahman into the Atman of the effect. Contemplation as the fulfillment of man finds a radical foundation in Aquinas teaching concerning the natural end or as he also referred to it, natural desire. The third book of the Summa Contra Gentiles begins the study of happiness with a consideration of natural desire. According to him, all creatures, even those devoid of understanding are ordered to God as an ultimate end. Intrinsically, a part of every nature is a tendency or inclination, originating in the natural form and tendency toward the end for which the possessor of nature exists. It is the study of the nature and finality of inclination that Aquinas establishes through an argument of induction man’s Contemplation of God as the fulfillment of his nature. The present paper is attempted to critically approach two important, seminal and originated thought, representing Indian and Western traditions which mark on the thinking of their respective times. Both these thoughts- Advaitic concept of Liberation in the Indian tradition and the concept of Contemplation in Thomas Aquinas’ Summa Contra Gentiles’- confront directly the question of the ultimate meaning of human existence. According to Sankara, it is knowledge and knowledge alone which is the means of moksa and the highest knowledge is moksa itself. Liberation in Sankara Vedanta is attained as a process of purification of self, which gradually and increasingly turns into purer and purer intentional construction. Man’s inner natural tendency for Aquinas is towards knowledge. The human subject is driven to know more and more about reality and in particular about the highest reality. Contemplation of this highest reality is fulfillment in the philosophy of Aquinas. Rather, Contemplation is the perfect activity in man’s present state of existence.

Keywords: liberation, Brahman, contemplation, fulfillment

Procedia PDF Downloads 192
158 Sludge Marvel (Densification): The Ultimate Solution For Doing More With Less Effort!

Authors: Raj Chavan

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At present, the United States is home to more than 14,000 Water Resource Recovery Facilities (WRRFs), of which approximately 35% have implemented nutrient limits of some kind. These WRRFs contribute 10 to 15% of the total nutrient burden to surface rivers in the United States and account for approximately 1% of total power demand and 2% of total greenhouse gas emissions (GHG). There are several factors that have influenced the development of densification technologies in the direction of more compact and energy-efficient nutrient removal processes. Prior to surface water discharge, existing facilities that necessitate capacity expansion or biomass densification for greater treatability within the same footprint are being subjected to stricter nutrient removal requirements. Densification of activated sludge as a method for nutrient removal and process intensification at WRRFs has garnered considerable attention in recent times. The biological processes take place within the aerobic sediment granules, which form the basis of the technology. The possibility of generating granular sludge through continuous (or conventional) activated sludge processes (CAS) or densification of biomass through the transfer of activated sludge flocs to a denser biomass aggregate as an exceptionally efficient intensification technique has generated considerable interest. This presentation aims to furnish attendees with a foundational comprehension of densification through the illustration of practical concerns and insights. The subsequent subjects will be deliberated upon. What are some potential techniques for producing and preserving densified granules? What processes are responsible for the densification of biological flocs? How do physical selectors contribute to the process of biological flocs becoming denser? What viable strategies exist for the management of densified biological flocs, and which design parameters of physical selection influence the retention of densified biological flocs? determining operational solutions for floc and granule customization in order to meet capacity and performance objectives? The answers to these pivotal questions will be derived from existing full-scale treatment facilities, bench-scale and pilot-scale investigations, and existing literature data. By the conclusion of the presentation, the audience will possess a fundamental comprehension of the densification concept and its significance in attaining effective effluent treatment. Additionally, case studies pertaining to the design and operation of densification procedures will be incorporated into the presentation.

Keywords: densification, intensification, nutrient removal, granular sludge

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157 Material Handling Equipment Selection Using Fuzzy AHP Approach

Authors: Priyanka Verma, Vijaya Dixit, Rishabh Bajpai

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This research paper is aimed at selecting appropriate material handling equipment among the given choices so that the automation level in material handling can be enhanced. This work is a practical case scenario of material handling systems in consumer electronic appliances manufacturing organization. The choices of material handling equipment among which the decision has to be made are Automated Guided Vehicle’s (AGV), Autonomous Mobile Robots (AMR), Overhead Conveyer’s (OC) and Battery Operated Trucks/Vehicle’s (BOT). There is a need of attaining a certain level of automation in order to reduce human interventions in the organization. This requirement of achieving certain degree of automation can be attained by material handling equipment’s mentioned above. The main motive for selecting above equipment’s for study was solely based on corporate financial strategy of investment and return obtained through that investment made in stipulated time framework. Since the low cost automation with respect to material handling devices has to be achieved hence these equipment’s were selected. Investment to be done on each unit of this equipment is less than 20 lakh rupees (INR) and the recovery period is less than that of five years. Fuzzy analytic hierarchic process (FAHP) is applied here for selecting equipment where the four choices are evaluated on basis of four major criteria’s and 13 sub criteria’s, and are prioritized on the basis of weight obtained. The FAHP used here make use of triangular fuzzy numbers (TFN). The inability of the traditional AHP in order to deal with the subjectiveness and impreciseness in the pair-wise comparison process has been improved in the FAHP. The range of values for general rating purposes for all decision making parameters is kept between 0 and 1 on the basis of expert opinions captured on shop floor. These experts were familiar with operating environment and shop floor activity control. Instead of generating exact value the FAHP generates the ranges of values to accommodate the uncertainty in decision-making process. The four major criteria’s selected for the evaluation of choices of material handling equipment’s available are materials, technical capabilities, cost and other features. The thirteen sub criteria’s listed under these following four major criteria’s are weighing capacity, load per hour, material compatibility, capital cost, operating cost and maintenance cost, speed, distance moved, space required, frequency of trips, control required, safety and reliability issues. The key finding shows that among the four major criteria selected, cost is emerged as the most important criteria and is one of the key decision making aspect on the basis of which material equipment selection is based on. While further evaluating the choices of equipment available for each sub criteria it is found that AGV scores the highest weight in most of the sub-criteria’s. On carrying out complete analysis the research shows that AGV is the best material handling equipment suiting all decision criteria’s selected in FAHP and therefore it is beneficial for the organization to carry out automated material handling in the facility using AGV’s.

Keywords: fuzzy analytic hierarchy process (FAHP), material handling equipment, subjectiveness, triangular fuzzy number (TFN)

Procedia PDF Downloads 433
156 Democratic Information Behavior of Social Scientists and Policy Makers in India

Authors: Mallikarjun Vaddenkeri, Suresh Jange

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This research study reports results of information behaviour by members of faculty and research scholars of various departments of social sciences working at universities with a sample of 300 and Members of Legislative Assembly and Council with 216 samples in Karnataka State, India. The results reveal that 29.3% and 20.3% of Social Scientists indicated medium and high level of awareness of primary sources - Primary Journals are found to be at scale level 5 and 9. The usage of primary journals by social scientists is found to be 28% at level 4, 24% of the respondent’s opined use of primary Conference Proceedings at level 5 as medium level of use. Similarly, the use of Secondary Information Sources at scale 8 and 9 particularly in case of Dictionaries (31.0% and 5.0%), Encyclopaedias (22.3% and 6.3%), Indexing Periodicals (7.0% and 15.3%) and Abstracting Periodicals (5.7% and 20.7%). For searching information from Journals Literature available in CD-ROM version, Keywords (43.7%) followed by Keywords with logical operators (39.7%) have been used for finding the required information. Statistical inference reveals rejection of null hypothesis `there is no association between designation of the respondents and awareness of primary information resources’. On the other hand, educational qualification possessed by Legislative members, more than half of them possess graduate degree as their academic qualification (57.4%) and just 16.7% of the respondents possess graduate degree while only 26.8% of the respondents possess degree in law and just 1.8% possess post-graduate degree in law. About 42.6% indicated the importance of information required to discharge their duties and responsibilities as a Policy Maker in the scale 8, as a Scholar (27.8%) on a scale 6, as a politician (64.8%) on a scale 10 and as a Councillor (51.9%) on a scale 8. The most preferred information agencies/sources very often contacted for obtaining useful information are by means of contacting the people of Karnataka State Legislative Library, listening Radio programmes, viewing Television programmes and reading the newspapers. The methods adopted for obtaining needed information quite often by means of sending their assistants to libraries to gather information (35.2%) and personally visiting the information source (64.8%). The null hypotheses `There is no association between Members of Legislature and Opinion on the usefulness of the resources of the Karnataka State Legislature Library’ is accepted using F ANOVA test. The studies conclude with a note revamp the existing library system in its structure and adopt latest technologies and educate and train social scientists and Legislators in using these resources in the interest of academic, government policies and decision making of the country.

Keywords: information use behaviour, government information, searching behaviour, policy makers

Procedia PDF Downloads 137
155 Air Breakdown Voltage Prediction in Post-arcing Conditions for Compact Circuit Breakers

Authors: Jing Nan

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The air breakdown voltage in compact circuit breakers is a critical factor in the design and reliability of electrical distribution systems. This voltage determines the threshold at which the air insulation between conductors will fail or 'break down,' leading to an arc. This phenomenon is highly sensitive to the conditions within the breaker, such as the temperature and the distance between electrodes. Typically, air breakdown voltage models have been reliable for predicting failure under standard operational temperatures. However, in conditions post-arcing, where temperatures can soar above 2000K, these models face challenges due to the complex physics of ionization and electron behaviour at such high-energy states. Building upon the foundational understanding that the breakdown mechanism is initiated by free electrons and propelled by electric fields, which lead to ionization and, potentially, to avalanche or streamer formation, we acknowledge the complexity introduced by high-temperature environments. Recognizing the limitations of existing experimental data, a notable research gap exists in the accurate prediction of breakdown voltage at elevated temperatures, typically observed post-arcing, where temperatures exceed 2000K.To bridge this knowledge gap, we present a method that integrates gap distance and high-temperature effects into air breakdown voltage assessment. The proposed model is grounded in the physics of ionization, accounting for the dynamic behaviour of free electrons which, under intense electric fields at elevated temperatures, lead to thermal ionization and potentially reach the threshold for streamer formation as Meek's criterion. Employing the Saha equation, our model calculates equilibrium electron densities, adapting to the atmospheric pressure and the hot temperature regions indicative of post-arc temperature conditions. Our model is rigorously validated against established experimental data, demonstrating substantial improvements in predicting air breakdown voltage in the high-temperature regime. This work significantly improves the predictive power for air breakdown voltage under conditions that closely mimic operational stressors in compact circuit breakers. Looking ahead, the proposed methods are poised for further exploration in alternative insulating media, like SF6, enhancing the model's utility for a broader range of insulation technologies and contributing to the future of high-temperature electrical insulation research.

Keywords: air breakdown voltage, high-temperature insulation, compact circuit breakers, electrical discharge, saha equation

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154 Congenital Diaphragmatic Hernia Outcomes in a Low-Volume Center

Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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153 The Effects of Goal Setting and Feedback on Inhibitory Performance

Authors: Mami Miyasaka, Kaichi Yanaoka

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Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity; symptoms often manifest during childhood. In children with ADHD, the development of inhibitory processes is impaired. Inhibitory control allows people to avoid processing unnecessary stimuli and to behave appropriately in various situations; thus, people with ADHD require interventions to improve inhibitory control. Positive or negative reinforcements (i.e., reward or punishment) help improve the performance of children with such difficulties. However, in order to optimize impact, reward and punishment must be presented immediately following the relevant behavior. In regular elementary school classrooms, such supports are uncommon; hence, an alternative practical intervention method is required. One potential intervention involves setting goals to keep children motivated to perform tasks. This study examined whether goal setting improved inhibitory performances, especially for children with severe ADHD-related symptoms. We also focused on giving feedback on children's task performances. We expected that giving children feedback would help them set reasonable goals and monitor their performance. Feedback can be especially effective for children with severe ADHD-related symptoms because they have difficulty monitoring their own performance, perceiving their errors, and correcting their behavior. Our prediction was that goal setting by itself would be effective for children with mild ADHD-related symptoms, and goal setting based on feedback would be effective for children with severe ADHD-related symptoms. Japanese elementary school children and their parents were the sample for this study. Children performed two kinds of go/no-go tasks, and parents completed a checklist about their children's ADHD symptoms, the ADHD Rating Scale-IV, and the Conners 3rd edition. The go/no-go task is a cognitive task to measure inhibitory performance. Children were asked to press a key on the keyboard when a particular symbol appeared on the screen (go stimulus) and to refrain from doing so when another symbol was displayed (no-go stimulus). Errors obtained in response to a no-go stimulus indicated inhibitory impairment. To examine the effect of goal-setting on inhibitory control, 37 children (Mage = 9.49 ± 0.51) were required to set a performance goal, and 34 children (Mage = 9.44 ± 0.50) were not. Further, to manipulate the presence of feedback, in one go/no-go task, no information about children’s scores was provided; however, scores were revealed for the other type of go/no-go tasks. The results revealed a significant interaction between goal setting and feedback. However, three-way interaction between ADHD-related inattention, feedback, and goal setting was not significant. These results indicated that goal setting was effective for improving the performance of the go/no-go task only with feedback, regardless of ADHD severity. Furthermore, we found an interaction between ADHD-related inattention and feedback, indicating that informing inattentive children of their scores made them unexpectedly more impulsive. Taken together, giving feedback was, unexpectedly, too demanding for children with severe ADHD-related symptoms, but the combination of goal setting with feedback was effective for improving their inhibitory control. We discuss effective interventions for children with ADHD from the perspective of goal setting and feedback. This work was supported by the 14th Hakuho Research Grant for Child Education of the Hakuho Foundation.

Keywords: attention deficit disorder with hyperactivity, feedback, goal-setting, go/no-go task, inhibitory control

Procedia PDF Downloads 101
152 Early Return to Play in Football Player after ACL Injury: A Case Report

Authors: Nicola Milani, Carla Bellissimo, Davide Pogliana, Davide Panzin, Luca Garlaschelli, Giulia Facchinetti, Claudia Casson, Luca Marazzina, Andrea Sartori, Simone Rivaroli, Jeff Konin

Abstract:

The patient is a 26 year-old male amateur football player from Milan, Italy; (81kg; 185cm; BMI 23.6 kg/m²). He sustained a non-contact anterior cruciate ligament tear to his right knee in June 2021. In September 2021, his right knee ligament was reconstructed using a semitendinosus graft. The injury occurred during a football match on natural grass with typical shoes on a warm day (32 degrees celsius). Playing as a defender he sustained the injury during a change of direction, where the foot was fixated on the grass. He felt pain and was unable to continue playing the match. The surgeon approved his rehabilitation to begin two weeks post-operative. The initial physiotherapist assessment determined performing two training sessions per day within the first three months. In the first three weeks, the pain was 4/10 on Numerical Rating Scale (NRS), no swelling, a range of motion was 0-110°, with difficulty fully extending his knee and minimal quadriceps activation. Crutches were discontinued at four weeks with improved walking. Active exercise, electrostimulator, physical therapy, massages, osteopathy, and passive motion were initiated. At week 6, he completed his first functional movement screen; the score was 16/21 with no pain and no swelling. At week 8, the isokinetic test showed a 23% differential deficit between the two legs in maximum strength (at 90°/s). At week 10, he improved to 15% of injury-induced deficit which suggested he was ready to start running. At week 12, the athlete sustained his first threshold test. At week 16, he performed his first return to sports movement assessment, which revealed a 10% stronger difference between the legs. At week 16, he had his second threshold test. At week 17, his first on-field test revealed a 5% differential deficit between the two legs in the hop test. At week 18, isokinetic test demonstrates that the uninjured leg was 7% stronger than the recovering leg in maximum strength (at 90°/s). At week 20, his second on-field test revealed a 2% difference in hop test; at week 21, his third isokinetic test demonstrated a difference of 5% in maximum strength (at 90°/s). At week 21, he performed his second return to sports movement assessment which revealed a 2% difference between the limbs. Since it was the end of the championship, the team asked him to partake in the playoffs; moreover the player was very motivated to participate in the playoffs also because he was the captain of the team. Together with the player and the team, we decided to let him play even though we were aware of a heightened risk of injury than what is reported in the literature because of two factors: biological recovery times and the results of the tests we performed. In the decision making process about the athlete’s recovery time, it is important to balance the information available from the literature with the desires of the patient to avoid frustration.

Keywords: ACL, football, rehabilitation, return to play

Procedia PDF Downloads 117
151 Static Charge Control Plan for High-Density Electronics Centers

Authors: Clara Oliver, Oibar Martinez, Jose Miguel Miranda

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Ensuring a safe environment for sensitive electronics boards in places with high limitations in size poses two major difficulties: the control of charge accumulation in floating floors and the prevention of excess charge generation due to air cooling flows. In this paper, we discuss these mechanisms and possible solutions to prevent them. An experiment was made in the control room of a Cherenkov Telescope, where six racks of 2x1x1 m size and independent cooling units are located. The room is 10x4x2.5 m, and the electronics include high-speed digitizers, trigger circuits, etc. The floor used in this room was antistatic, but it was a raised floor mounted in floating design to facilitate the handling of the cables and maintenance. The tests were made by measuring the contact voltage acquired by a person who was walking along the room with different footwear qualities. In addition, we took some measurements of the voltage accumulated in a person in other situations like running or sitting up and down on an office chair. The voltages were taken in real time with an electrostatic voltage meter and dedicated control software. It is shown that peak voltages as high as 5 kV were measured with ambient humidity of more than 30%, which are within the range of a class 3A according to the HBM standard. In order to complete the results, we have made the same experiment in different spaces with alternative types of the floor like synthetic floor and earthenware floor obtaining peak voltages much lower than the ones measured with the floating synthetic floor. The grounding quality one achieves with this kind of floors can hardly beat the one typically encountered in standard floors glued directly on a solid substrate. On the other hand, the air ventilation used to prevent the overheating of the boards probably contributed in a significant way to the charge accumulated in the room. During the assessment of the quality of the static charge control, it is necessary to guarantee that the tests are made under repeatable conditions. One of the major difficulties which one encounters during these assessments is the fact the electrostatic voltmeters might provide different values depending on the humidity conditions and ground resistance quality. In addition, the use of certified antistatic footwear might mask deficiencies in the charge control. In this paper, we show how we defined protocols to guarantee that electrostatic readings are reliable. We believe that this can be helpful not only to qualify the static charge control in a laboratory but also to asses any procedure oriented to minimize the risk of electrostatic discharge events.

Keywords: electrostatics, ESD protocols, HBM, static charge control

Procedia PDF Downloads 127
150 The Development of the Psychosomatic Nursing Model from an Evidence-Based Action Research on Proactive Mental Health Care for Medical Inpatients

Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

Procedia PDF Downloads 107
149 Contribution at Dimensioning of the Energy Dissipation Basin

Authors: M. Aouimeur

Abstract:

The environmental risks of a dam and particularly the security in the Valley downstream of it,, is a very complex problem. Integrated management and risk-sharing become more and more indispensable. The definition of "vulnerability “concept can provide assistance to controlling the efficiency of protective measures and the characterization of each valley relatively to the floods's risk. Security can be enhanced through the integrated land management. The social sciences may be associated to the operational systems of civil protection, in particular warning networks. The passage of extreme floods in the site of the dam causes the rupture of this structure and important damages downstream the dam. The river bed could be damaged by erosion if it is not well protected. Also, we may encounter some scouring and flooding problems in the downstream area of the dam. Therefore, the protection of the dam is crucial. It must have an energy dissipator in a specific place. The basin of dissipation plays a very important role for the security of the dam and the protection of the environment against floods downstream the dam. It allows to dissipate the potential energy created by the dam with the passage of the extreme flood on the weir and regularize in a natural manner and with more security the discharge or elevation of the water plan on the crest of the weir, also it permits to reduce the speed of the flow downstream the dam, in order to obtain an identical speed to the river bed. The problem of the dimensioning of a classic dissipation basin is in the determination of the necessary parameters for the dimensioning of this structure. This communication presents a simple graphical method, that is fast and complete, and a methodology which determines the main features of the hydraulic jump, necessary parameters for sizing the classic dissipation basin. This graphical method takes into account the constraints imposed by the reality of the terrain or the practice such as the one related to the topography of the site, the preservation of the environment equilibrium and the technical and economic side.This methodology is to impose the loss of head DH dissipated by the hydraulic jump as a hypothesis (free design) to determine all the others parameters of classical dissipation basin. We can impose the loss of head DH dissipated by the hydraulic jump that is equal to a selected value or to a certain percentage of the upstream total head created by the dam. With the parameter DH+ =(DH/k),(k: critical depth),the elaborate graphical representation allows to find the other parameters, the multiplication of these parameters by k gives the main characteristics of the hydraulic jump, necessary parameters for the dimensioning of classic dissipation basin.This solution is often preferred for sizing the dissipation basins of small concrete dams. The results verification and their comparison to practical data, confirm the validity and reliability of the elaborate graphical method.

Keywords: dimensioning, energy dissipation basin, hydraulic jump, protection of the environment

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148 Effects of Plasma Technology in Biodegradable Films for Food Packaging

Authors: Viviane P. Romani, Bradley D. Olsen, Vilásia G. Martins

Abstract:

Biodegradable films for food packaging have gained growing attention due to environmental pollution caused by synthetic films and the interest in the better use of resources from nature. Important research advances were made in the development of materials from proteins, polysaccharides, and lipids. However, the commercial use of these new generation of sustainable materials for food packaging is still limited due to their low mechanical and barrier properties that could compromise the food quality and safety. Thus, strategies to improve the performance of these materials have been tested, such as chemical modifications, incorporation of reinforcing structures and others. Cold plasma is a versatile, fast and environmentally friendly technology. It consists of a partially ionized gas containing free electrons, ions, and radicals and neutral particles able to react with polymers and start different reactions, leading to the polymer degradation, functionalization, etching and/or cross-linking. In the present study, biodegradable films from fish protein prepared through the casting technique were plasma treated using an AC glow discharge equipment. The reactor was preliminary evacuated to ~7 Pa and the films were exposed to air plasma for 2, 5 and 8 min. The films were evaluated by their mechanical and water vapor permeability (WVP) properties and changes in the protein structure were observed using Scanning Electron Microscopy (SEM) and X-ray diffraction (XRD). Potential cross-links and elimination of surface defects by etching might be the reason for the increase in tensile strength and decrease in the elongation at break observed. Among the times of plasma application tested, no differences were observed when higher times of exposure were used. The X-ray pattern showed a broad peak at 2θ = 19.51º that corresponds to the distance of 4.6Å by applying the Bragg’s law. This distance corresponds to the average backbone distance within the α-helix. Thus, the changes observed in the films might indicate that the helical configuration of fish protein was disturbed by plasma treatment. SEM images showed surface damage in the films with 5 and 8 min of plasma treatment, indicating that 2 min was the most adequate time of treatment. It was verified that plasma removes water from the films once weight loss of 4.45% was registered for films treated during 2 min. However, after 24 h in 50% of relative humidity, the water lost was recovered. WVP increased from 0.53 to 0.65 g.mm/h.m².kPa after plasma treatment during 2 min, that is desired for some foods applications which require water passage through the packaging. In general, the plasma technology affects the properties and structure of fish protein films. Since this technology changes the surface of polymers, these films might be used to develop multilayer materials, as well as to incorporate active substances in the surface to obtain active packaging.

Keywords: fish protein films, food packaging, improvement of properties, plasma treatment

Procedia PDF Downloads 162
147 Safety Considerations of Furanics for Sustainable Applications in Advanced Biorefineries

Authors: Anitha Muralidhara, Victor Engelen, Christophe Len, Pascal Pandard, Guy Marlair

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Production of bio-based chemicals and materials from lignocellulosic biomass is gaining tremendous importance in advanced bio-refineries while aiming towards progressive replacement of petroleum based chemicals in transportation fuels and commodity polymers. One such attempt has resulted in the production of key furan derivatives (FD) such as furfural, HMF, MMF etc., via acid catalyzed dehydration (ACD) of C6 and C5 sugars, which are further converted into key chemicals or intermediates (such as Furandicarboxylic acid, Furfuryl alcohol etc.,). In subsequent processes, many high potential FD are produced, that can be converted into high added value polymers or high energy density biofuels. During ACD, an unavoidable polyfuranic byproduct is generated which is called humins. The family of FD is very large with varying chemical structures and diverse physicochemical properties. Accordingly, the associated risk profiles may largely vary. Hazardous Material (Haz-mat) classification systems such as GHS (CLP in the EU) and the UN TDG Model Regulations for transport of dangerous goods are one of the preliminary requirements for all chemicals for their appropriate classification, labelling, packaging, safe storage, and transportation. Considering the growing application routes of FD, it becomes important to notice the limited access to safety related information (safety data sheets available only for famous compounds such as HMF, furfural etc.,) in these internationally recognized haz-mat classification systems. However, these classifications do not necessarily provide information about the extent of risk involved when the chemical is used in any specific application. Factors such as thermal stability, speed of combustion, chemical incompatibilities, etc., can equally influence the safety profile of a compound, that are clearly out of the scope of any haz-mat classification system. Irrespective of the bio-based origin, FD has so far received inconsistent remarks concerning their toxicity profiles. With such inconsistencies, there is a fear that, a large family of FD may also follow extreme judgmental scenarios like ionic liquids, by ranking some compounds as extremely thermally stable, non-flammable, etc., Unless clarified, these messages could lead to misleading judgements while ranking the chemical based on its hazard rating. Safety is a key aspect in any sustainable biorefinery operation/facility, which is often underscored or neglected. To fill up these existing data gaps and to address ambiguities and discrepancies, the current study focuses on giving preliminary insights on safety assessment of FD and their potential targeted by-products. With the available information in the literature and obtained experimental results, physicochemical safety, environmental safety as well as (a scenario based) fire safety profiles of key FD, as well as side streams such as humins and levulinic acid, will be considered. With this, the study focuses on defining patterns and trends that gives coherent safety related information for existing and newly synthesized FD in the market for better functionality and sustainable applications.

Keywords: furanics, humins, safety, thermal and fire hazard, toxicity

Procedia PDF Downloads 164
146 Boost for Online Language Course through Peer Evaluation

Authors: Kirsi Korkealehto

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The purpose of this research was to investigate how the peer evaluation concept was perceived by language teachers developing online language courses. The online language courses in question were developed in language teacher teams within a nationwide KiVAKO-project funded by the Finnish Ministry of Education and Culture. The participants of the project were 86 language teachers of 26 higher education institutions in Finland. The KiVAKO-project aims to strengthen the language capital at higher education institutions by building a nationwide online language course offering on a shared platform. All higher education students can study the courses regardless of their home institutions. The project covers the following languages: Chinese, Estonian, Finnish Sign Language, French, German, Italian, Japanese, Korean, Portuguese, Russian, and Spanish on the levels CEFR A1-C1. The courses were piloted in the autumn term of 2019, and an online peer evaluation session was organised for all project participating teachers in spring 2020. The peer evaluation utilised the quality criteria for online implementation, which was developed earlier within the eAMK-project. The eAMK-project was also funded by the Finnish Ministry of Education and Culture with the aim to improve higher education institution teachers’ digital and pedagogical competences. In the online peer evaluation session, the teachers were divided into Zoom breakout rooms, in each of which two pilot courses were presented by their teachers dialogically. The other language teachers provided feedback on the course on the basis of the quality criteria. Thereafter good practices and ideas were gathered to an online document. The breakout rooms were facilitated by one teacher who was instructed and provided a slide-set prior to the online session. After the online peer evaluation sessions, the language teachers were asked to respond to an online questionnaire for feedback. The questionnaire included three multiple-choice questions using the Likert-scale rating and two open-ended questions. The online questionnaire was answered after the sessions immediately, the questionnaire link and the QR-code to it was on the last slide of the session, and it was responded at the site. The data comprise online questionnaire responses of the peer evaluation session and the researcher’s observations during the sessions. The data were analysed with a qualitative content analysis method with the help of Atlas.ti programme, and the Likert scale answers provided results per se. The observations were used as complementary data to support the primary data. The findings indicate that the working in the breakout rooms was successful, and the workshops proceeded smoothly. The workshops were perceived as beneficial in terms of improving the piloted courses and developing the participants’ own work as teachers. Further, the language teachers stated that the collegial discussions and sharing the ideas were fruitful. The aspects to improve the workshops were to give more time for free discussions and the opportunity to familiarize oneself with the quality criteria and the presented language courses beforehand. The quality criteria were considered to provide a suitable frame for self- and peer evaluations.

Keywords: higher education, language learning, online learning, peer-evaluation

Procedia PDF Downloads 125
145 Valorization of Lignocellulosic Wastes– Evaluation of Its Toxicity When Used in Adsorption Systems

Authors: Isabel Brás, Artur Figueirinha, Bruno Esteves, Luísa P. Cruz-Lopes

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The agriculture lignocellulosic by-products are receiving increased attention, namely in the search for filter materials that retain contaminants from water. These by-products, specifically almond and hazelnut shells are abundant in Portugal once almond and hazelnuts production is a local important activity. Hazelnut and almond shells have as main constituents lignin, cellulose and hemicelluloses, water soluble extractives and tannins. Along the adsorption of heavy metals from contaminated waters, water soluble compounds can leach from shells and have a negative impact in the environment. Usually, the chemical characterization of treated water by itself may not show environmental impact caused by the discharges when parameters obey to legal quality standards for water. Only biological systems can detect the toxic effects of the water constituents. Therefore, the evaluation of toxicity by biological tests is very important when deciding the suitability for safe water discharge or for irrigation applications. The main purpose of the present work was to assess the potential impacts of waters after been treated for heavy metal removal by hazelnut and almond shells adsorption systems, with short term acute toxicity tests. To conduct the study, water at pH 6 with 25 mg.L-1 of lead, was treated with 10 g of shell per litre of wastewater, for 24 hours. This procedure was followed for each bark. Afterwards the water was collected for toxicological assays; namely bacterial resistance, seed germination, Lemna minor L. test and plant grow. The effect in isolated bacteria strains was determined by disc diffusion method and the germination index of seed was evaluated using lettuce, with temperature and humidity germination control for 7 days. For aquatic higher organism, Lemnas were used with 4 days contact time with shell solutions, in controlled light and temperature. For terrestrial higher plants, biomass production was evaluated after 14 days of tomato germination had occurred in soil, with controlled humidity, light and temperature. Toxicity tests of water treated with shells revealed in some extent effects in the tested organisms, with the test assays showing a close behaviour as the control, leading to the conclusion that its further utilization may not be considered to create a serious risk to the environment.

Keywords: lignocellulosic wastes, adsorption, acute toxicity tests, risk assessment

Procedia PDF Downloads 364