Search results for: hospital discharge

Authors: Ortega Ivan, De La Plaza Edurne

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Background: Spain and other European countries have implemented Uncontrolled Donation after Cardiac Death (uDCD) programs. After 15 years of experience in Spain, many things have changed. Recent evidence and technical breakthroughs achieved in resuscitation are relevant for uDCD programs and raise some ethical concerns related to these protocols. Aim: To rethink current uDCD programs in the light of recent evidence on available therapeutic procedures applicable to victims of out-of-hospital cardiac arrest (OHCA). To address the following question: What is the current standard of treatment owed to victims of OHCA before including them in an uDCD protocol? Materials and Methods: Review of the scientific and ethical literature related to both uDCD programs and innovative resuscitation techniques. Results: 1) The standard of treatment received and the chances of survival of victims of OHCA depend on whether they are classified as Non-Heart Beating Patients (NHBP) or Non-Heart-Beating-Donors (NHBD). 2) Recent studies suggest that NHBPs are likely to survive, with good quality of life, if one or more of the following interventions are performed while ongoing CPR -guided by suspected or known cause of OHCA- is maintained: a) direct access to a Cath Lab-H24 or/and to extra-corporeal life support (ECLS); b) transfer in induced hypothermia from the Emergency Medical Service (EMS) to the ICU; c) thrombolysis treatment; d) mobile extra-corporeal membrane oxygenation (mini ECMO) instituted as a bridge to ICU ECLS devices. 3) Victims of OHCA who cannot benefit from any of these therapies should be considered as NHBDs. Conclusion: Current uDCD protocols do not take into account recent improvements in resuscitation and need to be adapted. Operational criteria to distinguish NHBDs from NHBP should seek a balance between the technical imperative (to do whatever is possible), considerations about expected survival with quality of life, and distributive justice (costs/benefits). Uncontrolled DCD protocols can be performed in a way that does not hamper the legitimate interests of patients, potential organ donors, their families, the organ recipients, and the health professionals involved in these processes. Families of NHBDs’ should receive information which conforms to the ethical principles of respect of autonomy and transparency.

Keywords: uncontrolled donation after cardiac death resuscitation, refractory cardiac arrest, out of hospital cardiac, arrest ethics

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Authors: Alebachew Halefom, Navsal Kumar, Arunava Poddar

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The purpose of this work is to specify the parameter values, the base flow index (BFI), and to rank the methods that should be used for base flow separation. Three different digital graphical approaches are chosen and used in this study for the purpose of comparison. The daily time series discharge data were collected from the site for a period of 30 years (1986 up to 2015) and were used to evaluate the algorithms. In order to separate the base flow and the surface runoff, daily recorded streamflow (m³/s) data were used to calibrate procedures and get parameter values for the basin. Additionally, the performance of the model was assessed by the use of the standard error (SE), the coefficient of determination (R²), and the flow duration curve (FDC) and baseflow indexes. The findings indicate that, in general, each strategy can be used worldwide to differentiate base flow; however, the Sliding Interval Method (SIM) performs significantly better than the other two techniques in this basin. The average base flow index was calculated to be 0.72 using the local minimum method, 0.76 using the fixed interval method, and 0.78 using the sliding interval method, respectively.

Keywords: baseflow index, digital graphical methods, streamflow, Emba Madre Watershed

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Authors: Rinlee Butch M. Cervera, Princess Stephanie P. Llanos

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Lithium iron phosphate (LiFePO₄) is a potential cathode material for lithium-ion batteries due to its promising characteristics. In this study, pure LiFePO₄ (LFP) and carbon-coated nanograined LiFePO₄ (LFP-C) is synthesized and characterized for its microstructural properties. X-ray diffraction patterns of the synthesized samples can be indexed to an orthorhombic LFP structure with about 63 nm crystallite size as calculated by using Scherrer’s equation. Agglomerated particles that range from 200 nm to 300 nm are observed from scanning electron microscopy images. Transmission electron microscopy images confirm the crystalline structure of LFP and coating of amorphous carbon layer. Elemental mapping using energy dispersive spectroscopy analysis revealed the homogeneous dispersion of the compositional elements. In addition, galvanostatic charge and discharge measurements were investigated for the cathode performance of the synthesized LFP and LFP-C samples. The results showed that the carbon-coated sample demonstrated the highest capacity of about 140 mAhg^-1 as compared to non-coated and micrograined sized commercial LFP.

Keywords: ceramics, energy storage, electrochemical measurements, transmission electron microscope

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Authors: T. Imo, F. Latū, S. Aloi, J. Leung-Wai, V. Vaurasi, P. Amosa, M. A. Sheikh

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Contamination of heavy metals in coral reefs and coastal areas is a serious ecotoxicological and environmental problem due to direct runoff from anthropogenic wastes, commercial vessels, and discharge from industrial effluents. In Samoa, the information on the ecotoxicological impact of heavy metals on sediments is limited. This study presents baseline data on the concentration and distribution of heavy metals in sediments collected along the commercial and fishing ports in Samoa. Surface sediment samples were collected within the months of August-October 2013 from the 5 sites along the 2 ports. Sieved sample fractions were used for the evaluation of sediment physicochemical parameters namely pH, conductivity, organic matter, and bicarbonates of calcium. Heavy metal (Cu, Pb) analysis was achieved by flame atomic absorption spectrometry. Two heavy metals (Cu, Pb) were detected from each port with some concentration below the WHO permissible maximum concentration of environment quality standard. The results obtained from this study advocate for further studies regarding emerging threats of heavy metals on the vital marine resources which have significant importance to the livelihood of coastal societies, particularly Small Island States including Samoa.

Keywords: coastal environment, heavy metals, pollution, sediments

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Authors: Valentina V. Zhurikhina, Mihail I. Petrov, Alexandra A. Rtischeva, Mark Dussauze, Thierry Cardinal, Andrey A. Lipovskii

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Polarization of glass, often referred to as thermal poling, is a well-known method to modify the glass physical and chemical properties, that manifest themselves in loosing central symmetry of the medium, glass structure and refractive index modification. The usage of the poling for second optical harmonic generation, fabrication of optical waveguides and electrooptic modulators was also reported. Nevertheless, the detailed description of the poling of glasses, containing multiple charge carriers is still under discussion. In particular, the role of possible migration of electrons in the space charge formation usually remains out of the question. In this work, we performed the numerical simulation of thermal poling of a silicate glass, containing Na, K, Mg, and Ca. We took into consideration the contribution of electrons in the polarization process. The possible explanation of migration of electrons can be the break of non-bridging oxygen bonds. It was found, that the modeled depth of the space charge region is about 10 times higher if the migration of the negative charges is taken under consideration. The simulated profiles of cations, participating in the polarization process, are in a good agreement with the experimental data, obtained by glow discharge spectroscopy.

Keywords: glass poling, charge transport, modeling, concentration profiles

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Authors: Ritu Nambiar, Shazia Tariq, Sumaira Jamil, Farida Munawar, Imelda Israell

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GBS has emerged as a leading cause of neonatal infections worldwide and clinical trials have demonstrated that giving IAP was effective in reducing early onset GBS (EOGBS) disease of the newborn. There is no available data on the prevalence of GBS in the UAE, therefore, a retrospective chart analysis of our parturients were done to look at our prevalence. The aim of this study is: 1. To study the prevalence of GBS colonization of parturients at al Rahba Hospital following universal screening between 35-37 week. 2. To look at efficacy of GBS intrapartum antibiotic prophylaxis by NICU admission for EO GBS disease of the newborn. 1) The prevalence of GBS in our patient population is 24.15%. 2) Incidence of EO GBS disease of the newborn was 0.6%.

Keywords: GBS Screening, universal intrapartum antibiotic prophylaxis, parturients, newborn

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Authors: T. Taşköprü, M. Zor, E. Turan

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The advantages of nickel oxide as an electrochromic material are its good contrast of transmittance and its suitable use as a secondary electrochromic film with WO3 for electrochromic devices. Electrochromic nickel oxide film was prepared by using a simple and inexpensive chemical deposition bath (CBD) technique onto fluorine-doped tin oxide (FTO) coated glass substrates from nickel nitrate solution. The films were ace centered cubic NiO with preferred orientation in the (2 0 0) direction. The electrochromic (EC) properties of the films were studied as a function of pH (8, 9, 10 and 11) in an aqueous alkaline electrolyte (0.3 M KOH) using cyclic voltammetry (CV). The EC cell was formed with the following configuration; FTO/nickel oxide film/0.3 M KOH/Pt The potential was cycled from 0.1 to 0.6V at diffferent potential sweep rates in the range 10- 50 mV/s. The films exhibit anodic electrochromism, changing colour from transparent to black.CV results of a nickel oxide film showed well-resolved anodic current peak at potential; 45 mV and cathodic peak at potential 28 mV. The structural, morphological, and optical changes in NiO film following the CV were investigated by means of X-ray diffractometer (XRD), field emission electron microscopy (FESEM) and UV-Vis- NIR spectrophotometry. No change was observed in XRD, besides surface morphology undergoes change due to the electrical discharge. The change in tansmittance between the bleached and colored state is 68% for the film deposited with pH=11 precursor.

Keywords: nickel oxide, XRD, SEM, cyclic voltammetry

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Authors: Damian A. Mooney, Michael T. P. Mc Cann, J. M. Don MacElroy, Olli Antson, Denis P. Dowling

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Atmospheric pressure plasma liquid deposition (APPLD) is a novel technology used for the deposition of thin films via the injection of a reactive liquid precursor into a high-energy discharge plasma at ambient pressure. In this work, APPLD, utilising a TEOS precursor, was employed to produce asymmetric membranes consisting of a thin (100 nm) layer of deposited silica on a microporous silica support in order to assess their suitability for high temperature gas separation applications. He and N₂ gas permeability measurements were made for each of the fabricated membranes and a maximum ideal He/N₂ selectivity of 66 was observed at room temperature. He, N₂ and CO2 gas permeances were also measured at the elevated temperature of 673K and ideal He/N₂ and CO₂/N₂ selectivities of 300 and 7.4, respectively, were observed. The results suggest that this plasma-based deposition technique can be a viable method for the manufacture of membranes for the efficient separation of high temperature, post-combustion gases, including that of CO₂/N₂ where the constituent gases differ in size by fractions of an Ångstrom.

Keywords: asymmetric membrane, CO₂ separation, high temperature, plasma deposition, thin films

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Authors: Anshul Raja

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Cystic lesions of the spleen are rare and splenic hydatid cysts account for only 0.5% to 8% of all hydatidosis. Authors hereby report a case where a 50-year-old female presented to our hospital with the complains of heaviness and pain over left upper abdomen over the past 8-10 years. On radiological examination, ultrasonography revealed findings consistent with isolated splenic hydatid cyst and was later on confirmed on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). No other organ or system involvement was seen. The patient underwent splenectomy and hydatid cyst was confirmed on histopathology. Owing to its rarity, it offers a diagnostic challenge to physicians but can reliably be diagnosed with great confidence employing various imaging modalities like CT and MRI.

Keywords: gastrointestinal radiology, abdominal imaging, hydatid cyst, medical and health sciences

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Authors: Cynthia Mahadi, Norhafezah Kasmuri

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Water scarcity is a growing issue these days. As a result, saltwater is being considered a limitless supply of fresh water through the desalination process, which is likely to address the worldwide water crisis, including in Malaysia. This study aims to offer the best management practice for controlling brine discharge in Malaysia by comparing environmental regulations on brine waste management in other countries. Then, a survey was distributed to the public to acquire further information about their level of awareness of the harmful effects of brine waste and to find out their perspective on the proposed solutions to ensure the effectiveness of the measures. As a result, it has been revealed that Malaysia still lacks regulations regarding the disposal of brine waste. Thus, a recommendation based on practices in other nations has been put forth by this study. This study suggests that the government and Malaysia's environmental regulatory body should govern brine waste disposal in the Environmental Quality Act 1974. Also, to add the construction of a desalination plant in Schedule 1 of prescribed activities was necessary. Because desalination plants can harm the environment during both construction and operation, every proposal for the construction of a desalination plant should involve the submission of an environmental impact assessment (EIA).

Keywords: seawater desalination, brine waste, environmental impact assessment, fuzzy Delphi method

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Authors: Mina Sadat Orooje, Mohammad Mehdi Latifi, Behnam Fereydooni Eftekhari

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The integration of cutting-edge Internet of Things (IoT) technologies with advanced Artificial Intelligence (AI) systems is revolutionizing healthcare facility management. However, the current landscape of hospital building maintenance suffers from slow, repetitive, and disjointed processes, leading to significant financial, resource, and time losses. Additionally, the potential of Building Information Modeling (BIM) in facility maintenance is hindered by a lack of data within digital models of built environments, necessitating a more streamlined data collection process. This paper presents a robust framework that harmonizes AI with BIM-IoT technology to elevate healthcare Facility Maintenance Management (FMM) and address these pressing challenges. The methodology begins with a thorough literature review and requirements analysis, providing insights into existing technological landscapes and associated obstacles. Extensive data collection and analysis efforts follow to deepen understanding of hospital infrastructure and maintenance records. Critical AI algorithms are identified to address predictive maintenance, anomaly detection, and optimization needs alongside integration strategies for BIM and IoT technologies, enabling real-time data collection and analysis. The framework outlines protocols for data processing, analysis, and decision-making. A prototype implementation is executed to showcase the framework's functionality, followed by a rigorous validation process to evaluate its efficacy and gather user feedback. Refinement and optimization steps are then undertaken based on evaluation outcomes. Emphasis is placed on the scalability of the framework in real-world scenarios and its potential applications across diverse healthcare facility contexts. Finally, the findings are meticulously documented and shared within the healthcare and facility management communities. This framework aims to significantly boost maintenance efficiency, cut costs, provide decision support, enable real-time monitoring, offer data-driven insights, and ultimately enhance patient safety and satisfaction. By tackling current challenges in healthcare facility maintenance management it paves the way for the adoption of smarter and more efficient maintenance practices in healthcare facilities.

Keywords: artificial intelligence, building information modeling, healthcare facility maintenance, internet of things integration, maintenance efficiency

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Authors: Kalimi Trinadh, Corinne Nouveau, A. S. Khanna, Karanveer S. Aneja, K. Ram Mohan Rao

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This study concerns improving the corrosion resistance of low alloy steel after plasma nitriding performed at variable time and temperature. Nitriding carried out in the temperature range of 450-550ᵒC for a various time period of 1-8 hrs. at 500Pa in a glow discharge plasma of H₂ and N₂ (80:20). The substrate was kept biased negatively at 250V. Following nitriding the X-ray diffraction studies shown that the phases formed were mainly γ′ (Fe₄N) and ε (Fe₂₋₃N). The ε (Fe₂₋₃N) phase found to be the dominating phase. Cross sections of the samples under scanning electron microscope point analyses revealed the presence of nitrogen in the surface region. For the assessment of corrosion resistance property, potentiodynamic polarization tests were performed in 3.5% NaCl solution. It has been shown that the plasma nitriding significantly improved the corrosion resistance when compared to the as-received steel. Furthermore, it has also been found that nitriding for 6h has more corrosion resistance than nitriding for the 8h duration. The hardness of the nitrided samples was measured by Vicker’s microhardness tester. The hardness of the nitrided steel was found to be improved much above the hardness of the steel in the as-received condition. It was found to be around two-fold of the initial hardness.

Keywords: corrosion, steel, plasma nitriding, X-ray diffraction

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Authors: Ahmed M. Jamel

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Electronic government initiatives and public participation to them are among the indicators of today's development criteria of the countries. After consequent two wars, Iraq's current position in, for example, UN's e-government ranking is quite concerning and did not improve in recent years, either. In the preparation of this work, we are motivated with the fact that handling geographic data of the public facilities and resources are needed in most of the e-government projects. Geographical information systems (GIS) provide most common tools not only to manage spatial data but also to integrate such type of data with nonspatial attributes of the features. With this background, this paper proposes that establishing a working GIS in the health sector of Iraq would improve e-government applications. As the case study, investigating hospital locations in Erbil is chosen.

Keywords: e-government, GIS, Iraq, Erbil

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Authors: Y. Tiamaz, N. Souissi

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The purpose of this paper is to present a classification of Lean models which aims to capture all the concepts related to this approach and thus facilitate its implementation. This classification allows the identification of the most relevant models according to several dimensions. From this perspective, we present a review and an analysis of Lean models literature and we propose dimensions for the classification of the current proposals while respecting among others the axes of the Lean approach, the maturity of the models as well as their application domains. This classification allowed us to conclude that researchers essentially consider the Lean approach as a toolbox also they design their models to solve problems related to a specific environment. Since Lean approach is no longer intended only for the automotive sector where it was invented, but to all fields (IT, Hospital, ...), we consider that this approach requires a generic model that is capable of being implemented in all areas.

Keywords: lean approach, lean models, classification, dimensions, holistic view

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Authors: Syed Ali Taqi, Muhammad Ismail

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A comparative study of estimators of population means in two phase sampling in the presence of non-response when Unknown population means of the auxiliary variable(s) and incomplete information of study variable y as well as of auxiliary variable(s) is made. Three real data sets of University students, hospital and unemployment are used for comparison of all the available techniques in two phase sampling in the presence of non-response with the newly generalized ratio estimators.

Keywords: two-phase sampling, ratio estimator, product estimator, generalized estimators

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Authors: Zeytu G. Asfaw, Serkalem K. Abrha, Demisew G. Degefu

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Background: HIV/AIDS remains a major public health problem in Ethiopia and heavily affecting people of productive and reproductive age. We aimed to compare the performance of Parametric Survival Analysis and Bayesian Survival Analysis using simulations and in a real dataset application focused on determining predictors of HIV patient survival. Methods: A Parametric Survival Models - Exponential, Weibull, Log-normal, Log-logistic, Gompertz and Generalized gamma distributions were considered. Simulation study was carried out with two different algorithms that were informative and noninformative priors. A retrospective cohort study was implemented for HIV infected patients under Highly Active Antiretroviral Therapy in Alamata General Hospital, North Ethiopia. Results: A total of 320 HIV patients were included in the study where 52.19% females and 47.81% males. According to Kaplan-Meier survival estimates for the two sex groups, females has shown better survival time in comparison with their male counterparts. The median survival time of HIV patients was 79 months. During the follow-up period 89 (27.81%) deaths and 231 (72.19%) censored individuals registered. The average baseline cluster of differentiation 4 (CD4) cells count for HIV/AIDS patients were 126.01 but after a three-year antiretroviral therapy follow-up the average cluster of differentiation 4 (CD4) cells counts were 305.74, which was quite encouraging. Age, functional status, tuberculosis screen, past opportunistic infection, baseline cluster of differentiation 4 (CD4) cells, World Health Organization clinical stage, sex, marital status, employment status, occupation type, baseline weight were found statistically significant factors for longer survival of HIV patients. The standard error of all covariate in Bayesian log-normal survival model is less than the classical one. Hence, Bayesian survival analysis showed better performance than classical parametric survival analysis, when subjective data analysis was performed by considering expert opinions and historical knowledge about the parameters. Conclusions: Thus, HIV/AIDS patient mortality rate could be reduced through timely antiretroviral therapy with special care on the potential factors. Moreover, Bayesian log-normal survival model was preferable than the classical log-normal survival model for determining predictors of HIV patients survival.

Keywords: antiretroviral therapy (ART), Bayesian analysis, HIV, log-normal, parametric survival models

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Authors: Zehra Gencel Efe, Fatma Susam Ozsayın, Satı Tas

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Background and Aim: It is not possible to teach all the knowledge related to operating room nursing in the nursing education process. Certified courses are organized by the Ministry of Health to compensate the lack of postgraduate training and the theoretical and practical training needs of working nurses. In this study; It is aimed to investigate the participants’ opinions and recommendations attending the certified course of operating room nursing that organized in İKCU AtaturkTraining and Research Hospital. Method: Two operating room nursing courses were organized in 2016. The 1st Operating Room Nursing Certified Course Program was organized between March 07, 2016 and April 6, 2016and the 2nd Operating Room Nursing Certified Course Program was organized between 07 November 2016 - 06 December 2016 at the İKCU Ataturk Training and Research Hospital. The first program was accepted for 29 participants, the second program was accepted for 30 participants. In the collection of the data, the 'Operating Room Nursing Certified Training Program Evaluation Form', 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' were used. Three point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Evaluation Form’ (1=verygood, 2=good, 3=poor). Data is collected in five areas related to training program, operation room practice, communication, responsibility, experiences of learning. Four point Likert-type scale is used for responses in the 'Operating Room Nursing Certified Training Program Theoretical Training Evaluation Form' (1=verysatisfied, 2=quitesatisfied, 3=satisfied, 4=dissatisfied). Data is collected in two areas include presentation and content. Data were analyzed with SPSS 16 program. Findings and Conclusion: It was found that 93,22% of participants were female in addition, 62,7% had bachelor degree. It was seen that 33,87% of the work group had 1-5 years of experience in their field. It was found that; 88% of trainees participating in the first group to the operating room nursing-certified course program stated the training program was very good, 12% of them stated the training program was good. Nobody was signed the ‘poor’ choice. 81% of the trainees who participated in the 2nd group to the operating room nursing-certified course program stated the training program was very good, 19% of them stated the training program was good. Nobody was signed the ‘poor’ choice. It was found that there was no meaningful difference between the achievement ratios of the trainees and the learning status of the trainees when compared with the t test in the groups with success level of the operating room nursing certified course program according to the learning status of the participants (p ˃ 0,05). The trainees noted that the course was satisfied with theoretical and practical steps but the support services (lunch, coffee breaks etc.) were in adequate.

Keywords: certified courses, nursing certified courses, operating room nursing, training program

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Authors: Ali Aghazadegan, Ali Shokria, Julia Mullarneya, Jon Tunnicliffe

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River channel confluences are dynamic systems with branching structures that exhibit a high degree of complexity both in natural and man-made open channel networks. Recent and past fields and modeling have investigated the river dynamics modeling of confluent based on a series of over-simplified assumptions (i.e. straight tributary channel with a bend with a 90° junction angle). Accurate assessment of such systems is important to the design and management of hydraulic structures and river engineering processes. Despite their importance, there has been little study of the hydrodynamics characteristics of river confluences, and the link between flow hydrodynamics and confluence morphodynamics in the confluence is still incompletely understood. This paper studies flow structures in confluences, morphodynamics and deposition patterns in 30 and 90 degrees confluences with different flow conditions. The results show that the junction angle is primarily the key factor for the determination of the confluence bed morphology and sediment pattern, while the discharge ratio is a secondary factor. It also shows that super elevation created by mixing flows is a key function of the morphodynamics patterns.

Keywords: helical flow, river confluence, bed morphology , secondary flows, shear layer

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Authors: Sirus Mohammadi, Sara Ansari, Darush dehghan, Habib Hoshyari

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Batteries for storage of electricity from solar and wind generation farms are a key element in the success of sustainability. In recent years, due to large integration of Renewable Energy Sources (RESs) like wind turbine and photovoltaic unit into the Micro-Grid (MG), the necessity of Battery Energy Storage (BES) has increased dramatically. The BES has several benefits and advantages in the MG-based applications such as short term power supply, power quality improvement, facilitating integration of RES, ancillary service and arbitrage. This paper presents the cost-based formulation to determine the optimal size of the BES in the operation management of MG. Also, some restrictions, i.e. power capacity of Distributed Generators (DGs), power and energy capacity of BES, charge/discharge efficiency of BES, operating reserve and load demand satisfaction should be considered as well. In this paper, a methodology is proposed for the optimal allocation and economic analysis of ESS in MGs on the basis of net present value (NPV). As the optimal operation of an MG strongly depends on the arrangement and allocation of its ESS, economic operation strategies and optimal allocation methods of the ESS devices are required for the MG.

Keywords: microgrid, energy storage system, optimal sizing, net present value

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Authors: Sharon Baoas, Toni Beninato, Michael Zenilman, Gokhan Ozuner

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Background An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures. Results A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded (p = 0.37) and 30-day readmissions (p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant (p = 0.047). Conclusions An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.

Keywords: 30-day readmission, lenght of stay, Enhanced Recovery after surgery, Surgical site infection

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Authors: Xuzhen Yang, Yan Shan, Yabo Ding, Keke DIao, Yanjun Zhang, Yijia Huang

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Purpose: Our aim is to understand the unique experiences of patients with peritoneal dialysis and how they deal with issues brought on by disease and dialysis. Patients and Methods: Semi-structured interview was designed to collect information, and inpatients with peritoneal dialysis in a university-based tertiary hospital in the central province of China were purposively chosen as interviewees. The content analysis method was used to analyze the data. Results: Nine patients participated in the study, and three themes and eight subthemes were generated. Conclusion: Patients using peritoneal dialysis encounter numerous challenges and problems in the process of disease and dialysis, and they took attempt to cope with them well to adapt to living with peritoneal dialysis.

Keywords: peritoneal dialysis, experience, patient, coping strategy

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Authors: Laabassi Ayache, Boudehane Asma

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Macrophyte pond has developed strongly in the field of wastewater treatment for irrigation in rural areas and small communities. Their association allows, in some cases, to increase the hydraulic capacity while maintaining the highest level of quality. The present work is devoted to the treatment of domestic wastewater under climatic conditions of Algeria (semi-arid) through a system using two tanks planted with Salvinia natans. The performance study and treatment efficiency of the system overall shows that the latter provides a significant removal of nitrogen pollution: total Kjeldahl nitrogen NTK (85.2%), Ammonium NH₄⁺-N (79%), Nitrite NO₂⁻-N (40%) also, a major meaningful reduction of biochemical oxygen demand BOD₅ was observed at the output of the system (96.9 %). As BOD₅, the chemical oxygen demand (COD) removal was higher than 95% at the exit of the two tanks. A moderately low yield of phosphate-phosphorus (PO₄³-P) was achieved with values not exceeding 37%. In general, the quality of treated effluent meets the Algerian standard of discharge and which allows us to select a suitable species in constructed wetland treatment systems under semi-arid climate.

Keywords: nutrient removal, Salvinia natans, semi-arid climate, wastewater treatment

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Authors: Shalini Rajput, Dinesh Mohan

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Water is the most important and essential resources for existing of life on the earth. Water quality is gradually decreasing due to increasing urbanization and industrialization and various other developmental activities. It can pose a threat to the environment and public health therefore it is necessary to remove hazardous contaminants from wastewater prior to its discharge to the environment. Recently, magnetic iron oxide nanoparticles have been arise as significant materials due to its distinct properties. This article focuses on the synthesis method with a possible mechanism, structure and application of magnetic iron oxide nanoparticles. The various characterization techniques including X-ray diffraction, transmission electron microscopy, scanning electron microscopy with energy dispersive X-ray, Fourier transform infrared spectroscopy and vibrating sample magnetometer are useful to describe the physico-chemical properties of nanoparticles. Nanosized iron oxide particles utilized for remediation of contaminants from aqueous medium through adsorption process. Due to magnetic properties, nanoparticles can be easily separate from aqueous media. Considering the importance and emerging trend of nanotechnology, iron oxide nanoparticles as nano-adsorbent can be of great importance in the field of wastewater treatment.

Keywords: nanoparticles, adsorption, iron oxide, nanotechnology

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Authors: Romi Hardiyansyah, Raden Sugeng Joko Sarwono, Agus Samsi

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Indonesian people have a mother language but not Arabic. Meanwhile, they must be able to pronounce the Arabic because Islam is the biggest religion in Indonesia. Arabic is composed by ḫijaiyaḫ letters which has its own pronunciation. Sound production process in humans can be divided into three physiological processes, namely: the formation of airflow from the lungs, the change in airflow from the lungs into the sound, and articulation (the modulation/sound setting into a specific sound). Ḫijaiyaḫ letters has its own articulation, some of which seem strange for most people in Indonesia. Those letters come out from the middle and upper throat so that the letters has its own acoustic characteristics. Acoustic characteristics of voice can be observed by source-filter approach that has parameters: pitch, formant, and formant bandwidth. Pitch is the basic tone in every human being. Formant is the resonance frequency of the human voice. Formant bandwidth is the time-width of a formant. After recording the sound from 21 subjects, data is processed by software Praat version 5.3.39. The analysis showed that each pronunciation, syakal (vowel changer), and the place of discharge letters has the same timbre which are determined by third and fourth formant.

Keywords: ḫijaiyaḫ, articulation, pitch, formant, formant bandwidth, timbre

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Authors: Karan Gupta

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The floods cause huge loos each year, and their impact gets manifold with the increase of total duration of flood as well as recession time. Moreover, floods have increased in recent years due to climate change in floodplains. In the context of global climate change, the agreement in Paris convention (2015) stated to keep the increase in global average temperature well below 2°C and keep it at the limit of 1.5°C. Thus, this study investigates the impact of increasing temperature on the stage, discharge as well as total flood duration and recession time in the Meghna River basin in Bangladesh. This study considers the 100-year return period flood flows in the Meghna river under the specific warming levels (SWLs) of 1.5°C, 2°C, and 4°C. The results showed that the rate of increase of duration of flood is nearly 50% lesser at ∆T = 1.5°C as compared to ∆T = 2°C, whereas the rate of increase of duration of recession is 75% lower at ∆T = 1.5°C as compared to ∆T = 2°C. Understanding the change of total duration of flood as well as recession time of the flood gives a better insight to effectively plan for flood mitigation measures.

Keywords: flood, climate change, Paris convention, Bangladesh, inundation duration, recession duration

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Authors: Prashant Dhiman, Viranshu Kumar, Pradeep Joshi

Abstract:

Lot of research is going on to study the effect of cryogenic treatment on materials. Cryogenic treatment is a heat treatment process which is used widely to enhance the mechanical and metallurgical properties of various materials whether the material is ferrous or non ferrous. In almost all ferrous metals, it is found that retained austenite is converted into martensite. Generally deep cryogenic treatment is done using liquid nitrogen having temperature of -195 ℃. The austenite is unstable at this stage and converts into martensite. In non ferrous materials there presents a microcavity and under the action of stress it becomes crack. When this crack propagates, fracture takes place. As the metal contract under low temperature, by doing cryogenic treatment these microcavities will be filled hence increases the soundness of the material. Properties which are enhanced by cryogenic treatment of both ferrous and non ferrous materials are hardness, tensile strength, wear rate, electrical and thermal conductivity, and others. Also there is decrease in residual stress. A large number of manufacturing process (EDM, CNC etc.) are using cryogenic treatment on different tools or workpiece to reduce their wear. In this Review paper the use of cryogenic heat treatment in different manufacturing has been shown along with their advantages.

Keywords: cyrogenic treatment, EDM (Electrical Discharge Machining), CNC (Computer Numeric Control), Mechanical and Metallurgical Properties

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Authors: Thandie Veronicah Sima, Moatlhodi Wiseman Letshwenyo

Abstract:

Discharge of wastewater is one of the major sources of phosphorus entering streams, lakes and other water bodies causing undesired environmental problem such as eutrophication. This condition not only puts the ecosystem at risk but also causes severe economic damages. Stringent laws have been developed globally by different bodies to control the level of phosphorus concentrations into receiving environments. In order to satisfy the constraints, a high degree of tertiary treatment or at least a significant reduction of phosphorus concentration is obligatory. This comprehensive review summarizes phosphorus removal technologies, from the most commonly used conventional technologies such as chemical precipitation through metal addition, membrane filtration, reverse osmosis and enhanced biological phosphorus removal using activated sludge system to passive systems such as constructed wetlands and filtration systems. Trends, perspectives and scientific procedures conducted by different researchers have been presented. This review critically evaluates the advantages and limitations behind each of the technologies. Enhancement of passive systems using reactive media such as industrial wastes to provide additional uptake through adsorption or precipitation is also discussed in this article.

Keywords: adsorption, chemical precipitation, enhanced biological phosphorus removal, phosphorus removal

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Authors: Zouhour Neji Ben Salem

Abstract:

Microscopic evacuation focuses on the evacuee behavior and way of search of safety place in an egress situation. In recent years, several models handled microscopic evacuation problem. Among them, we have proposed Artificial Neural Network (ANN) as an alternative to mathematical models that can deal with such problem. In this paper, we present two ANN models: SOM map and Hopfield Network used to predict the evacuee behavior in a disaster situation. These models are tested in a real case, the second floor of Tunisian children hospital evacuation in case of fire. The two models are studied and compared in order to evaluate their performance.

Keywords: artificial neural networks, self-organization map, hopfield network, microscopic evacuation, fire building evacuation

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Authors: Chuang-Chun Chiou

Abstract:

Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Similar to hospital and other health care service, care home service do need to provide quality and cost-effective service to satisfy the dwellers. The main purpose of this paper is to show how lean thinking and service innovation can be applied to care home operation. The issues and key factors of implementing lean practice are discussed.

Keywords: lean, service improvement, SERVQUAL, care home service

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Authors: Kieren Wilson, Gulnaz Majeed

Abstract:

NHS constitution gives rights to the patient with suspected cancer to be seen by a cancer specialist within 2 weeks of referral. Guys and St Thomas Hospital (GSTT) is one of the largest cancer centres in London. NICE guidelines have provided guidance for health professionals to refer patients appropriately to RAC. In GSTT suspected gynae cancer referrals are mostly by NHS e-Referral Service with some fax, emails as well as paper referrals. The objective of this study was to evaluate compliance with 2-week referral pathway with emphasis on one stop diagnostic service with supporting efficient pathways. A prospective evaluation over 3 months (1 Jan 2017 to 31 Mar 2017) was undertaken. There were 26 clinics, 761 patients were booked in the clinics with a DNA rate of 13% (n=101) hence 606 patients were seen. Majority of referrals were for post menopausal bleeding (PMB) 25% (n=194) followed by cervical, vaginal, vulval reasons 23% (n=179) (abnormal cytology excluded as patients directly referred to colposcopy unit in GSTT), ovarian 7% (n=54) and endometrial 5% (n=41). Women with new or previous established diagnosis of cancer were 24, cervical (n=17), vulva (n=6) and vagina (n=1). Multifocal preinvasive disease vulva (VIN), vagina (VAIN) and cervix (CIN) was confirmed in twenty-six patients 4% (high prevalence in HIV patients). Majority of cervical referrals: PCB (n=14), cervical erosion (n=7), polyps (n=9) and cervical cyst were benign. However, two women with PMB had cervical cancer. Only 2 out of 13 referrals with vaginal concerns had VAIN. One case with non-cervical glandular cytology was confirmed to have endometrial cancer. One stop service based on the diagnostic support of ultrasound, colposcopy and hysteroscopy was achieved in 54% (n=359). Patients were discharged to GP, benign gynaecology, endometriosis, combined vulval/dermatology clinic or gynae oncology. 33% (n=202) required a second visit, 12% (n=70) third visit, 3% (n=19) fourth visit, 1% (n=4) fifth visit and 1% (n=6) sixth visit. Main reasons for follow ups were the unavailability of diagnostic slots, patient choice, need for interpreters, the discussion following gynae MDM review for triage to benign gynae, delay in availability of diagnostic results like histology/MRI/CT. Recommendations following this study are multi disciplinary review of pathways with the availability of additional diagnostic procedure slots to aim for one stop service. Furthermore, establishment of virtual and telephone consultations to reduce follow ups.

Keywords: multifocal disease, post menopausal bleeding, preinvasive disease, rapid access clinic

Procedia PDF Downloads 185