Search results for: intermittent positive airway pressure ventilation

Authors: Bin Zhou, Tongli Lu, Jianwu Zhang, Hongtao Hao

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Dual clutch transmissions (DCT) offer a high comfort performance in terms of the gearshift. Hydraulic multi-disk clutches are the key components of DCT, its engagement determines the shifting comfort. The prefill of the clutches requests an initial engagement which the clutches just contact against each other but not transmit substantial torque from the engine, this initial clutch engagement point is called the touch point. Open-loop control is typically implemented for the clutch prefill, a lot of uncertainties, such as oil temperature and clutch wear, significantly affects the prefill, probably resulting in an inappropriate touch point. Underfill causes the engine flaring in gearshift while overfill arises clutch tying up, both deteriorating the shifting comfort of DCT. Therefore, it is important to enable an adaptive capacity for the clutch prefills regarding the uncertainties. In this paper, a dynamic model of the hydraulic actuator system is presented, including the variable force solenoid and clutch piston, and validated by a test. Subsequently, the open-loop clutch prefill is simulated based on the proposed model. Two control parameters of the prefill, fast fill time and stable fill pressure is analyzed with regard to the impact on the prefill. The former has great effects on the pressure transients, the latter directly influences the touch point. Finally, an adaptive method is proposed for the clutch prefill during gear shifting, in which clutch fill control parameters are adjusted adaptively and continually. The adaptive strategy is changing the stable fill pressure according to the current clutch slip during a gearshift, improving the next prefill process. The stable fill pressure is increased by means of the clutch slip while underfill and decreased with a constant value for overfill. The entire strategy is designed in the Simulink/Stateflow, and implemented in the transmission control unit with optimization. Road vehicle test results have shown the strategy realized its adaptive capability and proven it improves the shifting comfort.

Keywords: clutch prefill, clutch slip, dual clutch transmission, touch point, variable force solenoid

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Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

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Authors: Mohammad Tipu Sultan, Farzana Sharmin, Ke Xue

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Social media create a better opportunity for travelers to search for travel information, select destination and share their personal experiences of the travel. This study proposes a framework which describes the relationships between social media, and positive or negative tourism experience sharing impact on destination choice. To find out new trends of travelers behavioral intention, we propose an extended theoretical model, the Theory of Reasoned Action (TRA). We conducted a survey to analyze three external factors, subjective norms, and positive and negative experience influence on travel destination choice. Structural questionnaire analysis was employed to confirm the proposed research hypothesis within the relationship between consumer influences on the shared experience of social media. The results of the study confirm that sharing positive experiences influence the positive effect of destination choice, while negative experiences decrease the destination selection option. The results indicate that attitudes, subjective norms are passively influenced by shared experience. Moreover, we find that sharing live pictures of travel experiences through social media helps to reduce negative perceptions of the destination brand. This research contribution is useable to the research field as a new determination factor and the findings could be used by destination organization management (DMO) to enhancing their tourism promotion through social media.

Keywords: destination choice, tourism experience sharing, Theory of Reasoned Action, TRA, social media

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Authors: See-Yuan Cheng, Kwang-Yhee Chin, Shuhaimi Mansor

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Rear-roof spoiler is commonly used for improving the aerodynamic performance of road vehicles. This study aims to investigate the effect of yaw angle on the effectiveness of strip-type rear-roof spoiler in providing lower drag and lift coefficients of a hatchback model. A computational fluid dynamics (CFD) method was used. The numerically obtained results were compared to the experimental data for validation of the CFD method. At increasing yaw angle, both the drag and lift coefficients of the model were to increase. In addition, the effectiveness of spoiler was deteriorated. These unfavorable effects were due to the formation of longitudinal vortices around the side edges of the model that had caused the surface pressure of the model to drop. Furthermore, there were significant crossflow structures developed behind the model at larger yaw angle, which were associated with the drop in the surface pressure of the rear section of the model and cause the drag coefficient to rise.

Keywords: Ahmed model, aerodynamics, spoiler, yaw angle

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Authors: Abdul-Dahiru El-Yuguda, Saka Saheed Baba, Tawa Monilade Adisa, Mustapha Bala Abubakar

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Background: Chikungunya (CHIK) virus, a previously anecdotally described arbovirus, is now assuming a worldwide public health burden. The CHIK virus infection is characterized by potentially life threatening and debilitating arthritis in addition to the high fever, arthralgia, myalgia, headache and rash. Method: Three hundred and seventy (370) serum samples were collected from outpatients with febrile illness attending University of Maiduguri Teaching Hospital, Nigeria, and was used to detect for Chikungunya (CHIK) virus IgG and IgM antibodies using the Enzyme Linked Immunosorbent Assays (ELISAs). Result: Out of the 370 sera tested, 39 (10.5%) were positive for presence of CHIK virus antibodies. A total of 24 (6.5%) tested positive for CHIK virus IgM only while none (0.0%) was positive for presence of CHIK virus IgG only and 15 (4.1%) of the serum samples were positive for both IgG and IgM antibodies. A significant difference (p<0.0001) was observed in the distribution of CHIK virus antibodies in relation to gender. The males had prevalence of 8.5% IgM antibodies as against 4.6% observed in females. On the other hand 4.6% of the females were positive for concurrent CHIK virus IgG and IgM antibodies when compared to a prevalence of 3.4% observed in males. Only the age groups ≤ 60 years and the undisclosed age group were positive for presence of CHIK virus IgG and/or IgM antibodies. No significant difference (p>0.05) was observed in the seasonal prevalence of CHIK virus antibodies among the study subjects Analysis of the prevalence of CHIK virus antibodies in relation to clinical presentation (as observed by Clinicians) of the patients revealed that headache and fever were the most frequently encountered ailments. Conclusion: The CHIK virus IgM and concurrent IgM and IgG antibody prevalence rates of 6.5% and 4.1% observed in this study indicates a current infection and the lack of IgG antibody alone observed shows that the infection is not endemic but sporadic. Recommendation: Further studies should be carried to establish the seasonal prevalence of CHIK virus infection vis-à-vis vector dynamics in the study area. A comprehensive study need to be carried out on the molecular characterization of the CHIK virus circulating in Nigeria with a view to developing CHIK virus vaccine.

Keywords: Chikungunya virus, IgM and IgG antibodies, febrile patients, enzyme linked immunosorbent assay

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Authors: Anoop T. R., Otman Basir, Robert F. Hess, Ben Thompson

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Strabismus refers to a misalignment of the eyes. Early detection and treatment of strabismus in childhood can prevent the development of permanent vision loss due to abnormal development of visual brain areas. Currently, many children with strabismus remain undiagnosed until school entry because current automated screening methods have limited success in the preschool age range. A method for strabismus detection using eye alignment stability (EAS) is proposed. This method starts with face detection, followed by facial landmark detection, eye region segmentation, eye gaze extraction, and eye alignment stability estimation. Binarization and morphological operations are performed for segmenting the pupil region from the eye. After finding the EAS, its absolute value is used to differentiate the strabismic eye from the non-strabismic eye. If the value of the eye alignment stability is greater than a particular threshold, then the eyes are misaligned, and if its value is less than the threshold, the eyes are aligned. The method was tested on 175 strabismic and non-strabismic images obtained from Kaggle and Google Photos. The strabismic eye is taken as a positive class, and the non-strabismic eye is taken as a negative class. The test produced a true positive rate of 100% and a false positive rate of 7.69%.

Keywords: strabismus, face detection, facial landmarks, eye segmentation, eye gaze, binarization

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Authors: Elmeida Effendy, Mustafa M. Amin, Nauli Aulia Lubis, P. J. Sirait

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Music therapy may have an effect on mental illnesses. This is a comparative, quasi-experimental study to examine the effect of music therapy added to standard care on Positive Negative Syndrome Scale, Cognitive Function and Quality of Life in female schizophrenic patients. 50 schizophrenic participants who were diagnosed with semistructured MINI ICD-X, were assigned into two groups received pharmacotherapy. Participants were assigned into each group of therapy by using matched allocation method. Music therapy added on to the first group. They received music therapy, using Mozart Sonata four times a week, over a period of six week. Positive and negative symptoms were measured by using Positive and Negative Syndrome Scale (PANSS). Cognitive function were measured by using Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA). All rating scale were administrated by certified skill residents every week after music therapy session. The participants who were received pharmaco-and-music therapy significantly showed greater response than who received pharmacotherapy only. The mean difference of response were -6,6164 (p=0,001) for PANNS, 2,911 (p=0,004) for MMSE, 3,618 (p=0,001) for MOCA, 4,599 (p=0,001) for SF-36. Music therapy have beneficial effects on PANSS, Cognitive Function and Quality of Life in schizophrenic patients.

Keywords: music therapy, rating scale, schizophrenia, symptoms

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Authors: H. Mat Kiah, Rafiziana M. Kasmani, Norazana Ibrahim, Roshafima R. Ali, Aziatul N.Sadikin

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An experimental study has been done to investigate the flame acceleration in a closed pipe. A horizontal steel pipe, 2m long and 0.1 m in diameter (L/D of 20), was used in this work. For tests with 90 degree bends, the bend had a radius of 0.1 m and thus, the pipe was lengthened 1 m (based on the centreline length of the segment). Ignition was affected one end of the vessel while the other end was closed. Only stoichiometric concentration (Ф, = 1.0) of natural gas/air mixtures will be reported in this paper. It was demonstrated that bend pipe configuration gave three times higher in maximum over-pressure (5.5 bars) compared to straight pipe (2.0 bars). From the results, the highest flame speed of 63 m s-1 was observed in a gas explosion with bent pipe, greater by a factor of ~3 as compared with straight pipe (23 m s-1). This occurs because bending acts similar to an obstacle, in which this mechanism can induce more turbulence, initiating combustion in an unburned pocket at the corner region and causing a high mass burning rate which increases the flame speed.

Keywords: bending, gas explosion, bending, flame acceleration, over-pressure

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Authors: Judit Nagy

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Many scientific studies claim that financial education should start as early as possible. Children are much more capable of and willing to absorb new concepts than adults. If we introduce children to financial knowledge early, their behaviour and attitudes to this subject will change, increasing later success in this area of life. However, poor financial decisions may entail severe consequences, not only to individuals but even to the wider society. Good financial decisions and economic attitudes may contribute to economic growth and well-being. Whilst in several countries, education about financial awareness and fundamentals is available, the understanding and acquisition of complex economic knowledge and the development of children’s independent problem-solving skills are still lacking. The results suggest that teaching economic and financial knowledge through accounting and making lectures interactive by using special tools of positive education is critical to stimulating children’s interest. Eighty percent of the students in the study liked the combined and interactive lecture. Introducing this kind of knowledge to individuals is a relevant objective, even at the societal level.

Keywords: positive psychology, education innovation, primary school, gender, economics, accounting, finance, personal finance, mathematics, economic growth, well-being, sustainability

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Authors: Lina Ismail Jassim, Robiah Yunus

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To successfully drill oil or gas well, two main characteristics of numerous other tasks of an efficient drilling fluid are required, which are suspended and carrying cuttings from the beneath wellbore to the surface and managed between pore (formation) and hydrostatic pressure (mud pressure). Several factors like mud composition and its rheology, wellbore design, drilled cuttings characteristics and drilling string rotation contribute to drill wellbore successfully. Simulation model can support an appropriate indication on the drilling fluid performance in the real field as Genting Timur field, located in Pahang in Malaysia on 4295 m depth, held the world record in Sempah Muda 1 (Vertical). A detailed 3 dimensional CFD analysis of vertical, concentric annular two phase flow was developed to study and asses Herschel Bulkley drilling fluid. The effect of Hematite, Barite and calcium carbonates types and size of cutting rock particles on such flow is analyzed. The vertical flows are also associated with a good amount of temperature variation along the depth. This causes a good amount of change in viscosity of the fluid, which is non-Newtonian in nature. Good understanding of the nature of such flows is imperative in developing and maintaining successful vertical well systems. A detailed analysis of flow characteristics due to the drill pipe rotation is done in this work. The inner cylinder of the annulus gets different rotational speed, depending upon the operating conditions. This speed induces a good swirl on the particles and primary fluids which interpret in Ester based drilling fluid cleaning well ability, which in turn determines energy loss along the pipe. Energy loss is assessed in this work in terms of wall shear stress and pressure drop along the pipe. The flow is under an adverse pressure gradient condition, which causes chance of reversed flow and transfers the rock cuttings to the surface.

Keywords: concentric annulus, non-Newtonian, two phase, Herschel Bulkley

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Authors: Sungeun Hyun, Sooin Lee, Gyewan Moon

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Work-Family Conflict has been an active research area for the past decades. Work-Family Conflict harms individuals and organizations, it is ultimately expected to bring the cost of losses to the company in the long run. WFC has mainly focused on effects of organizational effectiveness and job attitude such as Job Satisfaction, Organizational Commitment, and Turnover Intention variables. This study is different from consequence variable with previous research. For this purpose, we selected the positive job attitude 'Work Engagement' as a consequence of WFC. This research has its primary research purpose in identifying the negative effects of the Work-Family Conflict, and started out from the recognition of the problem that the research on the direct relationship on the influence of the WFC on Work Engagement is lacking. Based on the COR(Conservation of resource theory) and JD-R(Job Demand- Resource model), the empirical study model to examine the negative effects of WFC with Emotional Exhaustion as the link between WFC and Work Engagement was suggested and validated. Also, it was analyzed how much Positive Psychological Capital may buffer the negative effects arising from WFC within this relationship, and the Mediated Moderation model controlling the indirect effect influencing the Work Engagement by the Positive Psychological Capital mediated by the WFC and Emotional Exhaustion was verified. Data was collected by using questionnaires distributed to 500 employees engaged manufacturing, services, finance, IT industry, education services, and other sectors, of which 389 were used in the statistical analysis. The data are analyzed by statistical package, SPSS 21.0, SPSS macro and AMOS 21.0. The hierarchical regression analysis, SPSS PROCESS macro and Bootstrapping method for hypothesis testing were conducted. Results showed that all hypotheses are supported. First, WFC showed a negative effect on Work Engagement. Specifically, WIF appeared to be on more negative effects than FIW. Second, Emotional exhaustion found to mediate the relationship between WFC and Work Engagement. Third, Positive Psychological Capital showed to moderate the relationship between WFC and Emotional Exhaustion. Fourth, the effect of mediated moderation through the integration verification, Positive Psychological Capital demonstrated to buffer the relationship among WFC, Emotional Exhastion, and Work Engagement. Also, WIF showed a more negative effects than FIW through verification of all hypotheses. Finally, we discussed the theoretical and practical implications on research and management of the WFC, and proposed limitations and future research directions of research.

Keywords: emotional exhaustion, positive psychological capital, work engagement, work-family conflict

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Authors: A. Alkattib, M. Boumaza

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Steam reforming is industrially important as it is incorporated in several major chemical processes including the production of ammonia, methanol, hydrogen and ox alcohols. Due to the strongly endothermic nature of the process, a large amount of heat is supplied by fuel burning (commonly natural gas) in the furnace chamber. Reaction conversions, tube catalyst life, energy consumption and CO2 emission represent the principal factors affecting the performance of this unit and are directly influenced by the high operating temperatures and pressures. This study presents a simulation of the performance of the reforming of methane in a primary reformer, through a developed empirical relation which enables to investigate the effects of operating parameters such as the pressure, temperature, steam to carbon ratio on the production of hydrogen, as well as the fraction of non-converted methane. It appears from this analysis that the exit temperature Te, the operating pressure as well the steam to carbon ratio has an important effect on the reforming of methane.

Keywords: reforming, methane, performance, hydrogen, parameters

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Authors: Hussaini Doko Ibrahim, Hamilton Cyprian Chinwenyi, Henrietta Nkem Ude

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In this paper, efforts were made to examine and compare the algorithmic iterative solutions of the conjugate gradient method as against other methods such as Gauss-Seidel and Jacobi approaches for solving systems of linear equations of the form Ax=b, where A is a real n×n symmetric and positive definite matrix. We performed algorithmic iterative steps and obtained analytical solutions of a typical 3×3 symmetric and positive definite matrix using the three methods described in this paper (Gauss-Seidel, Jacobi, and conjugate gradient methods), respectively. From the results obtained, we discovered that the conjugate gradient method converges faster to exact solutions in fewer iterative steps than the two other methods, which took many iterations, much time, and kept tending to the exact solutions.

Keywords: conjugate gradient, linear equations, symmetric and positive definite matrix, gauss-seidel, Jacobi, algorithm

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Authors: Upasana Bhumbla

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Background: Hepatitis C virus is a major cause of chronic hepatitis, which can further lead to cirrhosis of the liver and hepatocellular carcinoma. Worldwide the burden of Hepatitis C infection has become a serious threat to the human race. Hepatitis C virus (HCV) has population-specific genotypes and provides valuable epidemiological and therapeutic information. Genotyping and assessment of viral load in HCV patients are important for planning the therapeutic strategies. The aim of the study is to study the changing trends of prevalence and genotypic distribution of hepatitis C virus in a tertiary care hospital in Western India. Methods: It is a retrospective study; blood samples were collected and tested for anti HCV antibodies by ELISA in Dept. of Microbiology. In seropositive Hepatitis C patients, quantification of HCV-RNA was done by real-time PCR and in HCV-RNA positive samples, genotyping was conducted. Results: A total of 114 patients who were seropositive for Anti HCV were recruited in the study, out of which 79 (69.29%) were HCV-RNA positive. Out of these positive samples, 54 were further subjected to genotype determination using real-time PCR. Genotype was not detected in 24 samples due to low viral load; 30 samples were positive for genotype. Conclusion: Knowledge of genotype is crucial for the management of HCV infection and prediction of prognosis. Patients infected with HCV genotype 1 and 4 will have to receive Interferon and Ribavirin for 48 weeks. Patients with these genotypes show a poor sustained viral response when tested 24 weeks after completion of therapy. On the contrary, patients infected with HCV genotype 2 and 3 are reported to have a better response to therapy.

Keywords: hepatocellular, genotype, ribavarin, seropositive

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Authors: Tejeet Singh, Harmanjit Singh

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Creep behavior of thick-walled functionally graded cylinder consisting of AlSiC and subjected to internal pressure and high temperature has been analyzed. The functional relationship between strain rate with stress can be described by the well-known threshold stress based creep law with a stress exponent of five. The effect of imposing non-linear particle gradient on the distribution of creep stresses in the thick-walled functionally graded composite cylinder has been investigated. The study revealed that for the assumed non-linear particle distribution, the radial stress decreases throughout the cylinder, whereas the tangential, axial and effective stresses have averaging effect. The strain rates in the functionally graded composite cylinder could be reduced to significant extent by employing non-linear gradient in the distribution of reinforcement.

Keywords: functionally graded material, pressure, steady state creep, thick-cylinder

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Authors: Mohammad Maruf Hasan

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Foreign Direct Investment (FDI) has been increased at a remarkable position around the globe in which emerging economies are getting more FDI compared to industrialized economies. This study aims to examine the determinants of inward FDI flows in Bangladesh. To estimate the long and short-run impact of the FDI determinants for 1996-2020, we employed the Autoregressive-Distributed Lag (ARDL) model. Results show that: (1) macroeconomic determinants, such as economic growth, infrastructure, and market size, have a significant and strong positive effect.(2) Inflation exchange rate shows insignificant effects, while trade openness has mixed (short-run negative, long-run positive) effects on FDI inflows in both the long and short run. (3) Current institutional determinants rule of law has a positive effect on FDI inflows but is statistically insignificant, political stability has a negative, and the rule of law has a considerable beneficial impact on inflows of FDI. (4) The macroeconomic factors have been determined to impact Bangladesh's FDI inflows. Finally, a stable macroeconomic climate is more effective at luring FDI, as this study confirms. From a policy perspective, this study will help the government and policymakers to make a new investment policy.

Keywords: determinants, FDI, ARDL, Bangladesh

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Authors: Anum Obaid, Iman Fatima, Wanisha Feroz, Haleema Imran, Hammad Tariq

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Unmarried women over thirty years of age as a health issue is a relatively young phenomenon, but it is rapidly growing in Pakistan; therefore, it is a public health issue. The challenges affecting nutrition and public health are some of the indispensable components that need to be met to achieve sustainable development goals (SDGs). This research intends to explain these goals in the context of nutrition and public health, especially analyzing the issues related to unmarried women above the age of thirty in Faisalabad, Pakistan. Still, this research is not feasible in Pakistan. In Pakistan alone, 10 million women over the age of 35 are unmarried, based on a recent United Nations report. The United Nations, in cooperation with the World Health Organization, has identified health as a state of being healthy, free from illness or disease, and not just a condition where there are no diseases or bodily disabilities. The current generation of women is unmarried and living a life under constant pressure from society to deliver changes like the diet these women take, and hence, their nutritional status defines their comprehensive health triangle, a mix of physical, mental, and social well-being. The research was carried out under the qualitative research paradigm, specifically through interviews with the participants who were unmarried women and married women above the age of thirty. This qualitative study explores how marriage affects the intake of nutrients, nutritional health, psychological and social well-being and their effects. The realization of well-being consisted of factors like physical health, mental and emotional health, pressure from society, social health, economic independence, and decision-making power to reveal the impact of singleness on well-being. The findings disclosed that marital status had a notable impact on the diet habits and nutritional behaviors of women in Faisalabad. Also, it was found that single women suffer from more stress and are not as positive as married women because they are lonely, as their husbands are absent from their lives. The findings established that nutritional understanding is differentially affected by marital status as a determinant of the health triangle consisting of physical, mental, and social health. Awareness of these factors is significant in designing specific goal-directed interventions that can enhance the nutritional well-being and general health status of unmarried women in Faisalabad. Hence, this study underscores the necessity of maintaining supportive environments and increasing the regard concerning the health state of single ladies beyond thirty.

Keywords: health triangle, over thirty, singleness, age barriers, unmarried women, women’s health, well-being

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Authors: Ioannis Panagiotopoulos, Efstathios Kastritis, Anastasia Katinioti, Georgios Efthymiadis, Argyrios Doumas, Maria Koutelou

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Introduction: Transthyretin amyloidosis (ATTR) is a rare but serious infiltrative disease. Myocardial scintigraphy with DPD has emerged as the most effective, non-invasive, highly sensitive, and highly specific diagnostic method for cardiac ATTR amyloidosis. However, there are cases in which additional laboratory investigations reveal AL amyloidosis or other diseases despite a positive DPD scintigraphy. We describe the experience from the Onassis Cardiac Surgery Center and the monitoring center for infiltrative myocardial diseases of the cardiology clinic at AHEPA. Materials and Methods: All patients with clinical suspicion of cardiac or extracardiac amyloidosis undergo a myocardial scintigraphy scan with Tc-99m DPD. In this way, over 500 patients have been examined. Further diagnostic approach based on clinical and imaging findings includes laboratory investigation and invasive techniques (e.g., biopsy). Results: Out of 76 patients in total with positive myocardial scintigraphy Grade 2 or 3 according to the Perugini scale, 8 were proven to suffer from AL Amyloidosis during the investigation of paraproteinemia. Among these patients, 3 showed Grade 3 uptake, while the rest were graded as Grade 2, or 2 to 3. Additionally, one patient presented diffuse and unusual radiopharmaceutical uptake in soft tissues throughout the body without cardiac involvement. These findings raised suspicions, leading to the analysis of κ and λ light chains in the serum, as well as immunostaining of proteins in the serum and urine of these specific patients. The final diagnosis was AL amyloidosis. Conclusion: The value of DPD scintigraphy in the diagnosis of cardiac amyloidosis from transthyretin is undisputed. However, positive myocardial scintigraphy with DPD should not automatically lead to the diagnosis of ATTR amyloidosis. Laboratory differentiation between ATTR and AL amyloidosis is crucial, as both prognosis and therapeutic strategy are dramatically altered. Laboratory exclusion of paraproteinemia is a necessary and essential step in the diagnostic algorithm of ATTR amyloidosis for all positive myocardial scintigraphy with diphosphonate tracers since >20% of patients with Grade 3 and 2 uptake may conceal AL amyloidosis.

Keywords: AL amyloidosis, amyloidosis, ATTR, myocardial scintigraphy, Tc-99m DPD

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Authors: Mariam Kutateladze

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In the twenty-first century, in the customer service settings for hospitality institution’s employee management and their well-being have become a core issue since it is linked to the customers' increased demand for high-quality service. Employees' positive attitude to customers plays an essential role in the serving process; for this reason, in the hospitality institutions service with a smile is a job requirement. This research is devoted to the issues of employee management systems improvement and its effect of the genuine smile as a positive attitude expressed by the employees to the customer. Different researchers work about the effect of the genuine smile, which is analyzed in the present paper. Based on it, the link between satisfied employees from service climate and their genuine smile is determined. An investigation in local resort hotels which are located in the regions of Georgia is conducted. In the methodology of the paper, we have used linkage research, which stated that employee satisfaction in a working place depends on the existing service climate in an organization. We have prepared questioners according to eight dimensions of good service climate by linkage research, and extra questions about the effect of the smile on customers were added. Questionnaires were distributed among employees, and the results have shown that dissatisfaction from organizations’ service climate led to employees' false smile toward customers. Demanding positive emotions from frustrated employees was the mistake of the hotel management. The false smile was easily recognized by the customers, and the frustrated employee with a false smile could not provide high-quality service. The findings of the paper will help managers to realize the importance of forming the positive service climate within the institutions since it is linked to employees' well-being who are the creators of high-quality service. The conclusion drawn from this study indicates there are core issues those managers need to take into account when planning their organizations’ profit. Managers should know their employees very well, their feelings and attitudes toward work before asking them expressing a smile since forced smile does not have a good result and quite often has bad outcomes; therefore, first of all, managers should investigate service climate in the organization. Managers should take into consideration employees’ opinions about the service climate in the organization, motivate their employees, and respect their ideas. Also, they should satisfy employees' basic needs and stress more value on extrinsic goals such as competence, relatedness, and autonomy. Managers should create a positive working environment, positive service climate, which will lead to employee satisfaction and genuine feelings, as well as improve the working environment since negative working climate will cause customers disappointment because of low-quality service provided by the unsatisfied employees.

Keywords: employee management, hotel, quality of service, service climate

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Authors: Manisha Bal, Amit Verma, B. C. Meikap

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Carbon dioxide (CO₂) is the most abundant waste produced by human activities. It is estimated to be one of the major contributors of greenhouse effect and also considered as a major air pollutant formed by burning of fossil fuels. The main sources of emissions are flue gas from thermal power plants and process industries. It is also a contributor of acid rain. Its exposure through inhalation can lead to health risks. Therefore, control of CO₂ emission in the environment is very necessary. The main focus of this study is on the removal of carbon dioxide from off gases using a self-priming venturi scrubber in submerged conditions using sodium hydroxide as the scrubbing liquid. A self-priming submerged venturi scrubber is an efficient device to remove gaseous pollutants. In submerged condition, venturi scrubber remains submerged in the liquid tank and the liquid enters at the throat section of venturi scrubber due to the pressure difference which includes the hydrostatic pressure of the liquid and static pressure of the gas. The inlet polluted air stream enters through converging section which moves at very high velocity in the throat section and atomizes the liquid droplets. This leads to absorption of CO₂ from the off gases in scrubbing liquid which resulted in removal of CO₂ gas from the off gases. Detailed investigation on the scrubbing of carbon dioxide has been done in this literature. Experiments were conducted at different throat gas velocities, liquid levels in outer cylinder and CO₂ inlet concentrations to study the carbon dioxide removal efficiency. Experimental results give more than 95% removal efficiency of CO₂ in the self priming venturi scrubber which can meet the environmental emission limit of CO₂ to save the human life.

Keywords: carbon dioxide, scrubbing, pollution control, self-priming venturi scrubber

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Authors: Abu Salim Mustafa

Abstract:

Polymerase chain reaction (PCR) assays targeting genomic DNA segments have been established for the detection of Helicobacter pylori in clinical specimens. However, the data on comparative evaluations of various targets in detection of H. pylori are limited. Furthermore, the frequencies of vacA (s1 and s2) and cagA genotypes, which are suggested to be involved in the pathogenesis of H. pylori in other parts of the world, are not well studied in Kuwait. The aim of this study was to evaluate PCR assays for the detection and genotyping of H. pylori by targeting the amplification of DNA targets from four genomic segments. The genomic DNA were isolated from 72 clinical isolates of H. pylori and tested in PCR with four pairs of oligonucleotides primers, i.e. ECH-U/ECH-L, ET-5U/ET-5L, CagAF/CagAR and Vac1F/Vac1XR, which were expected to amplify targets of various sizes (471 bp, 230 bp, 183 bp and 176/203 bp, respectively) from the genomic DNA of H. pylori. The PCR-amplified DNA were analyzed by agarose gel electrophoresis. PCR products of expected size were obtained with all primer pairs by using genomic DNA isolated from H. pylori. DNA dilution experiments showed that the most sensitive PCR target was 471 bp DNA amplified by the primers ECH-U/ECH-L, followed by the targets of Vac1F/Vac1XR (176 bp/203 DNA), CagAF/CagAR (183 bp DNA) and ET-5U/ET-5L (230 bp DNA). However, when tested with undiluted genomic DNA isolated from single colonies of all isolates, the Vac1F/Vac1XR target provided the maximum positive results (71/72 (99% positives)), followed by ECH-U/ECH-L (69/72 (93% positives)), ET-5U/ET-5L (51/72 (71% positives)) and CagAF/CagAR (26/72 (46% positives)). The results of genotyping experiments showed that vacA s1 (46% positive) and vacA s2 (54% positive) genotypes were almost equally associated with VaCA+/CagA- isolates (P > 0.05), but with VacA+/CagA+ isolates, S1 genotype (92% positive) was more frequently detected than S2 genotype (8% positive) (P< 0.0001). In conclusion, among the primer pairs tested, Vac1F/Vac1XR provided the best results for detection of H. pylori. The genotyping experiments showed that vacA s1 and vacA s2 genotypes were almost equally associated with vaCA⁺/cagA^- isolates, but vacA s1 genotype had a significantly increased association with vacA⁺/cagA⁺ isolates.

Keywords: H. pylori, PCR, detection, genotyping

Procedia PDF Downloads 132

Authors: Dongchuan Su, Hai Xie, Naibin Jiang

Abstract:

Under severe accident cases, the nuclear reactor core may meltdown inside the lower head of the reactor pressure vessel (RPV). Retaining the melt pool inside the RPV is an important strategy of severe accident management. During this process, the inner wall of the lower head will be heated to high temperature of a thousand centigrade, and the outer wall is immersed in a large amount of cooling water. The material of the lower head will have serious creep damage under the high temperature and the temperature difference, and this produces a great threat to the integrity of the RPV. In this paper, the ANSYS program is employed to build the finite element method (FEM) model of the lower head, the creep phenomena is simulated under the severe accident case, the time dependent strain and stress distribution is obtained, the creep damage of the lower head is investigated, the integrity of the RPV is evaluated and the theoretical basis is provided for the optimized design and safety assessment of the RPV.

Keywords: severe accident, lower head of RPV, creep, FEM

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Authors: Jianguo Chen, Fenggang Zang, Yu Yang, Liangang Zheng

Abstract:

Reactor Pressure Vessel (RPV) is an important security barrier in nuclear power plant. Crack like defects may be produced on RPV during the whole operation lifetime due to the harsh operation condition and irradiation embrittlement. During the severe loss of coolant accident, thermal shock happened as the injection of emergency cooling water into RPV, which results in re-pressurization of the vessel and very high tension stress on the vessel wall, this event called Pressurized Thermal Shock (PTS). Crack on the vessel wall may propagate even penetrate the vessel, so the safety of the RPV would undergo great challenge. Many assumptions in structure integrity evaluation make the result of deterministic fracture mechanics very conservative, which affect the operation lifetime of the plant. Actually, many parameters in the evaluation process, such as fracture toughness and nil-ductility transition temperature, have statistical distribution characteristics. So it is necessary to assess the structural integrity of RPV subjected to PTS event by means of Probabilistic Fracture Mechanics (PFM). Structure integrity evaluation methods of RPV subjected to PTS event are summarized firstly, then evaluation method based on probabilistic fracture mechanics are presented by considering the probabilistic characteristics of material and structure parameters. A comprehensive analysis example is carried out at last. The results show that the probability of crack penetrates through wall increases gradually with the growth of fast neutron irradiation flux. The results give advice for reactor life extension.

Keywords: fracture toughness, integrity evaluation, pressurized thermal shock, probabilistic fracture mechanics, reactor pressure vessel

Procedia PDF Downloads 250

Authors: Ebele V. Okoli, Emmanuel Nwobi, Dozie Ezechukwu, Ijeoma Itanyi

Abstract:

One in seven people worldwide suffer from a disability. 80% of people with disabilities live in developing countries. Negative attitudes and misconceptions among health-care providers constitute barri¬ers to optimal health care for people with disabilities. This underscores the relevance of a study of the attitude of Nigerian medical students towards disability and their willingness to work in the disability sector. This was a descriptive cross-sectional study conducted among 254 penultimate and final year medical students of a university in southeastern Nigeria. The mean age of the students was 24.8 ± 3.12 years. Majority of the students were male (75.2%), single (96.9%), of the Igbo tribe (86.6%), Christian (97.6%) and grew up in urban areas (68.1%). Results indicated that the medical students had a predominantly positive attitude towards people with disability as 73.8% had a positive attitude and mean attitude score was 67.03 ± 0.14 (positive attitude = 61 – 120, negative attitude = 0 - 60). Chi-square analysis did not show any significant effect of demographic and social factors on the students’ attitude towards People with Disabilities. The students were mostly willing to work in areas that address the challenges of people with disability (70.4%) but a greater proportion had never heard about Disability Studies (67.5%). About a third of the students (33.2%) would like to travel abroad to practice in the disability sector. Conclusions: The students generally had a positive attitude towards people with disability and a greater percentage were willing to work in the disability sector in their future career. About two-thirds had however, never heard about disability studies. There was some potential for brain drain among the students as a third of the population intended to practice abroad on graduation.

Keywords: attitudes, career interest, disability, medical students

Procedia PDF Downloads 356

Authors: Arij Yehya, Suhaila Ghuloum, Abdlmoneim Abdulhakam, Azza Al-Mujalli, Mark Opler, Samer Hammoudeh, Yahya Hani, Sundus Mari, Reem Elsherbiny, Ziyad Mahfoud, Hassen Al-Amin

Abstract:

Introduction: The Positive and Negative Syndrome Scale (PANSS) is a valid instrument developed by Kay and colleagues6 to assess symptoms of patients with schizophrenia. It consists of 30 items that factor the symptoms into three subscales: positive, negative and general psychopathology. This scale has been translated and validated in several languages. Objective: This study aims to determine the validity and psychometric properties of the Arabic version of the PANSS. Methods: A standardized translation and cultural adaptation method was adopted. Patients diagnosed with schizophrenia (n=98), according to psychiatrist’s diagnosis based on DSM-IV criteria, were recruited from the Psychiatry Department at Rumailah Hospital, Qatar. A first rater confirmed the diagnosis using the Arabic version of Mini International Neuropsychiatric Interview (MINI 6). A second and independent rater-administered the Arabic version of PANSS. Also, a control group (n=101), with no history of psychiatric disorder was recruited from the family and friends of the patients and from primary health care centers in Qatar. Results: There were more males than females in our sample of patients with schizophrenia (68.9% and 31.6%, respectively). On the other hand, in the control group the number of females outweighed that of males (58.4% and 41.6% respectively). The scale had a good internal consistency with Cronbach’s alpha 0.91. There was a significant difference between the scores on the three subscales of the PANSS. Patients with schizophrenia scored significantly higher (p<.0001) than the control subjects on subscales for positive symptoms 20.01(SD=7.21) and 7.30(SD=1.38), negative symptoms 18.89(SD=8.88) and 7.37(SD=2.38) and general psychopathology 34.41 (SD=11.56) and 16.93 (SD=3.93), respectively. Factor analysis and ROC curve were carried out to further test the psychometrics of the scale. Conclusions: The Arabic version of PANSS is a reliable and valid tool to assess both positive and negative symptoms of patients with schizophrenia in a balanced manner. In addition to providing the Arab population with a standardized tool to monitor symptoms of schizophrenia, this version provides a gateway to compare the prevalence of positive and negative symptoms in the Arab world which can be compared to others done elsewhere.

Keywords: Arabic version, assessment, diagnosis, schizophrenia, validation

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Authors: Tomohiko Utsuki, Kyoka Sato

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In emergency medicine, it is recognized that brain resuscitation is very important for the reduction of mortality rate and neurological sequelae. Especially, the control of brain temperature (BT), intracranial pressure (ICP), and cerebral blood flow (CBF) are most required for stabilizing brain’s physiological state in the treatment for such as brain injury, stroke, and encephalopathy. However, the manual control of BT, ICP, and CBF frequently requires the decision and operation of medical staff, relevant to medication and the setting of therapeutic apparatus. Thus, the integration and the automation of the control of those is very effective for not only improving therapeutic effect but also reducing staff burden and medical cost. For realizing such integration and automation, a mathematical model of brain physiological state is necessary as the controlled object in simulations, because the performance test of a prototype of the control system using patients is not ethically allowed. A model of cerebral blood circulation has already been constructed, which is the most basic part of brain physiological state. Also, a migration model of extracellular fluid in brain has been constructed, however the condition that the total volume of intracranial cavity is almost changeless due to the hardness of cranial bone has not been considered in that model. Therefore, in this research, the dynamic migration model of extracellular fluid in brain was constructed on the consideration of the changelessness of intracranial cavity’s total volume. This model is connectable to the cerebral blood circulation model. The constructed model consists of fourteen compartments, twelve of which corresponds to perfused area of bilateral anterior, middle and posterior cerebral arteries, the others corresponds to cerebral ventricles and subarachnoid space. This model enable to calculate the migration of tissue fluid from capillaries to gray matter and white matter, the flow of tissue fluid between compartments, the production and absorption of cerebrospinal fluid at choroid plexus and arachnoid granulation, and the production of metabolic water. Further, the volume, the colloid concentration, and the tissue pressure of/in each compartment are also calculable by solving 40-dimensional non-linear simultaneous differential equations. In this research, the obtained model was analyzed for its validation under the four condition of a normal adult, an adult with higher cerebral capillary pressure, an adult with lower cerebral capillary pressure, and an adult with lower colloid concentration in cerebral capillary. In the result, calculated fluid flow, tissue volume, colloid concentration, and tissue pressure were all converged to suitable value for the set condition within 60 minutes at a maximum. Also, because these results were not conflict with prior knowledge, it is certain that the model can enough represent physiological state of brain under such limited conditions at least. One of next challenges is to integrate this model and the already constructed cerebral blood circulation model. This modification enable to simulate CBF and ICP more precisely due to calculating the effect of blood pressure change to extracellular fluid migration and that of ICP change to CBF.

Keywords: dynamic model, cerebral extracellular migration, brain resuscitation, automatic control

Procedia PDF Downloads 155

Authors: Romain Lestage, Marc Bourreau

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In this paper we analyze the interplay between access to the last-mile network and net neutrality in the market for Internet access. We consider two Internet Service Providers (ISPs), which act as platforms between Internet users and Content Providers (CPs). One of the ISPs is vertically integrated and provides access to its last-mile network to the other (non-integrated) ISP. We show that a lower access price increases the integrated ISP's incentives to charge CPs positive termination fees (i.e., to deviate from net neutrality), and decreases the non-integrated ISP's incentives to charge positive termination fees.

Keywords: net neutrality, access regulation, internet access, two-sided markets

Procedia PDF Downloads 373

Authors: Marcel Hechler

Abstract:

The purpose of this study is to understand the impact of entrepreneurs' receptiveness to opposing views on their entrepreneurial passion. Following a cross-cultural approach, we surveyed 1,228 entrepreneurs in seven developing and emerging countries. Besides a positive relationship between receptiveness to opposing views and harmonious passion for entrepreneurship, we found first evidence for a significant moderating effect of access to information reinforcing the positive main effect.

Keywords: harmonious passion, developing and emerging countries, self-determination theory, receptiveness to opposing views

Procedia PDF Downloads 209

Authors: I. Parkova, A. Vališevskis, A. Viļumsone

Abstract:

Nocturnal enuresis or bed-wetting is intermittent incontinence during sleep of children after age 5 that may precipitate wide range of behavioural and developmental problems. One of the non-pharmacological treatment methods is the use of a bed-wetting alarm system. In order to improve comfort conditions of nocturnal enuresis alarm system, modular moisture sensor should be replaced by a textile sensor. In this study behaviour and moisture detection speed of woven and sewn sensors were compared by analysing change in electrical resistance after solution (salt water) was dripped on sensor samples. Material of samples has different structure and yarn location, which affects solution detection rate. Sensor system circuit was designed and two sensor tests were performed: system activation test and false alarm test to determine the sensitivity of the system and activation threshold. Sewn sensor had better result in system’s activation test – faster reaction, but woven sensor had better result in system’s false alarm test – it was less sensitive to perspiration simulation. After experiments it was found that the optimum switching threshold is 3V in case of 5V input voltage, which provides protection against false alarms, for example – during intensive sweating.

Keywords: conductive yarns, moisture textile sensor, industry, material

Procedia PDF Downloads 246

Authors: M. Sadoughi, R. Ehsani

Abstract:

The aim of the present study is examining the relationship between conceptual organizational culture and the level of tolerance in employees of Islamic Azad University of Shahre Ghods. This research is a correlational and analytic-descriptive one. The samples included 144 individuals. A 24-item standard questionnaire of organizational culture by Cameron and Queen was used in this study. This questionnaire has six criteria and each criterion includes four items that each item indicates one cultural dimension. Reliability coefficient of this questionnaire was normed using Cronbach's alpha of 0.91. Also, the 25-item questionnaire of tolerance by Conor and Davidson was used. This questionnaire is in a five-degree Likert scale form. It has seven criteria and is designed to measure the power of coping with pressure and threat. It has the needed content reliability and its reliability coefficient is normed using Cronbach's alpha of 0.87. Data were analyzed using Pearson correlation coefficient and multivariable regression. The results showed among various dimensions of organizational culture, there is a positive significant relationship between three dimensions (family, adhocracy, bureaucracy) and tolerance, there is a negative significant relationship between dimension of market and tolerance and components of organizational culture have the power of prediction and explaining the tolerance. In this explanation, the component of family is the most effective and the best predictor of tolerance.

Keywords: adhocracy, bureaucracy, organizational culture, tolerance

Procedia PDF Downloads 447