Search results for: mortality rates

Authors: Zahra Tolou-Ghamari

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Objective: Health care associated with multiresistant pathogens is rising globally. It is well known that nosocomial infections increase hospital stay, morbidity, mortality, and disability. Therefore, the aim of this study was to define the occurrence of nosocomial infections in a tertiary hospital in Isfahan/Iran. Materials and Methods: The data were extracted from the official database of hospital nosocomial infections records that included 9152 vertical rows. For each patient, the reported infections were coded by number as UTI-SUTI; Code 55, VAE-PVAP; Code 56, BSI-LCBI Code 19, SSI-DIP; Code 14, and so on. For continuous variables, mean ± standard deviation and for categorical variables, the frequency was used. Results: The study population was 5542 patients, comprised of males (n=3282) and females (n=2260). With a minimum of 15 and a maximum of 99, the mean age in 5313 patients was 58.5 ± 19.1 years old. The highest reported nosocomial infections (n= 77%) were associated with the ages 30-80 years old. Sites of nosocomial infections in 87% were as: VAE-PVAP; 27.3%, VAE-IVAC; 7.7, UTI-SUTI; 29.5%, BSI-LCBI; 12.9%, SSI-DIP; 9.5% and other individual infection (13%) with the main pathogens klebsiella pneumonia, acinetobacter baumannii and staphylococcus. Conclusions: For an efficient surveillance system, adopting pharmacotherapy used antibiotics in terms of monotherapy or polypharmacy control policy, in addition to advanced infection control programs at regional and national levels in Iran recommended.

Keywords: infection, nosocomial, ventilator, blood stream, Isfahan, Iran

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Authors: M. N. Baig, F. N. Khan, M. Junaid

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Titanium alloys are widely employed in aerospace, medical, chemical, and marine applications. These alloys offer many advantages such as low specific weight, high strength to weight ratio, excellent corrosion resistance, high melting point and good fatigue behavior. These attractive properties make titanium alloys very unique and therefore they require special attention in all areas of processing, especially welding. In this work, 1.6 mm thick sheets of Ti-5Al-2,5Sn, an alpha titanium (α-Ti) alloy, were welded using electron beam (EBW) and laser beam (LBW) welding processes to achieve a full penetration Bead-on Plate (BoP) configuration. The weldments were studied using polarized optical microscope, SEM, EDS and XRD. Microhardness distribution across the weld zone and smooth and notch tensile strengths of the weldments were also recorded. Residual stresses using Hole-drill Strain Measurement (HDSM) method and deformation patterns of the weldments were measured for the purpose of comparison of the two welding processes. Fusion zone widths of both EBW and LBW weldments were found to be approximately equivalent owing to fairly similar high power densities of both the processes. Relatively less oxide content and consequently high joint quality were achieved in EBW weldment as compared to LBW due to vacuum environment and absence of any shielding gas. However, an increase in heat-affected zone width and partial ά-martensitic transformation infusion zone of EBW weldment were observed because of lesser cooling rates associated with EBW as compared with LBW. The microstructure infusion zone of EBW weldment comprised both acicular α and ά martensite within the prior β grains whereas complete ά martensitic transformation was observed within the fusion zone of LBW weldment. Hardness of the fusion zone in EBW weldment was found to be lower than the fusion zone of LBW weldment due to the observed microstructural differences. Notch tensile specimen of LBW exhibited higher load capacity, ductility, and absorbed energy as compared with EBW specimen due to the presence of high strength ά martensitic phase. It was observed that the sheet deformation and deformation angle in EBW weldment were more than LBW weldment due to relatively more heat retention in EBW which led to more thermal strains and hence higher deformations and deformation angle. The lowest residual stresses were found in LBW weldments which were tensile in nature. This was owing to high power density and higher cooling rates associated with LBW process. EBW weldment exhibited highest compressive residual stresses due to which the service life of EBW weldment is expected to improve.

Keywords: Laser and electron beam welding, Microstructure and mechanical properties, Residual stress and distortions, Titanium alloys

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Authors: Shirin Sarejloo

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Background: Electrophysiological-related manifestation of COVID-19 is a matter of debate in the literature nowadays. A wide spectrum of arrhythmias was observed among patients who have been infected with COVID-19. Objectives: This study discussed the prevalence of arrhythmias and conduction system disease in patients with COVID-19. Method: In this retrospective study, demographic and electrocardiographic data of 432 expired COVID-19 patients who had been admitted to Faghihi Hospital of Shiraz University of Medical Sciences from August2020 until December 2020 were reviewed. Results: Atrioventricular nodal block (AVB) was found in 40(9.3%) patients. Furthermore, 28(6.5%) of them suffered from the first degree of AVB, and 12(2.8%) suffered from complete heart block (CHB). Among 189 cases (59.0%), ST-T changes agreed with myocardial infarction or localized myocarditis. Findings of myocardial injury, including fragmented QRS and prolonged QTc were observed among 91 (21.1%) and 28 (6.5%), respectively. In victims of COVID-19, conduction disease was not related to any comorbidities. Fragmented QRS, axis deviation, presence of S1Q3T3, and poor R wave progression were significantly related to conduction system abnormalities in victims of COVID-19 (P-value > 0.05). Conclusion: Our findings can serve in future studies that aim to develop a risk stratification method for susceptible COVID-19 patients. The myocardial injury appears to role significantly in COVID-19 morbidity and mortality. Consequently, we recommend health policymakers consider separate catheterization laboratories that provide service only to COVID-19 patients.

Keywords: COVID-19, conduction system, ECG, atrioventricular block

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Authors: Tahir Imran Qureshi

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This study was aimed at finding out effects of potential influence of alkalinity on the treatment of landfill leachate through the growth of algae at varying dilution rates and toxicity potential. pH control proved to be an effective factor influencing on algal growth. With the use of algae Scenedesmus sp. for the treatment of leachate, a sharp increase in the growth of algae was recorded until pH 9. However, at pH 9.3 and 25 °C temperature, the growing trend of algae population showed a weakening tendency with the increase of total alkalinity in the leachate solution. Highest growth of algae was recorded in the leachate samples with alkalinity ranged at 1500-2500 mg CaCO3/L under neutral condition at pH 7 after 48 hours of cultivation time. Under the similar conditions, total nitrogen and total phosphorous in the leachate also reduced to 80% and 85%, respectively, however, no significant removal of COD was observed during the course of experiment.

Keywords: leachate treatment, microalgae, nutrient removal, ammonia toxicity

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Authors: Mateusz Bilski, Jakub Klas, Emilia Kowalczyk, Sylwia Koziej, Katarzyna Kulszo, Ludmiła Grzybowska- Szatkowska

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Background: Liver metastases are a common complication of primary solid tumors and sig-nificantly reduce patient survival. In the era of increasing diagnosis of oligometastatic disease and oligoprogression, methods of local treatment of metastases, i.e. MDT, are becoming more important. Implementation of such treatment can be considered for liver metastases, which are a common complication of primary solid tumors and significantly reduce patient survival. To date, the mainstay of treatment for oligometastatic disease has been surgical resection, but not all patients qualify for the procedure. As an alternative to surgical resection, radiotherapy techniques have become available, including stereotactic body radiation therapy (SBRT) or high-dose interstitial brachytherapy (iBT). iBT is an invasive method that emits very high doses of radiation from the inside of the tumor to the outside. This technique provides better tumor coverage than SBRT while having little impact on surrounding healthy tissue and elim-inates some concerns involving respiratory motion. Methods: We conducted a systematic re-view of the scientific literature on the use of brachytherapy in the treatment of liver metasta-ses from 2018 - 2023 using PubMed and ResearchGate browsers according to PRISMA rules. Results: From 111 articles, 18 publications containing information on 729 patients with liver metastases were selected. iBT has been shown to provide high rates of tumor control. Among 14 patients with 54 unresectable RCC liver metastases, after iBT LTC was 92.6% during a median follow-up of 10.2 months, PFS was 3.4 months. In analysis of 167 patients after treatment with a single fractional dose of 15-25 Gy with brachytherapy at 6- and 12-month follow-up, LRFS rates of 88,4-88.7% and 70.7 - 71,5%, PFS of 78.1 and 53.8%, and OS of 92.3 - 96.7% and 76,3% - 79.6%, respectively, were achieved. No serious complications were observed in all patients. Distant intrahepatic progression occurred later in patients with unre-sectable liver metastases after brachytherapy (PFS: 19.80 months) than in HCC patients (PFS: 13.50 months). A significant difference in LRFS between CRC patients (84.1% vs. 50.6%) and other histologies (92.4% vs. 92.4%) was noted, suggesting a higher treatment dose is necessary for CRC patients. The average target dose for metastatic colorectal cancer was 40 - 60 Gy (compared to 100 - 250 Gy for HCC). To better assess sensitivity to therapy and pre-dict side effects, it has been suggested that humoral mediators be evaluated. It was also shown that baseline levels of TNF-α, MCP-1 and VEGF, as well as NGF and CX3CL corre-lated with both tumor volume and radiation-induced liver damage, one of the most serious complications of iBT, indicating their potential role as biomarkers of therapy outcome. Con-clusions: The use of brachytherapy methods in the treatment of liver metastases of various cancers appears to be an interesting and relatively safe therapeutic method alternative to sur-gery. An important challenge remains the selection of an appropriate brachytherapy method and radiation dose for the corresponding initial tumor type from which the metastasis origi-nated.

Keywords: liver metastases, brachytherapy, CT-HDRBT, iBT

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Authors: I. M. Sakr, Ali M. Abdelsalam, K. A. Ibrahim, W. A. El-Askary

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This paper presents an experimental study for hydrogen production using alkaline water electrolysis operated by solar energy. Two methods are used and compared for separation between the cathode and anode, which are acrylic separator and polymeric membrane. Further, the effects of electrolyte concentration, solar insolation, and space between the pair of electrodes on the amount of hydrogen produced and consequently on the overall electrolysis efficiency are investigated. It is found that the rate of hydrogen production increases using the polymeric membrane installed between the electrodes. The experimental results show also that, the performance of alkaline water electrolysis unit is dominated by the electrolyte concentration and the gap between the electrodes. Smaller gaps between the pair of electrodes are demonstrated to produce higher rates of hydrogen with higher system efficiency.

Keywords: hydrogen production, water electrolysis, solar energy, concentration

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Authors: Öykü Barutçu, Mehmet Özgür Kuzdan

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Aim: Laparoscopy is very risky in patients undergoing, multiple open abdominal surgeries. The aim of this study, to define a safe method for the first trocar placement in children with a history of multiple open abdominal surgeries. Methods: Children who underwent laparoscopic surgery between March 2019 and April 2020 with a history of three or more open abdominal surgeries were included in the retrospective study. Patient information was obtained from the hospital automation system. Ultrasonography was used to determine the location of adhesions preoperatively. The first trocar was placed according to ultrasonography findings, using the Hasson technique to create an air pocket with finger dissection. The patient's preoperative, perioperative, and postoperative findings are reported. Results: A total of 10 patients were included in the study. The median number of operations before laparoscopy was three. The most common site for the first trocar entry was Palmer's point (40%). No mortality or morbidity was observed amongst any patients. The average number of adhesions detected by USG and observed on laparoscopy were significantly positively correlated. Conclusion: In children with a history of multiple abdominal surgeries, abdominal wall ultrasonography for visualization of adhesions and finger dissection for the formation of an air pocket appears to be a safe method for the first trocar insertion.

Keywords: abdominal wall, child, laparoscopy, ultrasonography

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Authors: Maedeh Gharazi

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Adults with age 50 and older will include more than 70% of the diabetic populace by the year 2025. More established patients with diabetes are more inclined to have concurrent ceaseless conditions like hypertension, dyslipidemia, and cardiovascular sickness that may affect their nutritious necessities. The issue of achievement and support of an ideal body weight in elderly diabetic persons may not be as direct as in other age gatherings, and the risk-benefit ratio may be diverse too. Albeit expanded predominance of overweight and weight in the elderly adds to insulin resistance and hyperglycemia, more seasoned tenants of long haul care offices who experience the ill effects of diabetes have a tendency to be underweight. Both may mean insufficient nutritional status and lead to expanded grimness and mortality. The attendant problems of appetite changes, palatability of food, dietary restrictions, loneliness, and depression may influence the sort and amount of food devoured by elderly persons. Organized screening devices may recognize nutrition related issues that warrant proof based mediations. Despite the fact that glucose control and health concerns are essential calculates diet change in the more established populace, different contemplations incorporate personal satisfaction and individual inclinations. Redoing of nutritious rules to the needs of the more seasoned diabetic patient bodes well.

Keywords: diabetes, nutritious necessities, insulin resistance, glucose control

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Authors: Assamen Ayalew Ejigu, Liang-Chiun Chao

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In recent semiconductor and nanotechnology, quality material synthesis, proper characterizations, and productions are the big challenges. As cuprous oxide (Cu2O) is a promising semiconductor material for photovoltaic (PV) and other optoelectronic applications, this study was aimed at to grow and characterize high quality Cu2O nanorods for the improvement of the efficiencies of thin film solar cells and other potential applications. In this study, well-structured cuprous oxide (Cu2O) nanorods were successfully fabricated using IBSD method in which the Cu2O samples were grown on silicon substrates with a substrate temperature of 400°C in an IBSD chamber of pressure of 4.5 x 10-5 torr using copper as a target material. Argon, and oxygen gases were used as a sputter and reactive gases, respectively. The characterization of the Cu2O nanorods (NRs) were done in comparison with Cu2O thin film (TF) deposited with the same method but with different Ar:O2 flow rates. With Ar:O2 ratio of 9:1 single phase pure polycrystalline Cu2O NRs with diameter of ~500 nm and length of ~4.5 µm were grow. Increasing the oxygen flow rates, pure single phase polycrystalline Cu2O thin film (TF) was found at Ar:O2 ratio of 6:1. The field emission electron microscope (FE-SEM) measurements showed that both samples have smooth morphologies. X-ray diffraction and Rama scattering measurements reveals the presence of single phase Cu2O in both samples. The differences in Raman scattering and photoluminescence (PL) bands of the two samples were also investigated and the results showed us there are differences in intensities, in number of bands and in band positions. Raman characterization shows that the Cu2O NRs sample has pronounced Raman band intensities, higher numbers of Raman bands than the Cu2O TF which has only one second overtone Raman signal at 2 (217 cm-1). The temperature dependent photoluminescence (PL) spectra measurements, showed that the defect luminescent band centered at 720 nm (1.72 eV) is the dominant one for the Cu2O NRs and the 640 nm (1.937 eV) band was the only PL band observed from the Cu2O TF. The difference in optical and structural properties of the samples comes from the oxygen flow rate change in the process window of the samples deposition. This gave us a roadmap for further investigation of the electrical and other optical properties for the tunable fabrication of the Cu2O nano/micro structured sample for the improvement of the efficiencies of thin film solar cells in addition to other potential applications. Finally, the novel morphologies, excellent structural and optical properties seen exhibits the grown Cu2O NRs sample has enough quality to be used in further research of the nano/micro structured semiconductor materials.

Keywords: defect levels, nanorods, photoluminescence, Raman modes

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Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes

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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.

Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation

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Authors: Jin Sung Kim, Hoon Huh

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The material properties of OFHC copper film was investigated with the High-Speed Material Micro Testing Machine (HSMMTM) at the high strain rates. The rate-dependent stress-strain curves from the experiment and the Johnson-Cook curve fitting showed large discrepancies as the plastic strain increases since the constitutive model implies no rate-dependent strain hardening effect. A new constitutive model was proposed in consideration of rate-dependent strain hardening effect. The strain rate hardening term in the new constitutive model consists of the strain rate sensitivity coefficients of the yield strength and strain hardening.

Keywords: rate dependent material properties, dynamic constitutive model, OFHC copper film, strain rate

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Authors: Shital Patil, Surendra Bhosale

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Cardiac diseases are the leading causes of mortality and morbidity in the world, from recent few decades accounting for a large number of deaths have emerged as the most life-threatening disorder globally. Machine learning and Artificial intelligence have been playing key role in predicting the heart diseases. A relevant set of feature can be very helpful in predicting the disease accurately. In this study, we proposed a comparative analysis of 4 different features selection methods and evaluated their performance with both raw (Unbalanced dataset) and sampled (Balanced) dataset. The publicly available Z-Alizadeh Sani dataset have been used for this study. Four feature selection methods: Data Analysis, minimum Redundancy maximum Relevance (mRMR), Recursive Feature Elimination (RFE), Chi-squared are used in this study. These methods are tested with 8 different classification models to get the best accuracy possible. Using balanced and unbalanced dataset, the study shows promising results in terms of various performance metrics in accurately predicting heart disease. Experimental results obtained by the proposed method with the raw data obtains maximum AUC of 100%, maximum F1 score of 94%, maximum Recall of 98%, maximum Precision of 93%. While with the balanced dataset obtained results are, maximum AUC of 100%, F1-score 95%, maximum Recall of 95%, maximum Precision of 97%.

Keywords: cardio vascular diseases, machine learning, feature selection, SMOTE

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Authors: M. Pappa, C. Efstathiou, G. Livanos, P. Xidas, D. Vakondios, E. Maravelakis, M. Zervakis, A. Antoniadis

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The choice of cutting tools in manufacturing processes is an essential parameter on which the required manufacturing time, the consumed energy and the cost effort all depend. If the number of tool changing times could be minimized or even eliminated by using a single convex tool providing multiple profiles, then a significant benefit of time and energy saving, as well as tool cost, would be achieved. A typical machine contains a variety of tools in order to deal with different curvatures and material removal rates. In order to minimize the required cutting tool changes, Actively Deformable micro-Cutters (ADmC) will be developed. The design of the Actively Deformable micro-Cutters will be based on the same cutting technique and mounting method as that in typical cutters.

Keywords: deformable cutters, cutting tool, milling, turning, manufacturing

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Authors: Nabil Majd Alawi, Gia Hung Pham, Ahmed Barifcani

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Dry reforming of methane that converts two greenhouses gases (CH₄ and CO₂) to synthesis gas (a mixture of H₂ and CO) was studied in a commercial bench scale microwave (MW) plasma reactor system at atmospheric pressure. The CO₂, CH₄ and N₂ conversions; H₂, CO selectivities and yields, and syngas ratio (H₂/CO) were investigated in a wide range of total feed flow rate (0.45 – 2.1 L/min), MW power (700 – 1200 watt) and CO₂/CH₄ molar ratio (2 – 5). At the feed flow rates of CH₄, CO₂ and N₂ of 0.2, 0.4 and 1.5 L/min respectively, and the MWs input power of 700 W, the highest conversions of CH₄ and CO₂, selectivity and yield of H₂, CO and H₂/CO ratio of 79.35%, 44.82%, 50.12, 58.42, 39.77%, 32.89%, and 0.86, respectively, were achieved. The results of this work show that the product ratio increases slightly with the increasing total feed flow rate, but it decreases significantly with the increasing MW power and feeds CO₂/CH₄ ratio.

Keywords: dry reforming of methane, microwave discharge, plasma technology, synthesis gas production

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Authors: Craig Jantzen, Tim Abram, Dirk Engelberg, Hugues Lambert, Daniel Cooper

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Molten salts are of high interest for use as coolants in nuclear reactors due to favourable high temperature and thermodynamic properties. The corrosive behaviour of molten salts however pose a materials integrity challenge. Three Ni / Ni-Fe based and two Mo based alloys have been exposed to molten eutectics (LiCl-KCl at 59.5:40.5 mol% and KCl-MgCl2 at 68:32 mol%) at 600°C and 800°C for durations up to 500hrs. Corrosion was observed to preferentially attack alloy constituents in order of their reactivity, with chromium the most vulnerable and depleted element. Alloy weight-loss per unit area was calculated to give linear corrosion rates, discounting any initial rapid corrosion of impurities. Further analysis was carried out using ICP-MS, SEM and EDX techniques to give a more detailed view of the corrosion mechanisms.

Keywords: molten salt, salt, corrosion, high temperature, licl, KCL, MgCl, molybdenum, nickel, superalloys

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Authors: Salma Aboussalam, Karima Khalil, Khalid Elkalay

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The Ecopath model was utilized to evaluate the trophic structure, function, and current status of the Moroccan Mediterranean Sea ecosystem. The model incorporated 31 functional groups, including fish species, invertebrates, primary producers, and detritus. Through the analysis of trophic interactions among these groups, an average trophic transfer efficiency of 23% was found. The findings revealed that the ecosystem produced more energy than it consumed, with high respiration and consumption rates. Indicators of stability and development were low, indicating that the ecosystem is disturbed by a linear trophic structure. Additionally, keystone species were identified through the use of the keystone index and mixed trophic impact analysis, with demersal invertebrates, zooplankton, and cephalopods found to have a significant impact on other groups.

Keywords: ecopath, food web, trophic flux, Moroccan Mediterranean Sea

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Authors: Richard E. Miller

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12.7-mm thick plates of 6061-T6511 aluminum alloy and high hardness steel (528 HV) were successfully joined by a friction stir bonding process using a tungsten-rhenium stir tool. Process parameter variation experiments, which included tool design geometry, plunge and traverse rates, tool offset, spindle tilt, and rotation speed, were conducted to develop a parameter set which yielded a defect free joint. Laboratory tensile tests exhibited yield stresses which exceed the strengths of comparable AA6061-to-AA6061 fusion and friction stir weld joints. Scanning electron microscopy and energy dispersive X-ray spectroscopy analysis also show atomic diffusion at the material interface region.

Keywords: dissimilar materials, friction stir, welding, materials science

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Authors: Pei Yi Lin

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Objective: The objective of this study is to use machine learning methods to build an early prediction classifier model for acute delirium to improve the quality of medical care for intensive care patients. Background: Delirium is a common acute and sudden disturbance of consciousness in critically ill patients. After the occurrence, it is easy to prolong the length of hospital stay and increase medical costs and mortality. In 2021, the incidence of delirium in the intensive care unit of internal medicine was as high as 59.78%, which indirectly prolonged the average length of hospital stay by 8.28 days, and the mortality rate is about 2.22% in the past three years. Therefore, it is expected to build a delirium prediction classifier through big data analysis and machine learning methods to detect delirium early. Method: This study is a retrospective study, using the artificial intelligence big data database to extract the characteristic factors related to delirium in intensive care unit patients and let the machine learn. The study included patients aged over 20 years old who were admitted to the intensive care unit between May 1, 2022, and December 31, 2022, excluding GCS assessment <4 points, admission to ICU for less than 24 hours, and CAM-ICU evaluation. The CAMICU delirium assessment results every 8 hours within 30 days of hospitalization are regarded as an event, and the cumulative data from ICU admission to the prediction time point are extracted to predict the possibility of delirium occurring in the next 8 hours, and collect a total of 63,754 research case data, extract 12 feature selections to train the model, including age, sex, average ICU stay hours, visual and auditory abnormalities, RASS assessment score, APACHE-II Score score, number of invasive catheters indwelling, restraint and sedative and hypnotic drugs. Through feature data cleaning, processing and KNN interpolation method supplementation, a total of 54595 research case events were extracted to provide machine learning model analysis, using the research events from May 01 to November 30, 2022, as the model training data, 80% of which is the training set for model training, and 20% for the internal verification of the verification set, and then from December 01 to December 2022 The CU research event on the 31st is an external verification set data, and finally the model inference and performance evaluation are performed, and then the model has trained again by adjusting the model parameters. Results: In this study, XG Boost, Random Forest, Logistic Regression, and Decision Tree were used to analyze and compare four machine learning models. The average accuracy rate of internal verification was highest in Random Forest (AUC=0.86), and the average accuracy rate of external verification was in Random Forest and XG Boost was the highest, AUC was 0.86, and the average accuracy of cross-validation was the highest in Random Forest (ACC=0.77). Conclusion: Clinically, medical staff usually conduct CAM-ICU assessments at the bedside of critically ill patients in clinical practice, but there is a lack of machine learning classification methods to assist ICU patients in real-time assessment, resulting in the inability to provide more objective and continuous monitoring data to assist Clinical staff can more accurately identify and predict the occurrence of delirium in patients. It is hoped that the development and construction of predictive models through machine learning can predict delirium early and immediately, make clinical decisions at the best time, and cooperate with PADIS delirium care measures to provide individualized non-drug interventional care measures to maintain patient safety, and then Improve the quality of care.

Keywords: critically ill patients, machine learning methods, delirium prediction, classifier model

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Authors: Hameed B. Mahood, Ali Sh. Baqir

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Vaporization of a single n-pentane drop in a direct contact with another flowing immiscible liquid (warm water) has been experimentally investigated. The experiments were carried out utilising a cylindrical Perspex tube of diameter 10 cm and height and 150 cm. Saturated liquid n-pentane and warm water at 45oC were used as the dispersed and continuous phases, respectively. Photron FASTCAM SA 1.1high speed camera (75,000f/s) with software V. 321 was implemented during the experiments. Five different continuous phase flow rates (warm water) (10, 20, 30, 40, and 46 L⁄h) were used in the study. The results indicated that the increase of the continuous phase (warm water) flow rate results in increasing of the drop/bubble diameter.

Keywords: drop evaporation, direct contact heat transfer, drop/bubble growth, experimental technique

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Authors: Patrícia T. Souza, Marina Ansolin, Eduardo A. C. Batista, Antonio J. A. Meirelles, Matthieu Tubino

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Lipid oxidation is a major cause of the deterioration of the quality of the biodiesel, because the waste generated damages the engines. Among the main undesirable effects are the increase of viscosity and acidity, leading to the formation of insoluble gums and sediments which cause the blockage of fuel filters. The auto-oxidation is defined as the spontaneous reaction of atmospheric oxygen with lipids. Unsaturated fatty acids are usually the components affected by such reactions. They are present as free fatty acids, fatty esters and glycerides. To determine the oxidative stability of biodiesels, through the induction period, IP, the Rancimat method is used, which allows continuous monitoring of the induced oxidation process of the samples. During the oxidation of the lipids, volatile organic acids are produced as byproducts, in addition, other byproducts, including alcohols and carbonyl compounds, may be further oxidized to carboxylic acids. By the methodology developed in this work using ion chromatography, IC, analyzing the water contained in the conductimetric vessel, were quantified organic anions of carboxylic acids in samples subjected to oxidation induced by Rancimat. The optimized chromatographic conditions were: eluent water:acetone (80:20 v/v) with 0.5 mM sulfuric acid; flow rate 0.4 mL min-1; injection volume 20 µL; eluent suppressor 20 mM LiCl; analytical curve from 1 to 400 ppm. The samples studied were methyl biodiesel from soybean oil and unsaturated fatty acids standards: oleic, linoleic and linolenic. The induced oxidation kinetics curves were constructed by analyzing the water contained in the conductimetric vessels which were removed, each one, from the Rancimat apparatus at prefixed intervals of time. About 3 g of sample were used under the conditions of 110 °C and air flow rate of 10 L h-1. The water of each conductimetric Rancimat measuring vessel, where the volatile compounds were collected, was filtered through a 0.45 µm filter and analyzed by IC. Through the kinetic data of the formation of the organic anions of carboxylic acids, the formation rates of the same were calculated. The observed order of the rates of formation of the anions was: formate >>> acetate > hexanoate > valerate for the oleic acid; formate > hexanoate > acetate > valerate for the linoleic acid; formate >>> valerate > acetate > propionate > butyrate for the linolenic acid. It is possible to suppose that propionate and butyrate are obtained mainly from linolenic acid and that hexanoate is originated from oleic and linoleic acid. For the methyl biodiesel the order of formation of anions was: formate >>> acetate > valerate > hexanoate > propionate. According to the total rate of formation these anions produced during the induced degradation of the fatty acids can be assigned the order of reactivity: linolenic acid > linoleic acid >>> oleic acid.

Keywords: anions of carboxylic acids, biodiesel, ion chromatography, oxidation

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Authors: Mahmoud M. S. Albattah

Abstract:

Urbanization results in the expansion of administrative boundaries, mainly at the periphery, ultimately leading to changes in landcover. Agricultural land, naturally vegetated land, and other land types are converted into residential areas with a high density of constructs, such as transportation systems and housing. In urban regions of rapid growth and change, urban planners need regular information on up to date ground change. Amman (the capital of Jordan) is growing at unprecedented rates, creating extensive urban landscapes. Planners interact with these changes without having a global view of their impact. The use of aerial photographs and satellite images data combined with topographic information and field survey could provide effective information to develop urban change and growth inventory which could be explored towards producing a very important signature for the built-up area changes.

Keywords: highway design, satellite technologies, remote sensing, GIS, image segmentation, classification

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Authors: Alireza Fallahfard, Ludwig Vinches, Stephane Halle

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In the workplace, the exposure level of airborne contaminants should be evaluated due to health and safety issues. It can be done by numerical models or experimental measurements, but the numerical approach can be useful when it is challenging to perform experiments. One of the simplest models is the well-mixed room (WMR) model, which has shown its usefulness to predict inhalation exposure in many situations. However, since the WMR is limited to gases and vapors, it cannot be used to predict exposure to aerosols. The main objective is to modify the WMR model to expand its application to exposure scenarios involving aerosols. To reach this objective, the standard WMR model has been modified to consider the deposition of particles by gravitational settling and Brownian and turbulent deposition. Three deposition models were implemented in the model. The time-dependent concentrations of airborne particles predicted by the model were compared to experimental results conducted in a 0.512 m3 chamber. Polystyrene particles of 1, 2, and 3 µm in aerodynamic diameter were generated with a nebulizer under two air changes per hour (ACH). The well-mixed condition and chamber ACH were determined by the tracer gas decay method. The mean friction velocity on the chamber surfaces as one of the input variables for the deposition models was determined by computational fluid dynamics (CFD) simulation. For the experimental procedure, the particles were generated until reaching the steady-state condition (emission period). Then generation stopped, and concentration measurements continued until reaching the background concentration (decay period). The results of the tracer gas decay tests revealed that the ACHs of the chamber were: 1.4 and 3.0, and the well-mixed condition was achieved. The CFD results showed the average mean friction velocity and their standard deviations for the lowest and highest ACH were (8.87 ± 0.36) ×10-2 m/s and (8.88 ± 0.38) ×10-2 m/s, respectively. The numerical results indicated the difference between the predicted deposition rates by the three deposition models was less than 2%. The experimental and numerical aerosol concentrations were compared in the emission period and decay period. In both periods, the prediction accuracy of the modified model improved in comparison with the classic WMR model. However, there is still a difference between the actual value and the predicted value. In the emission period, the modified WMR results closely follow the experimental data. However, the model significantly overestimates the experimental results during the decay period. This finding is mainly due to an underestimation of the deposition rate in the model and uncertainty related to measurement devices and particle size distribution. Comparing the experimental and numerical deposition rates revealed that the actual particle deposition rate is significant, but the deposition mechanisms considered in the model were ten times lower than the experimental value. Thus, particle deposition was significant and will affect the airborne concentration in occupational settings, and it should be considered in the airborne exposure prediction model. The role of other removal mechanisms should be investigated.

Keywords: aerosol, CFD, exposure assessment, occupational settings, well-mixed room model, zonal model

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Authors: Inayatullah Khan, Afzal Khan, Hamzullah Khan, Afzal Khan

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Objectives: The objective of this study was to compare different statistical variables for vaccinated and unvaccinated children in measles cases. Material and Methods: This cross sectional comparative study was conducted at Isolation ward, Department of Paediatrics, Lady Reading Hospital (LRH), Peshawar, from April 2012 to March 2013. A total of 566 admitted cases of measles were enrolled. Data regarding age, sex, address, vaccination status, measles contact, hospital stay and outcome was collected and recorded on a proforma. History of measles vaccination was ascertained either by checking the vaccination cards or on parental recall. Result: In 566 cases of measles, 211(39%) were vaccinated and 345 (61%) were unvaccinated. Three hundred and ten (54.80%) patients were males and 256 (45.20%) were females with a male to female ratio of 1.2:1.The age range was from 1 year to 14 years with mean age with SD of 3.2 +2 years. Majority (371, 65.5%) of the patients were 1-3 years old. Mean hospital stay was 3.08 days with a range of 1-10 days and a standard deviation of ± 1.15. History of measles contact was present in 393 (69.4%) cases. Fourty eight patients were expired with a mortality rate of 8.5%. Conclusion: Majority of the children in Khyber Pukhtunkhwa are unvaccinated and unprotected against measles. Among vaccinated children, 39% of children attracted measles which indicate measles vaccine failure. This figure is clearly higher than that accepted for measles vaccine (2-10%).

Keywords: measles, vaccination, immunity, population

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Authors: Sadia Munir

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Preeclampsia is the contributor to the worldwide maternal mortality of approximately 100,000 deaths a year. It complicates about 10% of all pregnancies and is the first cause of maternal admission to intensive care units. Predicting preeclampsia is a major challenge in obstetrics. More importantly, no major progress has been achieved in the treatment of preeclampsia. As placenta is the main cause of the disease, the only way to treat the disease is to extract placental and deliver the baby. In developed countries, the cost of an average case of preeclampsia is estimated at £9000. Interestingly, preeclampsia may have an impact on the health of mother or infant, beyond the pregnancy. We performed a systematic search of PubMed including the combination of terms such as preeclampsia, biomarkers, treatment, hypoxia, inflammation, oxidative stress, vascular endothelial growth factor A, activin A, inhibin A, placental growth factor, transforming growth factor β-1, Nodal, placenta, trophoblast cells, microRNAs. In this review, we have summarized current knowledge on the identification of potential biomarkers for the diagnosis of preeclampsia. Although these studies show promising data in early diagnosis of preeclampsia, the current value of these factors as biomarkers, for the precise prediction of preeclampsia, has its limitation. Therefore, future studies need to be done to support some of the very promising and interesting data to develop affordable and widely available tests for early detection and treatment of preeclampsia.

Keywords: activin, biomarkers, growth factors, miroRNA

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Authors: Zuhrotun Ulya, Muchammad Syamsulhadi, Debree Septiawan

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Patients with bipolar disorder are three times more likely to suffer cardiovascular disorders than the general population, which will influence their level of morbidity and rate of mortality. Bipolar disorder also affects the pulmonary system. The choice of long term-monotherapy and other combinative therapies have clinical impacts on patients. This study investigates the case of a woman who has been suffering from bipolar disorder for 16 years, and who has a history of Steven Johnson Syndrome. At present she is suffering also from cardiovascular and pulmonary disorder. An analysis of the results of this study suggests that there is a relationship between cardiovascular disorder, drug therapies, Steven Johnson Syndrome and mood stabilizer obtained from the PubMed, Cochrane, Medline, and ProQuest (publications between 2005 and 2015). Combination therapy with mood stabilizer is recommended for patients who do not have side effect histories from these drugs. The replacement drugs and combinations may be applied, especially for those with bipolar disorders, and the combination between atypical antipsychotic groups and mood stabilizers is often made. Clinicians, however, should be careful with the patients’ physical and metabolic changes, especially those who have experienced long-term therapy and who showed a history of Steven Johnson Syndrome (for which clinicians probably prescribed one type of medicine).

Keywords: cardiopulmonary disease, bipolar disorder, SJS, therapy

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Authors: Muhammad Naeem, Abdulrahman A. Al-Rabiah

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Technical mixture of C4 containing 1-butene and n-butane are very close to each other with respect to their boiling points i.e. -6.3°C for 1-butene and -1°C for n-butane. Extractive distillation process is used for the separation of 1-butene from the existing mixture of C4. The solvent is the essential of extractive distillation, and an appropriate solvent shows an important role in the process economy of extractive distillation. Aspen Plus has been applied for the separation of these hydrocarbons as a simulator; moreover NRTL activity coefficient model was used in the simulation. This model indicated that the material balances in this separation process were accurate for several solvent flow rates. Mixture of acetonitrile and water used as a solvent and 99 % pure 1-butene was separated. This simulation proposed the ratio of the feed to solvent as 1 : 7.9 and 15 plates for the solvent recovery column, previously feed to solvent ratio was more than this and the proposed plates were 30, which can economize the separation process.

Keywords: extractive distillation, 1-butene, Aspen Plus, ACN solvent

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Authors: Jean Akiana, Digne Merveille Nganga Bouanga, Nardiouf Sjelin Nsana, Wilfrid Sapromet Ngoubili, Chyvanelle Ndous Akiridzo, Vishnou Reize Ampiri, Henri-Joseph Parra, Florence Fenollar, Didier Raoult, Oleg Mediannikov, Cheikh Sadhibou Sokhna

Abstract:

Schistosoma haematobium schistosomiasis is an endemic disease in which the level of human exposure, incidence, and fatality attributed to it remains, unfortunately, high worldwide. The erection of hydroelectric infrastructures constitute a major factor in the emergence of this disease. In the context of the Republic of the Congo, which considers industrialization and modernization as two essential pillars of development, building the hydroelectric dams of Liouesso (19 Mw) and the feasibility studies of the dams of Chollet (600MW) in the Sangha, of Sounda (1000MW) in Kouilou and Kouembali (150MW) on Lefini is necessary to increase the country's energy capacities. Likewise, the urbanization of former endemic localities should take into account the maintenance of contamination points. However, health impact studies on schistosomiasis epidemiology in general and urinary bilharzia, in particular, have never been carried out in these areas, neither before nor after the erection of those dams. Participants benefited from an investigative questionnaire, urinalysis both by dipstick and urine filtrate examined under a microscope. Assessment of the genetic diversity of schistosoma species populations was considered as well as PCR analysis to confirm the test strip and microscopy tests. 405 participants were registered in five localities. The sampling was made up of a balanced population in terms of male/female ratio, which is around 1. The prevalence rate was 45% (55/123) in Nkayi, 10.40% (11/106) in Loudima, 1 case in Mbomo (West Cuvette), which would probably be imported, zero in Liouesso and Kabo. The highest oviuria (number of eggs per volume of urine) is 150 S. haematobium eggs/10ml in Nkayi, apart from the case of imported Mbomo, imported from Gabon, which has 160 S. haematobium eggs/10ml. The lowest oviuria was 2 S. haematobium eggs/10ml. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program.

Keywords: Bilharzia, Schistosoma haematobium, oviuria, urbanization, Congo

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Authors: B. Yaman, G. Acikbas, N. Calis Acikbas

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Epoxy based materials have advantages in tribological applications due to their unique properties such as light weight, self-lubrication capacity and wear resistance. On the other hand, their usage is often limited by their low load bearing capacity and low thermal conductivity values. In this study, it is aimed to improve tribological and also mechanical properties of epoxy by reinforcing with ceramic based porcelain waste. It is well-known that the reuse or recycling of waste materials leads to reduction in production costs, ease of manufacturing, saving energy, etc. From this perspective, epoxy and epoxy matrix composites containing 60wt% porcelain waste with different particle size in the range of below 90µm and 150-250µm were fabricated, and the effect of filler particle size on the mechanical and tribological properties was investigated. The microstructural characterization was carried out by scanning electron microscopy (SEM), and phase analysis was determined by X-ray diffraction (XRD). The Archimedes principle was used to measure the density and porosity of the samples. The hardness values were measured using Shore-D hardness, and bending tests were performed. Microstructural investigations indicated that porcelain particles were homogeneously distributed and no agglomerations were encountered in the epoxy resin. Mechanical test results showed that the hardness and bending strength were increased with increasing particle size related to low porosity content and well embedding to the matrix. Tribological behavior of these composites was evaluated in terms of friction, wear rates and wear mechanisms by ball-on-disk contact with dry and rotational sliding at room temperature against WC ball with a diameter of 3mm. Wear tests were carried out at room temperature (23–25°C) with a humidity of 40 ± 5% under dry-sliding conditions. The contact radius of cycles was set to 5 mm at linear speed of 30 cm/s for the geometry used in this study. In all the experiments, 3N of constant test load was applied at a frequency of 8 Hz and prolonged to 400m wear distance. The friction coefficient of samples was recorded online by the variation in the tangential force. The steady-state CoFs were changed in between 0,29-0,32. The dimensions of the wear tracks (depth and width) were measured as two-dimensional profiles by a stylus profilometer. The wear volumes were calculated by integrating these 2D surface areas over the diameter. Specific wear rates were computed by dividing the wear volume by the applied load and sliding distance. According to the experimental results, the use of porcelain waste in the fabrication of epoxy resin composites can be suggested to be potential materials due to allowing improved mechanical and tribological properties and also providing reduction in production cost.

Keywords: epoxy composites, mechanical properties, porcelain waste, tribological properties

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Authors: Pooja Rawat, Rakhi Tyagi

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Globally, almost 3 billion people rely on biomass (wood, charcoal, dung and crop residues) and coal as their primary source of domestic energy. Cooking and heating with solid fuels on open fire give rise to major pollutants. Women are primarily affected by these pollutants as they spend most of their time in the house. The WHO World Health Report 2002 estimates that indoor air pollution (IAP) is responsible for 2.7% of the loss of disability adjusted life years (DALYs) worldwide and 3.7% in high mortality developing countries. Indoor air pollution has the potential to not only impact health, but also impact the general economic well-being of the household. Exposure to high level of household pollution lead to acute and chronic respiratory conditions (e.g.: pneumonia, chronic obstructive pulmonary disease, lung cancer and cataract). There has been many strategies for reducing IAP like subsidize cleaner fuel technologies, for example use of kerosene rather than traditional biomass fuels. Another example is development, promotion of 'improved cooking stoves'. India, likely ranks second- distributing over 12 million improved stoves in the first seven years of a national program to develop. IAP should be reduced by understanding the welfare effects of reducing IAP within households and to understanding the most cost effective way to reduce it.

Keywords: open fire, indoor pollution, lung diseases, indoor air pollution

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Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

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Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

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