Search results for: early discharge

Authors: Davide Palma, Dimitra Papagiannaki, Marco Minella, Manuel Lai, Rita Binetti, Claire Richard

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Modern analytical technologies allow us to detect water contaminants at trace and ultra-trace concentrations highlighting how a large number of organic compounds is not efficiently abated by most wastewater treatment facilities relying on biological processes; we usually refer to these micropollutants as contaminants of emerging concern (CECs). The availability of reliable end effective technologies, able to guarantee the high standards of water quality demanded by legislators worldwide, has therefore become a primary need. In this context, water plasma stands out among developing technologies as it is extremely effective in the abatement of numerous classes of pollutants, cost-effective, and environmentally friendly. In this work, a custom-built non-thermal pulsed plasma discharge generator was used to abate the concentration of selected CECs in the water samples. Samples were treated in a 50 mL pyrex reactor using two different types of plasma discharge occurring at the surface of the treated solution or, underwater, working with positive polarity. The distance between the tips of the electrodes determined where the discharge was formed: underwater when the distance was < 2mm, at the water surface when the distance was > 2 mm. Peak voltage was in the 100-130kV range with typical current values of 20-40 A. The duration of the pulse was 500 ns, and the frequency of discharge could be manually set between 5 and 45 Hz. Treatment of 100 µM diclofenac solution in MilliQ water, with a pulse frequency of 17Hz, revealed that surface discharge was more efficient in the degradation of diclofenac that was no longer detectable after 6 minutes of treatment. Over 30 minutes were required to obtain the same results with underwater discharge. These results are justified by the higher rate of H₂O₂ formation (21.80 µmolL⁻¹min⁻¹ for surface discharge against 1.20 µmolL⁻¹min⁻¹ for underwater discharge), larger discharge volume and UV light emission, high rate of ozone and NOx production (up to 800 and 1400 ppb respectively) observed when working with surface discharge. Then, the surface discharge was used for the treatment of the three selected perfluoroalkyl compounds, namely, perfluorooctanoic acid (PFOA), perfluorohexanoic acid (PFHxA), and pefluorooctanesulfonic acid (PFOS) both individually and in mixture, in ultrapure and groundwater matrices with initial concentration of 1 ppb. In both matrices, PFOS exhibited the best degradation reaching complete removal after 30 min of treatment (degradation rate 0.107 min⁻¹ in ultrapure water and 0.0633 min⁻¹ in groundwater), while the degradation rate of PFOA and PFHxA was slower of around 65% and 80%, respectively. Total nitrogen (TN) measurements revealed levels up to 45 mgL⁻¹h⁻¹ in water samples treated with surface discharge, while, in analogous samples treated with underwater discharge, TN increase was 5 to 10 times lower. These results can be explained by the significant NOx concentrations (over 1400 ppb) measured above functioning reactor operating with superficial discharge; rapid NOx hydrolysis led to nitrates accumulation in the solution explaining the observed evolution of TN values. Ionic chromatography measures confirmed that the vast majority of TN was under the form of nitrates. In conclusion, non-thermal pulsed plasma discharge, obtained with a custom-built generator, was proven to effectively degrade diclofenac in water matrices confirming the potential interest of this technology for wastewater treatment. The surface discharge was proven to be more effective in CECs removal due to the high rate of formation of H₂O₂, ozone, reactive radical species, and strong UV light emission. Furthermore, nitrates enriched water obtained after treatment could be an interesting added-value product to be used as fertilizer in agriculture. Acknowledgment: This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 765860.

Keywords: CECs removal, nitrogen fixation, non-thermal plasma, water treatment

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Authors: Clara Oliver, Oibar Martinez

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This paper is intended to reveal the severity of electrostatic discharge (ESD) effects in electronic and optoelectronic devices by performing sensitivity tests based on Human Body Model (HBM) standard. We explain here the HBM standard in detail together with the typical failure modes associated with electrostatic discharges. In addition, a prototype of electrostatic charge generator has been designed, fabricated, and verified to stress electronic devices, which features a compact high voltage source. This prototype is inexpensive and enables one to do a battery of pre-compliance tests aimed at detecting unexpected weaknesses to static discharges at the component level. Some tests with different devices were performed to illustrate the behavior of the proposed generator. A set of discharges was applied according to the HBM standard to commercially available bipolar transistors, complementary metal-oxide-semiconductor transistors and light emitting diodes. It is observed that high current and voltage ratings in electronic devices not necessarily provide a guarantee that the device will withstand high levels of electrostatic discharges. We have also compared the result obtained by performing the sensitivity tests based on HBM with a real discharge generated by a human. For this purpose, the charge accumulated in the person is monitored, and a direct discharge against the devices is generated by touching them. Every test has been performed under controlled relative humidity conditions. It is believed that this paper can be of interest for research teams involved in the development of electronic and optoelectronic devices which need to verify the reliability of their devices in terms of robustness to electrostatic discharges.

Keywords: human body model, electrostatic discharge, sensitivity tests, static charge monitoring

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Authors: Anne Joseph, Yinusa Asiwaju-Bello, Oluwaseun Olabode

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Sustainable administration of groundwater resources tapped in Coastal Plain Sands aquifer in Abesan area, Eastern Dahomey Basin, Southwestern Nigeria necessitates the knowledge of the pattern of groundwater flow in meeting a suitable environmental need for habitation. Thirty hand-dug wells were identified and evaluated to study the groundwater flow dynamics and anionic species distribution in the study area. Topography and water table levels method with the aid of Surfer were adopted in the identification of recharge and discharge zones where six recharge and discharge zones were delineated correspondingly. Dissolved anionic species of HCO3-, Cl-, SO42-and NO3- were determined using titrimetric and spectrophotometric method. The trend of significant anionic concentrations of groundwater samples are in the order Cl- > HCO3-> SO42- > NO3-. The prominent anions in the discharge and recharge area are Cl- and HCO3- ranging from 0.22ppm to 3.67ppm and 2.59ppm to 0.72ppm respectively. Analysis of groundwater head distribution and the groundwater flow vector in Abesan area confirmed that Cl- concentration is higher than HCO3- concentration in recharge zones. Conversely, there is a high concentration of HCO3- than Cl- inland towards the continent; therefore, HCO3-concentration in the discharge zones is higher than the Cl- concentration. The anions were to be closely related to the recharge and discharge areas which were confirmed by comparison of activities such as rainfall regime and anthropogenic activities in Abesan area. A large percentage of the samples showed that HCO3-, Cl-, SO42-and NO3- falls within the permissible limit of the W.H.O standard. Most of the samples revealed Cl- / (CO3- + HCO3-) ratio higher than 0.5 indicating that there is saltwater intrusion imprints in the groundwater of the study area. Gibbs plot shown that most of the samples is from rock dominance, some from evaporation dominance and few from precipitation dominance. Potential salinity and SO42/ Cl- ratios signifies that most of the groundwater in Abesan is saline and falls in a water class found to be insuitable for irrigation. Continuous dissolution of these anionic species may pose a significant threat to the inhabitants of Abesan area in the nearest future.

Keywords: Abessan, Anionic species, Discharge, Groundwater flow, Recharge

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Authors: Mohamed Adel Abdallah

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A high voltage magnetic pulse is designed by applying an electrical pulse to the coil. Capacitor banks are developed to generate a pulse current. Switching circuit consisting of DPDT switches, thyristor, and triggering circuit is built and tested. The coil current is measured using a Hall-effect current sensor. The magnetic pulse created is measured and tabulated in the graph. Simulation using FEMM is done to compare the results obtained between experiment and simulation. This technology can be applied to area such as medical equipment, measuring instrument, and military equipment.

Keywords: high voltage, magnetic pulse, capacitor discharge, coil

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Authors: Mohammad Javad Behzadnia, Amir Bahador Boroumand

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Introduction: Limited facility situations require allocating the most available resources for most casualties. Accordingly, Traumatic Brain Injury (TBI) is the one that may need to transport the patient as soon as possible. In a mass casualty event, deciding when the facilities are restricted is hard. The Extended Glasgow Outcome Score (GOSE) has been introduced to assess the global outcome after brain injuries. Therefore, we aimed to evaluate the prognostic factors associated with GOSE. Materials and Methods: In a multicenter cross-sectional study conducted on 144 patients with TBI admitted to trauma emergency centers. All the patients with isolated TBI who were mentally and physically healthy before the trauma entered the study. The patient’s information was evaluated, including demographic characteristics, duration of hospital stays, mechanical ventilation on admission laboratory measurements, and on-admission vital signs. We recorded the patients’ TBI-related symptoms and brain computed tomography (CT) scan findings. Results: GOSE assessments showed an increasing trend by the comparison of on-discharge (7.47 ± 1.30), within a month (7.51 ± 1.30), and within three months (7.58 ± 1.21) evaluations (P < 0.001). On discharge, GOSE was positively correlated with Glasgow Coma Scale (GCS) (r = 0.729, P < 0.001) and motor GCS (r = 0.812, P < 0.001), and inversely with age (r = −0.261, P = 0.002), hospitalization period (r = −0.678, P < 0.001), pulse rate (r = −0.256, P = 0.002) and white blood cell (WBC). Among imaging signs and trauma-related symptoms in univariate analysis, intracranial hemorrhage (ICH), interventricular hemorrhage (IVH) (P = 0.006), subarachnoid hemorrhage (SAH) (P = 0.06; marginally at P < 0.1), subdural hemorrhage (SDH) (P = 0.032), and epidural hemorrhage (EDH) (P = 0.037) were significantly associated with GOSE at discharge in multivariable analysis. Conclusion: Our study showed some predictive factors that could help to decide which casualty should transport earlier to a trauma center. According to the current study findings, GCS, pulse rate, WBC, and among imaging signs and trauma-related symptoms, ICH, IVH, SAH, SDH, and EDH are significant independent predictors of GOSE at discharge in TBI patients.

Keywords: field, Glasgow outcome score, prediction, traumatic brain injury.

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Authors: W. Ling, Mohamed Saufi Bin Awang

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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.

Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis

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Authors: Bhupinder Singh, Joy Prakash Misra

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This article provides the information regarding machining of hastelloy-X on wire electro spark machining (WEDM). Experimental investigation has been carried out by varying pulse-on time (TON), pulse-off time (TOFF), peak current (IP) and spark gap voltage (SV). Effect of these parameters is studied on material removal rate (MRR). Experiments are designed as per box-behnken design (BBD) technique of response surface methodology (RSM). Analysis of variance (ANOVA) results indicates that TON, TOFF, IP, SV, TON x IP are significant parameters that influenced the MRR, and it is depicted that value of MRR is more at high discharge energy (HDE) and less at low discharge energy (LDE). Furthermore, miniature impeller and miniature gear (OD≤10MM) is fabricated by WEDM at optimized condition.

Keywords: advanced manufacturing, WEDM, super alloy, gear

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Authors: Kanak Parmanandani

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The present study aims to explore the impact of perceived parenthood styles in early nonage on attachment styles, and how it affects the emotional capacity of youthful grown-ups. Current studies suggest that there are 4 attachment styles. An existent gets attached to their significant other and important people, and understanding attachment styles helps to dissect a person’s nonage and duly understand an existent. Parenthood styles play a major part in children’s early development, and how they see the world and the people around them. A parent plays a huge part in the emotional development of a child. Both parents must be present to give their children a healthy terrain to grow up.

Keywords: parent styles, attachment styles, early development, parenting styles

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Authors: D. Schafer, H. Booke, R. Nordmeier

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Patients suffering from chronic musculoskeletal pain ( > 12 months) are a challenging clientele for pain specialists. A multimodal approach, characterized by a two weeks inpatient treatment, often is the ultimate therapeutic attempt. The lasting effects of such a multimodal approach were analyzed, especially since two weeks of inpatient therapy, although very intense, often seem too short to make a difference in patients suffering from chronic pain for years. The study includes 32 consecutive patients suffering from chronic pain over years who underwent a two weeks multimodal inpatient treatment of pain. Twelve months after discharge, each patient was interviewed to objectify any lasting effects. Pain was measured on admission and 12 months after discharge using the numeric rating scale (NRS). For statistics, a paired students' t-test was used. Significance was defined as p < 0.05. The average intensity of pain on admission was 8,6 on the NRS. Twelve months after discharge, the intensity of pain was still reduced by an average of 48% (average NRS 4,4), p < 0.05. Despite this significant improvement in pain severity, two thirds (66%) of the patients still judge their treatment as not sufficient. In conclusion, inpatient treatment of chronic pain has a long-lasting effect on the intensity of pain in patients suffering from chronic musculoskeletal pain for more than 12 months.

Keywords: chronic pain, inpatient treatment, multimodal pain treatment, musculoskeletal pain

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Authors: Mohammad Hossain Validad

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Background and Aim: Epidemic keratoconjunctivitis is a type of conjunctivitis caused by adenoviruses that can spread rapidly through direct and indirect contact. The aim of this study was to evaluate the therapeutic effects of Povidone-Iodine 0.4% and 0.2% in improving the symptoms and signs of patients with epidemic keratoconjunctivitis. Materials and Methods: In this clinical trial study, 60 patients with a mean age of 27.8±8.4 years who were eligible for inclusion criteria were randomly divided into three groups. The first group received eye drops of Povidone-Iodine 0.4% and betamethasone 0.1%, the second group received PovidoneIodine 0.2% and betamethasone 0.1% and the third group received betamethasone 0.1%. Follow-ups were on the first, fourth, seventh and tenth days after starting treatment. Parameters examined at each examination were hyperaemia, mucopurulent discharge, eyelid edema, hemorrhage, and subepithelial infiltration. Results: The results showed that mucopurulent discharge on the fourth day of the examination (P = 0.005) and the seventh day of the examination (P = 0.001) were significantly different in the three treatment groups. Sub-epithelial infiltration on the tenth day after treatment did not show a significant difference in the 3 groups (P = 0.287). Conclusion: Based on the results of this study, Povidone-Iodine is more effective in relieving some of signs of EKC, such as reduced mucopurulent discharge than steroids alone.

Keywords: EKC, topical bethadine, adenovirus, sub epithelial opacity

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Authors: Moses Balina, Archbald Bahizi

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Introduction: Early onset neonatal sepsis is a systemic infection in a newborn baby during the first week after birth and contributes to 50% of neonatal deaths each year. Risk factors for early onset neonatal sepsis, which can be maternal, health care provider, or health care facility associated, can be prevented with access to quality antenatal care. Objective: The objective of the study was to assess early onset neonatal sepsis and antenatal factors associated with Fort Portal Regional Referral Hospital. Methodology: A cross sectional study design was used. The study involved 60 respondents who were mothers of breastfeeding neonates being treated for early onset neonatal sepsis at Fort Portal Regional Referral Hospital neonatal intensive care unit. Simple random sampling was used to select study participants. Data were collected using questionnaires, entered in Stata 16, and analysed using logistic regression. Results: The prevalence of early onset neonatal sepsis at Fort Portal Regional Referral Hospital was 25%. Multivariate analysis revealed that institutional factors were the only antenatal factors found to be significantly associated with early onset neonatal sepsis at Fort Portal Regional Referral Hospital (p < 0.01). Bivariate analysis revealed that attending antenatal care at a health centre III or IV instead of a hospital (p = 0.011) and attending antenatal care in health care facilities with no laboratory investigations (p = 0.048) were risk factors for early onset neonatal sepsis in the newborn at Fort Portal Regional Referral Hospital. Conclusion: Antenatal factors were associated with early onset neonatal sepsis, and health care facility factors like lower level health centre and unavailability of quality laboratory investigations to pregnant women contributed to early onset neonatal sepsis in the newborn. Mentorships, equipping/stocking laboratories, and improving staffing levels were necessary to reduce early onset neonatal sepsis.

Keywords: antenatal factors, early onset neonatal sepsis, neonates 0-7 days, fort portal regional referral hospital

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Authors: P. Treyer, M. Kujda, H. Urs

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The purpose of this paper is to digitally compensate for the apparent discharge time constant of the coaxial cable so that the current step response is flat and can be used to calibrate current transducers using the convolution method. For proper use of convolution, the step response record length is required to be at least the same as the waveform duration to be evaluated. The current step generator based on the cable discharge is compared to the Blumlein generator. Moreover, the influence of each component of the system on the performance of the step is described, which allows building the appropriate measurement set-up. In the end, the calibration of current viewing resistors dedicated to high current impulse is computed.

Keywords: Blumlein generator, cable attenuation, convolution, current step generator

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Authors: Mazen Al-Bulaihed, Nissar Wani, Abdulrahman Al-Arainy, Yasin Khan

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Partial Discharge (PD) measurements are widely used for diagnostic purposes in electrical equipment used in power systems. The main cause of these measurements is to prevent large power failures as cables are prone to aging, which usually results in embrittlement, cracking and eventual failure of the insulating and sheathing materials, exposing the conductor and risking a potential short circuit, a likely cause of the electrical fire. Many distribution networks rely heavily on medium voltage (MV) power cables. The presence of joints in these networks is a vital part of serving the consumer demand for electricity continuously. Such measurements become even more important when the extent of dependence increases. Moreover, it is known that the partial discharge in joints and termination are difficult to track and are the most crucial point of failures in large power systems. This paper discusses the diagnostic techniques of four samples of XLPE insulated cable joints, each included with a different type of defect. Experiments were carried out by measuring PD and tanδ at very low frequency applied high voltage. The results show the importance of combining PD and tanδ for effective cable assessment.

Keywords: partial discharge, tan delta, very low frequency, XLPE cable

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Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

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Authors: Chia-Chia Chang, Jhen-Ting Huang, Hu-Cheng Weng, An-Ya Lo

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This study developed a simple hierarchical porous carbon (HPC) synthesis process and used for supercapacitor application. In which, mesopore provides huge specific surface area, meanwhile, macropore provides excellent mass transfer. Thus the hierarchical porous electrode improves the charge-discharge performance. On the other hand, cerium oxide (CeO2) have also got a lot research attention owing to its rich in content, low in price, environmentally friendly, good catalytic properties, and easy preparation. Besides, a rapid redox reaction occurs between trivalent cerium and tetravalent cerium releases oxygen atom and increase the conductivity. In order to prevent CeO2 from disintegration under long-term charge-discharge operation, the CeO2 carbon porous materials were was integrated as composite material in this study. For in the ex-situ analysis, scanning electron microscope (SEM), X-ray diffraction (XRD), transmission electron microscope (TEM) analysis were adopted to identify the surface morphology, crystal structure, and microstructure of the composite. 77K Nitrogen adsorption-desorption analysis was used to analyze the porosity of each specimen. For the in-situ test, cyclic voltammetry (CV) and chronopotentiometry (CP) were conducted by potentiostat to understand the charge and discharge properties. Ragone plot was drawn to further analyze the resistance properties. Based on above analyses, the effect of macropores/mespores and the CeO2/HPC ratios on charge-discharge performance were investigated. As a result, the capacitance can be greatly enhanced by 2.6 times higher than pristine mesoporous carbon electrode.

Keywords: hierarchical porous carbon, cerium oxide, supercapacitor

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Authors: John Yahng, Hansraj Riteesh Bookun

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Objective: This was a retrospective cross-sectional study evaluating the safety of discharge on the first postoperative day following carotid surgery - principally carotid endarterectomy. Methods: Between January 2010 to October 2017, 252 patients with mean age of 72 years, underwent carotid surgery by seven surgeons. Their medical records were consulted and their operative as well as complication timelines were databased. Descriptive statistics were used to analyse pooled responses and our indicator variables. The statistical package used was STATA 13. Results: There were 183 males (73%) and the comorbid burden was as follows: ischaemic heart disease (54%), diabetes (38%), hypertension (92%), stage 4 kidney impairment (5%) and current or ex-smoking (77%). The main indications were transient ischaemic attacks (42%), stroke (31%), asymptomatic carotid disease (16%) and amaurosis fugax (8%). 247 carotid endarterectomies (109 with patch arterioplasty, 88 with eversion and transection technique, 50 with endarterectomy only) were performed. 2 carotid bypasses, 1 embolectomy, 1 thrombectomy with patch arterioplasty and 1 excision of a carotid body tumour were also performed. 92% of the cases were performed under general anaesthesia. A shunt was used in 29% of cases. The mean length of stay was 5.1 ± 3.7days with the range of 2 to 22 days. No patient was discharged on day 1. The mean time from admission to surgery was 1.4 ± 2.8 days, ranging from 0 to 19 days. The mean time from surgery to discharge was 2.7 ± 2.0 days with the of range 0 to 14 days. 36 complications were encountered over this period, with 12 failed repairs (5 major strokes, 2 minor strokes, 3 transient ischaemic attacks, 1 cerebral bleed, 1 occluded graft), 11 bleeding episodes requiring a return to the operating theatre, 5 adverse cardiac events, 3 cranial nerve injuries, 2 respiratory complications, 2 wound complications and 1 acute kidney injury. There were no deaths. 17 complications occurred on postoperative day 0, 11 on postoperative day 1, 6 on postoperative day 2 and 2 on postoperative day 3. 78% of all complications happened before the second postoperative day. Out of the complications which occurred on the second or third postoperative day, 4 (1.6%) were bleeding episodes, 1 (0.4%) failed repair , 1 respiratory complication (0.4%) and 1 wound complication (0.4%). Conclusion: Although it has been common practice to discharge patients on the second postoperative day following carotid endarterectomy, we find here that discharge on the first operative day is safe. The overall complication rate is low and most complications are captured before the second postoperative day. We suggest that patients having an uneventful first 24 hours post surgery be discharged on the first day. This should reduce hospital length of stay and the health economic burden.

Keywords: carotid, complication, discharge, surgery

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Authors: Pushpendra S. Bharti, S. Maheshwari

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Electric discharge machining (EDM) is one of the most widely used non-conventional manufacturing process to shape difficult-to-cut materials. The process yield, in terms of material removal rate, surface roughness and tool wear rate, of EDM may considerably be improved by selecting the optimal combination(s) of process parameters. This paper employs Multi-response signal-to-noise (MRSN) ratio technique to find the optimal combination(s) of the process parameters during EDM of Inconel 718. Three cases v.i.z. high cutting efficiency, high surface finish, and normal machining have been taken and the optimal combinations of input parameters have been obtained for each case. Analysis of variance (ANOVA) has been employed to find the dominant parameter(s) in all three cases. The experimental verification of the obtained results has also been made. MRSN ratio technique found to be a simple and effective multi-objective optimization technique.

Keywords: electric discharge machining, material removal rate, surface roughness, too wear rate, multi-response signal-to-noise ratio, multi response signal-to-noise ratio, optimization

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Authors: Supalak Fakkhum, Wannita Pochanakul

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This research is qualitative research that aims to study the application of local wisdom in health care of early childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province. The target is one folk medicine healer and 45 parents who have children or grandchildren aged between 0-5 years. The folk medicine healer was interviewed and observed during early childhood health care practice. Parents were interviewed. The results showed that local wisdom in health care of early childhood are as follows: 1. Local wisdom about early childhood diseases: It is believed that the disease was determined while the child was still in the womb, in the third month of pregnancy. When a child is born, they will have La, La-ong and Saang diseases, which are URI (upper respiratory infection) and DI (diarrhea) diseases. Supernatural aspect is also considered. 2. The treatment is chosen to match the symptoms of the disease. Caring for early childhood includes psychological therapy by rituals and spells. 3. For local wisdom concerning prevention and health promotion, parents normally bring their child to folk medicine healers for “throat paint” as an act of protection and health promotion. Folk healers often prescribe food according to belief and local wisdom.

Keywords: local wisdom, early childhood, folk medicine, healer

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Authors: Shane D. Inder, Mehrdad Khamooshi

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Efficient energy storage is a crucial factor in facilitating the uptake of renewable energy resources. Among the many options available for energy storage systems required to balance imbalanced supply and demand cycles, compressed air energy storage (CAES) is a proven technology in grid-scale applications. This paper reviews the current state of micro scale CAES technology and describes a micro-scale advanced adiabatic CAES (A-CAES) system, where heat generated during compression is stored for use in the discharge phase. It will also describe a thermodynamic model, developed in EES (Engineering Equation Solver) to evaluate the performance and critical parameters of the discharge phase of the proposed system. Three configurations are explained including: single turbine without preheater, two turbines with preheaters, and three turbines with preheaters. It is shown that the micro-scale A-CAES is highly dependent upon key parameters including; regulator pressure, air pressure and volume, thermal energy storage temperature and flow rate and the number of turbines. It was found that a micro-scale AA-CAES, when optimized with an appropriate configuration, could deliver energy input to output efficiency of up to 70%.

Keywords: CAES, adiabatic compressed air energy storage, expansion phase, micro generation, thermodynamic

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Authors: Sara Ataei, Mohammad Bagher Oghazian, Mania Radfar

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We describe a patient with hypercalcemia associated with the injection of high doses vitamin D as supplement for a period of six months. A 76-year-old woman had been taking an intramuscular injection of vitamin D 300,000 IU every ten days for six months. She was hospitalized with symptoms of hypercalcemia: chronic constipation, unstable gait, a chronic generalized musculoskeletal pain and increased fatigue. On admission her 25 (OH) vitamin D and Calcium levels were 559 nmol/L and 13.85 mg/dL respectively, and Parathyroid Hormone (PTH) level was 7.1 pg/mL. Immediately she received diuresis therapy with saline and furosemide in conjunction with calcitonin and pamidronate. At discharge her serum calcium level was 11.5 mg/dL. To lower endogenous overproduction of calcitriol, prednisolone 20 mg/day for 10 days was administered at discharge time.

Keywords: vitamin D, hypercalcemia, vitamin D toxicity, parathyroid hormone

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Authors: Himanshu Payal, Sachin Maheshwari, Pushpendra S. Bharti

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Electrical discharge machining (EDM), a non-conventional machining process, finds wide applications for shaping difficult-to-cut alloys. Process modeling of EDM is required to exploit the process to the fullest. Process modeling of EDM is a challenging task owing to involvement of so many electrical and non-electrical parameters. This work is an attempt to model the EDM process using artificial neural network (ANN). Experiments were carried out on die-sinking EDM taking Inconel 825 as work material. ANN modeling has been performed using experimental data. The prediction ability of trained network has been verified experimentally. Results indicate that ANN can predict the values of performance measures of EDM satisfactorily.

Keywords: artificial neural network, EDM, metal removal rate, modeling, surface roughness

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Authors: Anne Tan, Kok-Sing Tang, Audrey Cooke

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Play has always been a prominent pedagogy in early childhood. However, there is growing evidence of success in students’ learning using explicit instruction, especially in literacy in the early years. There is also limited research using explicit instruction in early childhood mathematics, and play is usually prominently mentioned. This proposed research aims to investigate the possibilities and benefits of integrating guided play with explicit instruction in early childhood mathematics education. While play has traditionally been a prominent pedagogy in early childhood, there is growing evidence of success in student learning through explicit instruction, particularly in literacy. However, limited research exists on the integration of explicit instruction in early childhood mathematics, where play remains prominently mentioned. This study utilises a multiple case study methodology to gather data and provide immediate opportunities for curriculum improvement. The research will commence with semi-structured interviews to gain insights into educators' background knowledge. Highly structured observations will be conducted to record the frequency and manner in which guided play is integrated with specific elements of explicit instruction during mathematics teaching in early childhood. To enhance the observations, video recordings will be made using cameras with video settings and Microsoft Teams meeting recordings. In addition to interviews and observations, educators will maintain journals and use the Microsoft Teams platform for self-reflection on the integration of guided play and explicit instruction in their classroom practices and experiences. The study participants will include educators with early childhood degrees and students in years one and two. The primary goal of this research is to inform the benefits of integrating two high-impact pedagogies, guided play, and explicit instruction, for enhancing student learning outcomes in mathematics education. By exploring the integration of these pedagogical approaches, this study aims to contribute to the development of effective instructional strategies in early childhood mathematics education.

Keywords: early childhood, early childhood mathematics, early childhood numbers, guided play, play-based learning, explicit instruction

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Authors: Witri Pratiwi, Shopa Nur Fauzah, Dini Norviatin

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WHO recommends breastfeeding exclusively for infants aged 0 to 6 months because breast milk is the best nutrition. There are several factors associated with the success of exclusive breastfeeding. This study aims to determine the factors associated with the success of exclusive breastfeeding. A cross-sectional study was conducted at 6 community health centers in Cirebon City, Indonesia. Primary data were obtained from a validated questionnaire given to mothers who have children aged 6 to 24 months. A total of 326 mothers participated in this study. Two hundred and eighteen (66.9%) mothers gave exclusive breastfeeding to their babies, and 108 (33.1%) did not give exclusive breastfeeding. The baby gender (p=0.240), birth weight (p=0.436), and place of birth (0.137) were not related to exclusive breastfeeding. Mode of delivery (p=0.029) and early initiation of breastfeeding (p=0.001) were significantly associated with exclusive breastfeeding. Infants with early initiation of breastfeeding are three times more likely to get exclusive breastfeeding compared to those who do not get breastfeeding early (p=0.001; OR=3.696 [95% CI 1.764 – 7.746]). Early initiation of breastfeeding is the most important factor in determining the success of exclusive breastfeeding. Promotion and education on the importance of early breastfeeding initiation to prospective mothers, families, and health workers are expected to be improved.

Keywords: early initiation of breastfeeding, exclusive breastfeeding, mode of delivery, Indonesia

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Authors: J. Jebunnesa, Y. Budd, T. Mason

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COVID-19 changed the pedagogical expectations of early childhood education as many teachers across Australia had to quickly adapt to new teaching practices such as remote teaching. An important factor in the successful implementation of any new teaching and learning approach is teacher preparation, however, due to the pandemic, the transformation to remote teaching was immediate. A timely question to be asked is how early childhood teachers managed the transition from face-to-face teaching to remote teaching and what was learned through this time. This study explores the experiences of early childhood educators in Australia during COVID-19 lockdowns. Data were collected from an online survey conducted through the official Facebook forum of “Early Childhood Education and Care Australia,” and a constructivist grounded theory methodology was used to analyse the data. Initial research results suggest changing expectations of teachers’ roles and responsibilities during the lockdown, with a significant category related to transitioning teacher identities emerging. The concept of transitioning represents the shift from the role of early childhood educator to educational innovator, essential worker, social worker, and health officer. The findings illustrate the complexity of early childhood educators’ roles during the pandemic.

Keywords: changing role of teachers, constructivist grounded theory, lessons learned, teaching during COVID-19

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Authors: Alilu Getahun Sulito

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Exceptional floods are now prevalent in many places in Ethiopia, resulting in a large number of human deaths and property destruction. Lake Boyo watershed, in particular, had also traditionally been vulnerable to flash floods throughout the Boyo watershed. The goal of this research is to create flood and inundation maps for the Boyo Catchment. The integration of Geographic information system(GIS) technology and the hydraulic model (HEC-RAS) were utilized as methods to attain the objective. The peak discharge was determined using Fuller empirical methodology for intervals of 5, 10, 15, and 25 years, and the results were 103.2 m3/s, 158 m3/s, 222 m3/s, and 252 m3/s, respectively. River geometry, boundary conditions, manning's n value of varying land cover, and peak discharge at various return periods were all entered into HEC-RAS, and then an unsteady flow study was performed. The results of the unsteady flow study demonstrate that the water surface elevation in the longitudinal profile rises as the different periods increase. The flood inundation charts clearly show that regions on the right and left sides of the river with the greatest flood coverage were 15.418 km2 and 5.29 km2, respectively, flooded by 10,20,30, and 50 years. High water depths typically occur along the main channel and progressively spread to the floodplains. The latest study also found that flood-prone areas were disproportionately affected on the river's right bank. As a result, combining GIS with hydraulic modelling to create a flood inundation map is a viable solution. The findings of this study can be used to care again for the right bank of a Boyo River catchment near the Boyo Lake kebeles, according to the conclusion. Furthermore, it is critical to promote an early warning system in the kebeles so that people can be evacuated before a flood calamity happens. Keywords: Flood, Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

Keywords: Weira River, Boyo, GIS, HEC- GEORAS, HEC- RAS, Inundation Mapping

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Authors: Amir Ahmad Dehghani, Morteza Nabizadeh

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This paper presents the application of an Adaptive Neuro-Fuzzy Inference System (ANFIS) to flood hydrograph modeling of Shahid Rajaee reservoir dam located in Iran. This was carried out using 11 flood hydrographs recorded in Tajan river gauging station. From this dataset, 9 flood hydrographs were chosen to train the model and 2 flood hydrographs to test the model. The different architectures of neuro-fuzzy model according to the membership function and learning algorithm were designed and trained with different epochs. The results were evaluated in comparison with the observed hydrographs and the best structure of model was chosen according the least RMSE in each performance. To evaluate the efficiency of neuro-fuzzy model, various statistical indices such as Nash-Sutcliff and flood peak discharge error criteria were calculated. In this simulation, the coordinates of a flood hydrograph including peak discharge were estimated using the discharge values occurred in the earlier time steps as input values to the neuro-fuzzy model. These results indicate the satisfactory efficiency of neuro-fuzzy model for flood simulating. This performance of the model demonstrates the suitability of the implemented approach to flood management projects.

Keywords: adaptive neuro-fuzzy inference system, flood hydrograph, hybrid learning algorithm, Shahid Rajaee reservoir dam

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Authors: Abdulrahman Abdulrahman

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Critical depth meters, such as abroad crested weir, Venture Flume and combined control flume are standard devices for measuring flow in open channels. The discharge relation for these devices cannot be solved directly, but it needs iteration process to account for the approach velocity head. In this paper, analytical solution was developed to calculate the discharge in a combined critical depth-meter namely, a hump combined with lateral contraction in rectangular channel with subcritical approach flow including energy losses. Also analytical formulae were derived for approach velocity head coefficient for different types of critical depth meters. The solution was derived by solving a standard cubic equation considering energy loss on the base of trigonometric identity. The advantage of this technique is to avoid iteration process adopted in measuring flow by these devices. Numerical examples are chosen for demonstration of the proposed solution.

Keywords: broad crested weir, combined control meter, control structures, critical flow, discharge measurement, flow control, hydraulic engineering, hydraulic structures, open channel flow

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Authors: Fawwaz Eniola Fajingbesi, Nur Shahida Midia, Elsheikh M. A. Elsheikh, Siti Hajar Yusoff

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Empirical analysis of lightning related phenomena in real time is extremely dangerous due to the relatively high electric discharge involved. Hence, design and optimization of efficient grounding systems depending on real time empirical methods are impeded. Using numerical methods, the dynamics of complex systems could be modeled hence solved as sets of linear and non-linear systems . In this work, the induced current distribution as lightning strike traverses the soil have been numerically modeled in a 2D axial-symmetry and solved using finite element method (FEM) in COMSOL Multiphysics 5.2 AC/DC module. Stratified and non- stratified electrode system were considered in the solved model and soil conductivity (σ) varied between 10 – 58 mS/m. The result discussed therein were the electric field distribution, current distribution and soil ionization phenomena. It can be concluded that the electric field and current distribution is influenced by the injected electric potential and the non-linearity in soil conductivity. The result from numerical calculation also agrees with previously laboratory scale empirical results.

Keywords: current distribution, grounding systems, lightning discharge, numerical model, soil conductivity, soil ionization

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Authors: Priyanka Govender, S. Mtshali, Theresa Moonsamy, Zanele Mkwanazi, L. Mthembu

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Chemically enhanced primary treatment (CEPT) can be used at wastewater works to improve the quality of the final effluent discharge, provided that the plant has spare anaerobic digestion capacity. CEPT can transfer part of the organic load to the digesters thereby effectively relieving the hydraulic loading on the plant and in this way can allow the plant to continue operating long after the hydraulic capacity of the plant has been exceeded. This can allow a plant to continue operating well beyond its original design capacity, requiring only fairly simple and inexpensive modifications to the primary settling tanks as well as additional chemical costs, thereby delaying or even avoiding the need for expensive capital upgrades. CEPT can also be effective at plants where high organic loadings prevent the wastewater discharge from meeting discharge standards, especially in the case of COD, phosphates and suspended solids. By increasing removals of these pollutants in the primary settling tanks, CEPT can enable the plant to conform to specifications without the need for costly upgrades. Laboratory trials were carried out recently at the Umbilo WWTW in Durban and these were followed by a baseline assessment of the current plant performance and a subsequent full scale trial on the Conventional plant i.e. West Plant. The operating conditions of the plant are described and the improvements obtained in COD, phosphate and suspended solids, are discussed. The PST and plant overall suspended solids removal efficiency increased by approximately 6% during the trial. Details regarding the effect that CEPT had on sludge production and the digesters are also provided. The cost implications of CEPT are discussed in terms of capital costs as well as operation and maintenance costs and the impact of Ferric chloride on the infrastructure was also studied and found to be minimal. It was concluded that CEPT improves the final quality of the discharge effluent, thereby improving the compliance of this effluent with the discharge license. It could also allow for a delay in upgrades to the plant, allowing the plant to operate above its design capacity. This will be elaborated further upon presentation.

Keywords: chemically enhanced, ferric, wastewater, primary

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Authors: Chan Hui-Ya, Ding Shin-Tan

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Background and Aim: The discharge planning is considered helpful to reduce the hospital length of stay and readmission rate, and then increased satisfaction with healthcare for patients and professionals. In order to decrease the waiting time of long-term care and boost the care quality of patients after discharge from the hospital, the Ministry of Health and Welfare department in Taiwan initiates a program “discharge planning connects with long-term care 2.0 services” in 2017. The purpose of this study is to investigate the outcome of the pilot of this program in a medical center. Methods: By purpose sampling, the study chose five wards in a medical center as pilot units. The researchers compared the beds of service, the numbers of cases which were transferred to the long-term care center and transferred rates per month between the pilot units and the other units, and analyze the basic data, the long-term care service needs and the approval service items of cases transfer to the long-term care center in pilot units. Results: From June to September 2017, a total of 92 referrals were made, and 51 patients were enrolled into the pilot program. There is a significant difference of transferring rate between the pilot units and the other units (χ = 702.6683, p < 0.001). Only 20 cases (39.2% success rate) were approved to accept the parts of service items of long-term care in the pilot units. The most approval item was respite care service (n = 13; 65%), while it was third at needs ranking of service lists during linking services process. Among the reasons of patients who cancelled the request, 38.71% reasons were related to the services which could not match the patients’ needs and expectation. Conclusion: The results indicate there is a requirement to modify the long-term care services to fit the needs of cases. The researchers suggest estimating the potential cases by screening data from hospital informatics systems and to hire more case manager according the service time of potential cases. Meanwhile, the strategies shortened the assessment scale and authorized hospital case managers to approve some items of long-term care should be considered.

Keywords: discharge planning, long-term care, case manager, patient care

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