Search results for: safety work
14917 State Estimator Performance Enhancement: Methods for Identifying Errors in Modelling and Telemetry
Authors: M. Ananthakrishnan, Sunil K Patil, Koti Naveen, Inuganti Hemanth Kumar
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State estimation output of EMS forms the base case for all other advanced applications used in real time by a power system operator. Ensuring tuning of state estimator is a repeated process and cannot be left once a good solution is obtained. This paper attempts to demonstrate methods to improve state estimator solution by identifying incorrect modelling and telemetry inputs to the application. In this work, identification of database topology modelling error by plotting static network using node-to-node connection details is demonstrated with examples. Analytical methods to identify wrong transmission parameters, incorrect limits and mistakes in pseudo load and generator modelling are explained with various cases observed. Further, methods used for active and reactive power tuning using bus summation display, reactive power absorption summary, and transformer tap correction are also described. In a large power system, verifying all network static data and modelling parameter on regular basis is difficult .The proposed tuning methods can be easily used by operators to quickly identify errors to obtain the best possible state estimation performance. This, in turn, can lead to improved decision-support capabilities, ultimately enhancing the safety and reliability of the power grid.Keywords: active power tuning, database modelling, reactive power, state estimator
Procedia PDF Downloads 714916 Investigation of Vibration in Diesel-Fueled Motoblocks in the Case of Supplying Different Types of Fuel Mixture
Authors: Merab Mamuladze, Mixeil Lejava, Fadiko Abuselidze
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At present, where most of the soils of Georgia have a small contour, the demand for small-capacity technical means, in particular motoblocks, has increased. Motoblocks perform agricultural work for various purposes, where the work process is performed by the operator, who experiences various magnitudes of vibration, impact, noise, and in general, as a result of long-term work production, causes body damage, dynamic load, and respiratory diseases in people. In the scientific paper, the dependence on the vibration of different types of diesel fuel is investigated in the case of five different revolutions in the internal combustion engine. Studies have shown that fuel and engine speed are the only risk factors that contradict the ISO 5349-2(2004) international standard. The experience of four years of work studies showed that 10% of operators received various types of injuries as a result of working with motoblocks. Experiments also showed that the amount of vibration decreases when the number of revolutions of the engine increases, and in the case of using biodiesel fuel, the damage risk factor is 5-10%, and in the case of using conventional diesel, this indicator has gone up to 20%.Keywords: engine, vibration, biodiesel, high risk factor, working conditions
Procedia PDF Downloads 8014915 Industrial Process Mining Based on Data Pattern Modeling and Nonlinear Analysis
Authors: Hyun-Woo Cho
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Unexpected events may occur with serious impacts on industrial process. This work utilizes a data representation technique to model and to analyze process data pattern for the purpose of diagnosis. In this work, the use of triangular representation of process data is evaluated using simulation process. Furthermore, the effect of using different pre-treatment techniques based on such as linear or nonlinear reduced spaces was compared. This work extracted the fault pattern in the reduced space, not in the original data space. The results have shown that the non-linear technique based diagnosis method produced more reliable results and outperforms linear method.Keywords: process monitoring, data analysis, pattern modeling, fault, nonlinear techniques
Procedia PDF Downloads 38714914 The Relationship between Characteristics of Nurses and Organizational Commitment of Nurses in Geriatric Intermediate Care Facilities in Japan
Authors: Chiharu Miyata, Hidenori Arai
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Background: The quality of care in geriatric intermediate facilities (GIFs) in Japan is not in a satisfied level. To improve it, it is crucial to reconsider nurses’ professionalism. Our goal is to create an organizational system that allows nurses to succeed professionally. To do this, we must first discuss the relationship between nurses’ characteristics and the organization. Objectives: The aim of the present study was to determine the extent to which demographic and work-related factors are related to organizational commitment among nurses in GIFs. Method: A quantitative, cross-sectional method was adopted, using a self-completion questionnaire survey. The questionnaires consisted of 49 items for job satisfaction, the three-dimensional commitment model of organizational commitment and the background information of respondents. Results: A total of 1,189 nurses participated. Of those, 91% (n=1084) were women, and mean age was 48.2 years. Most participants were staff nurses (n=791; 66%). Significant differences in 'affective commitment' (AC) scores were found for age (p < .001), overall work experience (p < .001), and work status (p < .001). For work experience in the current facility, significant differences were found in all organizational commitment scores (p < .001). The group with high job satisfaction scored significantly higher in all types of organizational commitment (p < 0.001). Conclusions: These results led to a conclusion that understanding the expectations of nurses at the workplace to adapt with the organization, and creating a work environment that clarifies contents of tasks, especially allowing for nurses to feel significance and achievement with tasks, would increase AC.Keywords: geriatric intermediate care facilities, geriatric nursing, job satisfaction, organizational commitment
Procedia PDF Downloads 14114913 'Disability' and Suffering: The Case of Workers Affected by Repetitive Strain Injury/Work Related Musculoskeletal Disorder in a Removal from Work Situation in Santos, São Paulo, Brazil
Authors: Maria Do Carmo Baracho De Alencar, Marciene Campos Fialho, Maria Do Carmo Vitório Ramos
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The subjects affected by Repetitive Strain Injury/Work Related Musculoskeletal Disorder (RSI/WRMSD) face an everyday life marked by pain, feelings of worthlessness and incapacity caused by the disease, and aggravated often because of discrimination society. Aim: To investigate the experiences and feelings of workers affected by RSI/WRMSD in removal from work situations and to understand the repercussions on mental health. Methods: Clinical records of workers were consulted, opened from July 1, 2014, to July 1, 2015, at the Reference Center for Worker's Health, in Santos city-SP. Selection of workers affected by RSI /WRMSD and who had experienced the removal from work situation due to the disease, and invitation to participate in the study. Semi-structured and individual interviews were carried out based on a pre-elaborated script, and for thematic content analysis. Results: Of a total of 502 medical records, 157 were selected, and of these, 18 workers participated in the interviews, both gender, most of them with low education level, aged between 35 and 56 years, and from different professions. Diseases affected several physical body regions and some workers had more than one body region affected by chronic pain. In the testimonies emerged the psychic suffering by the process of illness at work, fear of dismissal, invisibility of pain, in medical expertise attendance, by the incapacity to perform tasks that were easily achievable, with feelings of uselessness, revolt, and injustice, among others. Conclusion: The workers need to be readapted to new life situations, and the study promotes reflections on the need for more interdisciplinary actions and of the Psychology to the workers affected by RSI/ WRMSD.Keywords: repetitive strain injury, cumulative trauma disorder, absence from work, mental health, occupational health
Procedia PDF Downloads 15914912 The Femoral Eversion Endarterectomy Technique with Transection: Safety and Efficacy
Authors: Hansraj Riteesh Bookun, Emily Maree Stevens, Jarryd Leigh Solomon, Anthony Chan
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Objective: This was a retrospective cross-sectional study evaluating the safety and efficacy of femoral endarterectomy using the eversion technique with transection as opposed to the conventional endarterectomy technique with either vein or synthetic patch arterioplasty. Methods: Between 2010 to mid 2017, 19 patients with mean age of 75.4 years, underwent eversion femoral endarterectomy with transection by a single surgeon. There were 13 males (68.4%), and the comorbid burden was as follows: ischaemic heart disease (53.3%), diabetes (43.8%), stage 4 kidney impairment (13.3%) and current or ex-smoking (73.3%). The indications were claudication (45.5%), rest pain (18.2%) and tissue loss (36.3%). Results: The technical success rate was 100%. One patient required a blood transfusion following bleeding from intraoperative losses. Two patients required blood transfusions from low post operative haemogloblin concentrations – one of them in the context of myelodysplastic syndrome. There were no unexpected returns to theatre. The mean length of stay was 11.5 days with two patients having inpatient stays of 36 and 50 days respectively due to the need for rehabilitation. There was one death unrelated to the operation. Conclusion: The eversion technique with transection is safe and effective with low complication rates and a normally expected length of stay. It poses the advantage of not requiring a synthetic patch. This technique features minimal extraneous dissection as there is no need to harvest vein for a patch. Additionally, future endovascular interventions can be performed by puncturing the native vessel. There is no change to the femoral bifurcation anatomy after this technique. We posit that this is a useful adjunct to the surgeon’s panoply of vascular surgical techniques.Keywords: endarterectomy, eversion, femoral, vascular
Procedia PDF Downloads 19914911 An Enhanced Approach in Validating Analytical Methods Using Tolerance-Based Design of Experiments (DoE)
Authors: Gule Teri
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The effective validation of analytical methods forms a crucial component of pharmaceutical manufacturing. However, traditional validation techniques can occasionally fail to fully account for inherent variations within datasets, which may result in inconsistent outcomes. This deficiency in validation accuracy is particularly noticeable when quantifying low concentrations of active pharmaceutical ingredients (APIs), excipients, or impurities, introducing a risk to the reliability of the results and, subsequently, the safety and effectiveness of the pharmaceutical products. In response to this challenge, we introduce an enhanced, tolerance-based Design of Experiments (DoE) approach for the validation of analytical methods. This approach distinctly measures variability with reference to tolerance or design margins, enhancing the precision and trustworthiness of the results. This method provides a systematic, statistically grounded validation technique that improves the truthfulness of results. It offers an essential tool for industry professionals aiming to guarantee the accuracy of their measurements, particularly for low-concentration components. By incorporating this innovative method, pharmaceutical manufacturers can substantially advance their validation processes, subsequently improving the overall quality and safety of their products. This paper delves deeper into the development, application, and advantages of this tolerance-based DoE approach and demonstrates its effectiveness using High-Performance Liquid Chromatography (HPLC) data for verification. This paper also discusses the potential implications and future applications of this method in enhancing pharmaceutical manufacturing practices and outcomes.Keywords: tolerance-based design, design of experiments, analytical method validation, quality control, biopharmaceutical manufacturing
Procedia PDF Downloads 8014910 Participation in the Decision Making and Job Satisfaction in Greek Fish Farms
Authors: S. Anastasiou, C. Nathanailides
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There is considerable evidence to suggest that employees participation in the decision-making process of an organisation, has a positive effect on job satisfaction and work performance of the employees. The purpose of the present work was to examine the HRM practices, demographics and the level of job satisfaction of employees in Greek Aquaculture fish farms. A survey of employees (n=86) in 6 Greek Aquaculture Firms was carried out. The results indicate that HRM practices such as recruitment of the personnel and communication between the departments did not vary between different firms. The most frequent method of recruitment was through the professional network or the personal network of the managers. The preferred method of HRM communication was through the line managers and through group meeting. The level of job satisfaction increased with work experience participation and participation in the decision making process. A high percentage of the employees (81,3%±8.39) felt that they frequently participated in the decision making process. The Aquaculture employees exhibited high level of job satisfaction (88,1±6.95). The level of job satisfaction was related with participation in the decision making process (-0.633, P<0.05) but was not related with as age or gender. In terms of the working conditions, employees were mostly satisfied with their work itself, their colleagues and mostly dissatisfied with working hours, salary issues and low prospects of pay rises.Keywords: aquaculture, human resources, job satisfaction
Procedia PDF Downloads 46814909 Work System Design in Productivity for Small and Medium Enterprises: A Systematic Literature Review
Authors: Silipa Halofaki, Devi R. Seenivasagam, Prashant Bijay, Kritin Singh, Rajeshkannan Ananthanarayanan
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This comprehensive literature review delves into the effects and applications of work system design on the performance of Small and Medium-sized Enterprises (SMEs). The review process involved three independent reviewers who screened 514 articles through a four-step procedure: removing duplicates, assessing keyword relevance, evaluating abstract content, and thoroughly reviewing full-text articles. Various criteria, such as relevance to the research topic, publication type, study type, language, publication date, and methodological quality, were employed to exclude certain publications. A portion of articles that met the predefined inclusion criteria were included as a result of this systematic literature review. These selected publications underwent data extraction and analysis to compile insights regarding the influence of work system design on SME performance. Additionally, the quality of the included studies was assessed, and the level of confidence in the body of evidence was established. The findings of this review shed light on how work system design impacts SME performance, emphasizing important implications and applications. Furthermore, the review offers suggestions for further research in this critical area and summarizes the current state of knowledge in the field. Understanding the intricate connections between work system design and SME success can enhance operational efficiency, employee engagement, and overall competitiveness for SMEs. This comprehensive examination of the literature contributes significantly to both academic research and practical decision-making for SMEs.Keywords: literature review, productivity, small and medium sized enterprises-SMEs, work system design
Procedia PDF Downloads 9414908 Advancements in Laser Welding Process: A Comprehensive Model for Predictive Geometrical, Metallurgical, and Mechanical Characteristics
Authors: Seyedeh Fatemeh Nabavi, Hamid Dalir, Anooshiravan Farshidianfar
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Laser welding is pivotal in modern manufacturing, offering unmatched precision, speed, and efficiency. Its versatility in minimizing heat-affected zones, seamlessly joining dissimilar materials, and working with various metals makes it indispensable for crafting intricate automotive components. Integration into automated systems ensures consistent delivery of high-quality welds, thereby enhancing overall production efficiency. Noteworthy are the safety benefits of laser welding, including reduced fumes and consumable materials, which align with industry standards and environmental sustainability goals. As the automotive sector increasingly demands advanced materials and stringent safety and quality standards, laser welding emerges as a cornerstone technology. A comprehensive model encompassing thermal dynamic and characteristics models accurately predicts geometrical, metallurgical, and mechanical aspects of the laser beam welding process. Notably, Model 2 showcases exceptional accuracy, achieving remarkably low error rates in predicting primary and secondary dendrite arm spacing (PDAS and SDAS). These findings underscore the model's reliability and effectiveness, providing invaluable insights and predictive capabilities crucial for optimizing welding processes and ensuring superior productivity, efficiency, and quality in the automotive industry.Keywords: laser welding process, geometrical characteristics, mechanical characteristics, metallurgical characteristics, comprehensive model, thermal dynamic
Procedia PDF Downloads 4814907 Study and Evaluation of Occupational Health and Safety in Power Plant in Pakistan
Authors: Saira Iqbal
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Occupational Health and Safety issues nowadays have become an important esteem in the context of Industrial Production. This study is designed to measure the workplace hazards at Kohinoor Energy Limited. Mainly focused hazards were Heat Stress, Noise Level, Light Level and Ergonomics. Measurements for parameters like Wet, Dry, Globe, WBGTi and RH% were taken directly by visiting the Study Area. The temperature in Degrees was recoded at Control Room and Engine Hall. Highest Temperature was recoded in Engine Hall which was about 380C. Efforts were made to record emissions of Noise Levels from the main area of concern like Engines in Engine hall, parking area, and mechanical workshop. Permissible level for measuring Noise is 85 and its Unit of Measurement is dB (A). In Engine Hall Noise was very high which was about 109.6 dB (A) and that level was exceeding the limits. Illumination Level was also recorded at different areas of Power Plant. The light level was though under permissible limits but in some areas like Engine Hall and Boiler Room, level of light was very low especially in Engine Hall where the level was 29 lx. Practices were performed for measuring hazards in context of ergonomics like extended reaching, deviated body postures, mechanical stress, and vibration exposures of the worker at different units of plants by just observing workers during working hours. Since KEL is ISO 8000 and 14000 certified, the researcher found no serious problems in the parameter Ergonomics however it was a common scenario that workers were reluctant to apply PPEs.Keywords: workplace hazards, heat hazard, noise hazard, illumination, ergonomics
Procedia PDF Downloads 32114906 Impact of Contemporary Performance Measurement System and Organization Justice on Academic Staff Work Performance
Authors: Amizawati Mohd Amir, Ruhanita Maelah, Zaidi Mohd Noor
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As part of the Malaysia Higher Institutions' Strategic Plan in promoting high-quality research and education, the Ministry of Higher Education has introduced various instrument to assess the universities performance. The aims are that university will produce more commercially-oriented research and continue to contribute in producing professional workforce for domestic and foreign needs. Yet the spirit of the success lies in the commitment of university particularly the academic staff to translate the vision into reality. For that reason, the element of fairness and justice in assessing individual academic staff performance is crucial to promote directly linked between university and individual work goals. Focusing on public research universities (RUs) in Malaysia, this study observes at the issue through the practice of university contemporary performance measurement system. Accordingly management control theory has conceptualized that contemporary performance measurement consisting of three dimension namely strategic, comprehensive and dynamic building upon equity theory, the relationships between contemporary performance measurement system and organizational justice and in turn the effect on academic staff work performance are tested based on online survey data administered on 365 academic staff from public RUs, which were analyzed using statistics analysis SPSS and Equation Structure Modeling. The findings validated the presence of strategic, comprehensive and dynamic in the contemporary performance measurement system. The empirical evidence also indicated that contemporary performance measure and procedural justice are significantly associated with work performance but not for distributive justice. Furthermore, procedural justice does mediate the relationship between contemporary performance measurement and academic staff work performance. Evidently, this study provides evidence on the importance of perceptions of justice towards influencing academic staff work performance. This finding may be a fruitful input in the setting up academic staff performance assessment policy.Keywords: comprehensive, dynamic, distributive justice, contemporary performance measurement system, strategic, procedure justice, work performance
Procedia PDF Downloads 40814905 Virtual Process Hazard Analysis (Pha) Of a Nuclear Power Plant (Npp) Using Failure Mode and Effects Analysis (Fmea) Technique
Authors: Lormaine Anne A. Branzuela, Elysa V. Largo, Monet Concepcion M. Detras, Neil C. Concibido
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The electricity demand is still increasing, and currently, the Philippine government is investigating the feasibility of operating the Bataan Nuclear Power Plant (BNPP) to address the country’s energy problem. However, the lack of process safety studies on BNPP focused on the effects of hazardous substances on the integrity of the structure, equipment, and other components, have made the plant operationalization questionable to the public. The three major nuclear power plant incidents – TMI-2, Chernobyl, and Fukushima – have made many people hesitant to include nuclear energy in the energy matrix. This study focused on the safety evaluation of possible operations of a nuclear power plant installed with a Pressurized Water Reactor (PWR), which is similar to BNPP. Failure Mode and Effects Analysis (FMEA) is one of the Process Hazard Analysis (PHA) techniques used for the identification of equipment failure modes and minimizing its consequences. Using the FMEA technique, this study was able to recognize 116 different failure modes in total. Upon computation and ranking of the risk priority number (RPN) and criticality rating (CR), it showed that failure of the reactor coolant pump due to earthquakes is the most critical failure mode. This hazard scenario could lead to a nuclear meltdown and radioactive release, as identified by the FMEA team. Safeguards and recommended risk reduction strategies to lower the RPN and CR were identified such that the effects are minimized, the likelihood of occurrence is reduced, and failure detection is improved.Keywords: PHA, FMEA, nuclear power plant, bataan nuclear power plant
Procedia PDF Downloads 13114904 A Multidimensional Genetic Algorithm Applicable for Our VRP Variant Dealing with the Problems of Infrastructure Defaults SVRDP-CMTW: “Safety Vehicle Routing Diagnosis Problem with Control and Modified Time Windows”
Authors: Ben Mansour Mouin, Elloumi Abdelkarim
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We will discuss the problem of routing a fleet of different vehicles from a central depot to different types of infrastructure-defaults with dynamic maintenance requests, modified time windows, and control of default maintained. For this reason, we propose a modified metaheuristicto to solve our mathematical model. SVRDP-CMTW is a variant VRP of an optimal vehicle plan that facilitates the maintenance task of different types of infrastructure-defaults. This task will be monitored after the maintenance, based on its priorities, the degree of danger associated with each default, and the neighborhood at the black-spots. We will present, in this paper, a multidimensional genetic algorithm “MGA” by detailing its characteristics, proposed mechanisms, and roles in our work. The coding of this algorithm represents the necessary parameters that characterize each infrastructure-default with the objective of minimizing a combination of cost, distance and maintenance times while satisfying the priority levels of the most urgent defaults. The developed algorithm will allow the dynamic integration of newly detected defaults at the execution time. This result will be displayed in our programmed interactive system at the routing time. This multidimensional genetic algorithm replaces N genetic algorithm to solve P different type problems of infrastructure defaults (instead of N algorithm for P problem we can solve in one multidimensional algorithm simultaneously who can solve all these problemsatonce).Keywords: mathematical model, VRP, multidimensional genetic algorithm, metaheuristics
Procedia PDF Downloads 19614903 Bibliometric Analysis of Risk Assessment of Inland Maritime Accidents in Bangladesh
Authors: Armana Huq, Wahidur Rahman, Sanwar Kader
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Inland waterways in Bangladesh play an important role in providing comfortable and low-cost transportation. However, a maritime accident takes away many lives and creates unwanted hazards every year. This article deals with a comprehensive review of inland waterway accidents in Bangladesh. Additionally, it includes a comparative study between international and local inland research studies based on maritime accidents. Articles from inland waterway areas are analyzed in-depth to make a comprehensive overview of the nature of the academic work, accident and risk management process and different statistical analyses. It is found that empirical analysis based on the available statistical data dominates the research domain. For this study, major maritime accident-related works in the last four decades in Bangladesh (1981-2020) are being analyzed for preparing a bibliometric analysis. A study of maritime accidents of passenger's vessels during (1995-2005) indicates that the predominant causes of accidents in the inland waterways of Bangladesh are collision and adverse weather (77%), out of which collision due to human error alone stands (56%) of all accidents. Another study refers that the major causes of waterway accidents are the collision (60.3%) during 2005-2015. About 92% of this collision occurs due to direct contact with another vessel during this period. Rest 8% of the collision occurs by contact with permanent obstruction on waterway roots. The overall analysis of another study from the last 25 years (1995-2019) shows that one of the main types of accidents is collisions, with about 50.3% of accidents being caused by collisions. The other accident types are cyclone or storm (17%), overload (11.3%), physical failure (10.3%), excessive waves (5.1%), and others (6%). Very few notable works are available in testing or comparing the methods, proposing new methods for risk management, modeling, uncertainty treatment. The purpose of this paper is to provide an overview of the evolution of marine accident-related research domain regarding inland waterway of Bangladesh and attempts to introduce new ideas and methods to abridge the gap between international and national inland maritime-related work domain which can be a catalyst for a safer and sustainable water transportation system in Bangladesh. Another fundamental objective of this paper is to navigate various national maritime authorities and international organizations to implement risk management processes for shipping accident prevention in waterway areas.Keywords: inland waterways, safety, bibliometric analysis, risk management, accidents
Procedia PDF Downloads 18214902 Characteristics of the Labor Intensity of Secondary School Teachers
Authors: Meruyert Burumbayeva, Aiman Mussina, Gulshat Yerdenova, Bakyt Ilyassova, Aiymtory Abildaeva, Gulnoza Aldabekova
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In this paper, there were analyzed the intensity of teachers of secondary schools of Astana. The analysis is based on the account of the whole complex of factors of production, creating the preconditions for the emergence of adverse neuro-emotional states (surge). All the factors of the labor process in the qualitative or quantitative terms were grouped into types of loads: intellectual, sensory, emotional, monotone, regime. The results showed that teachers' work activity is more intense in terms of sensory, intellectual, emotional work schedule loads and characterized class working conditions for tensions as '1st degree of harmful stressful work' and by a combined indicator refers to the category of high labor intensity.Keywords: intensity of teachers, neuro-emotional states, labor process, occupational stress
Procedia PDF Downloads 32614901 A Systematic Review Examining the Experimental methodology behind in vivo testing of hiatus hernia and Diaphragmatic Hernia Mesh
Authors: Whitehead-Clarke T., Beynon V., Banks J., Karanjia R., Mudera V., Windsor A., Kureshi A.
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Introduction: Mesh implants are regularly used to help repair both hiatus hernias (HH) and diaphragmatic hernias (DH). In vivo studies are used to test not only mesh safety but increasingly comparative efficacy. Our work examines the field of in vivo mesh testing for HH and DH models to establish current practices and standards. Method: This systematic review was registered with PROSPERO. Medline and Embase databases were searched for relevant in vivo studies. 44 articles were identified and underwent abstract review, where 22 were excluded. 4 further studies were excluded after full text review – leaving 18 to undergo data extraction. Results: Of 18 studies identified, 9 used an in vivo HH model and 9 a DH model. 5 studies undertook mechanical testing on tissue samples – all uniaxial in nature. Testing strip widths ranged from 1-20mm (median 3mm). Testing speeds varied from 1.5-60mm/minute. Upon histology, the most commonly assessed structural and cellular factors were neovascularization and macrophages, respectively (n=9 each). Structural analysis was mostly qualitative, where cellular analysis was equally likely to be quantitative. 11 studies assessed adhesion formation, of which 8 used one of four scoring systems. 8 studies measured mesh shrinkage. Discussion: In vivo studies assessing mesh for HH and DH repair are uncommon. Within this relatively young field, we encourage surgical and materials testing institutions to discuss its standardisation.Keywords: hiatus, diaphragmatic, hernia, mesh, materials testing, in vivo
Procedia PDF Downloads 21414900 Prediction of the Behavior of 304L Stainless Steel under Uniaxial and Biaxial Cyclic Loading
Authors: Aboussalih Amira, Zarza Tahar, Fedaoui Kamel, Hammoudi Saleh
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This work focuses on the simulation of the prediction of the behaviour of austenitic stainless steel (SS) 304L under complex loading in stress and imposed strain. The Chaboche model is a cable to describe the response of the material by the combination of two isotropic and nonlinear kinematic work hardening, the model is implemented in the ZébuLon computer code. First, we represent the evolution of the axial stress as a function of the plastic strain through hysteresis loops revealing a hardening behaviour caused by the increase in stress by stress in the direction of tension/compression. In a second step, the study of the ratcheting phenomenon takes a key place in this work by the appearance of the average stress. In addition to the solicitation of the material in the biaxial direction in traction / torsion.Keywords: damage, 304L, Ratcheting, plastic strain
Procedia PDF Downloads 9414899 Saline Aspiration Negative Intravascular Test: Mitigating Risk with Injectable Fillers
Authors: Marcelo Lopes Dias Kolling, Felipe Ferreira Laranjeira, Guilherme Augusto Hettwer, Pedro Salomão Piccinini, Marwan Masri, Carlos Oscar Uebel
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Introduction: Injectable fillers are among the most common nonsurgical cosmetic procedures, with significant growth yearly. Knowledge of rheological and mechanical characteristics of fillers, facial anatomy, and injection technique is essential for safety. Concepts such as the use of cannula versus needle, aspiration before injection, and facial danger zones have been well discussed. In case of an accidental intravascular puncture, the pressure inside the vessel may not be sufficient to push blood into the syringe due to the characteristics of the filler product; this is especially true for calcium hydroxyapatite (CaHA) or hyaluronic acid (HA) fillers with high G’. Since viscoelastic properties of normal saline are much lower than those of fillers, aspiration with saline prior to filler injection may decrease the risk of a false negative aspiration and subsequent catastrophic effects. We discuss a technique to add an additional safety step to the procedure with saline aspiration prior to injection, a ‘’reverse Seldinger’’ technique for intravascular access, which we term SANIT: Saline Aspiration Negative Intravascular Test. Objectives: To demonstrate the author’s (PSP) technique which adds an additional safety step to the process of filler injection, with both CaHA and HA, in order to decrease the risk of intravascular injection. Materials and Methods: Normal skin cleansing and topical anesthesia with prilocaine/lidocaine cream are performed; the facial subunits to be treated are marked. A 3mL Luer lock syringe is filled with 2mL of 0.9% normal saline and a 27G needle, which is turned one half rotation. When a cannula is to be used, the Luer lock syringe is attached to a 27G 4cm single hole disposable cannula. After skin puncture, the 3mL syringe is advanced with the plunger pulled back (negative pressure). Progress is made to the desired depth, all the while aspirating. Once the desired location of filler injection is reached, the syringe is exchanged for the syringe containing a filler, securely grabbing the hub of the needle and taking care to not dislodge the needle tip. Prior to this, we remove 0.1mL of filler to allow for space inside the syringe for aspiration. We again aspirate and inject retrograde. SANIT is especially useful for CaHA, since the G’ is much higher than HA, and thus reflux of blood into the syringe is less likely to occur. Results: The technique has been used safely for the past two years with no adverse events; the increase in cost is negligible (only the cost of 2mL of normal saline). Over 100 patients (over 300 syringes) have been treated with this technique. The risk of accidental intravascular puncture has been calculated to be between 1:6410 to 1:40882 syringes among expert injectors; however, the consequences of intravascular injection can be catastrophic even with board-certified physicians. Conclusions: While the risk of intravascular filler injection is low, the consequences can be disastrous. We believe that adding the SANIT technique can help further mitigate risk with no significant untoward effects and could be considered by all performing injectable fillers. Further follow-up is ongoing.Keywords: injectable fillers, safety, saline aspiration, injectable filler complications, hyaluronic acid, calcium hydroxyapatite
Procedia PDF Downloads 15014898 Behavior of Pet Packaging on Quality Characteristics of an Algerian Virgin Olive Oil Under Various Conditions of Storage
Authors: Hamitri-Guerfi Fatiha, Mekimene Lekhder, Madani Khodir, Youyou Ahcene
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Virgin olive oil is appreciated by consumers, the quality of the oil is regulated by the international olive oil council depends on its chemical composition, so, the correct packing conditions are a prerequisite to preserve oil color, flavor, and nutriments, from production to consumption. The contact of food with various materials of packaging, since the production, until their consumption constitutes one of the essential aspects of food safety (directive 76/833/CEE). In Algeria, plastic bottles, although, they are economic and light are largely used at packaging olive oil but not used in other countries. This is due to migration phenomena that can occur from these materials. Thus, the goal of this work is to examine the physicochemical behavior of the couple packaging plastic-oil during their exposure to three temperatures corresponding to the conditions of storage applied in Algeria. Like, it is difficult to compare blowers of bottles which are heavy engineering, it comes out from this study that the effect of heat, the absorption of water, the constraints of storage of acidity, as well as the composition of oil, the PET bottles showed a remarkable structural instability, this defect of quality was confirmed by the analysis of morphology by electronic scan microscopy. These bottles present a total migration significantly higher than the threshold of acceptance. Moreover, a metal contamination of oil by its packaging was confirmed by the spectroscopy of atomic absorption and a microanalysis. The differences observed between the results of the microanalysis applied and the mechanical characterizations of the various bottles are reported, showing the reality of the container-contents exchanges.Keywords: interaction, stability, pet, virgin olive oil
Procedia PDF Downloads 46014897 Comparative Study on Effectiveness and Safety of Oral Antidiabetic Medications in Patients with Type 2 Diabetes Mellitus in a Tertiary Care Hospital of Bangalore, South India - A Prospective Cohort Study
Authors: Shobha Rani R. Hiremath, Keerthana R., Madhuvan H. S.
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1.BACKGROUND: Type 2 Diabetes is a chronic health condition where the body cannot effectively use the insulin it produces, leading to elevated blood sugar levels It is often associated with lifestyle factors and insulin resistance. Globally, diabetes is on the rise, with urban areas like Bangalore seeing a surge due to lifestyle changes, stress, and dietary habits. To manage diabetes effectively, over 50 medications are available, each serving to regulate blood sugar through different mechanisms. This reflects the complex and individualized nature of diabetes treatment. Given the increase in medications for Type 2 diabetes mellitus, it is important to evaluate their effectiveness and safety so that clinicians can make informed choices while treating their patients. 2.OBJECTIVES: To evaluate the effectiveness of various anti-diabetic medications used in the hospital in Type 2 diabetes patients by monitoring their HbA1c levels. To assess the safety of these medications by monitoring Adverse drug reactions if any. 3. METHODOLOGY: Design : Prospective Cohort study, Study period: 8 months, Sample Size: 100 patients. Inclusion Criteria: Patients above 18 years of both genders who were diagnosed with T2DM and who were prescribed oral hypoglycaemic agents. Exclusion Criteria: Diabetic patients with hepatic/renal failure, patients prescribed with insulin /not prescribed with OHAs and patients who were terminally ill, pregnant and lactating patients. Source of Data: Prescriptions, lab reports, ECG reports. Data collection forms were used to collect data which consisted of patient demographic details, drugs prescribed, laboratory investigations such as HbA1C, FBS, PPBS , ECG and any ADRs experienced. Data was collected at baseline, 3 months, and 6 months. It was statistically analyzed using SPSS (version 26) software. 4. RESULTS: Greater number of patients (46%) were in the age group of greater than 61 years. 43 patients had no co-morbidities whereas 51 patients had Hypertension as the co morbidity. Basically 5 Drug combinations were prescribed as follows. Combination 1: Tablet Metformin HCL + Glimepiride (500, 2 mg) : 1-0-1, Combination 2: Tablet Sitagliptin + Metformin HCL (50, 500 mg) : 1-0-1, Combination 3: Tablet Vildagliptin + Metformin HCL (50, 500 mg): 1-0-1, Combination 4: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2 ,2 ,500mg): : 1-0-1, Combination 5: Tablet Voglibose+ Glimepiride+ Metformin HCL (0.2, 2 ,500mg): : 1-0-1 and T. Sitagliptin +Metformin HCL (50, 500 mg): 0-1-0. Combination 5 (Voglibose, Glimepiride, Metformin, Sitagliptin) was most effective in reducing HbA1c levels, showing a significant decrease (-0.00682, p = 0.001), followed by Combinations 4 and 3. However, Combination 5 also had the highest incidence of gastrointestinal side effects (72.7%) and ECG abnormalities (27.3%). Combination 1 (Metformin + Glimepiride) had the highest occurrence of hypoglycemia due to Glimepiride's insulin-stimulating effects. Weight loss was most notable in Combination 5, affecting 36.36% of patients. 5.CONCLUSION: The enhanced effectiveness of Combinations 3, 4, and 5 suggests that a multi-drug approach that incorporates different mechanisms of action is more effective in managing HbA1c levels in patients with diabetes. Adverse effect profiles should be considered for personalized treatment strategies.Keywords: type 2 diabetes, safety, oral anti diabetic medications, effectiveness
Procedia PDF Downloads 1014896 Rear Seat Belt Use in Developing Countries: A Case Study from the United Arab Emirates
Authors: Salaheddine Bendak, Sara S. Alnaqbi
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The seat belt is a vital tool in improving traffic safety conditions and minimising injuries due to traffic accidents. Most developing countries are facing a big problems associated with the human and financial losses due to traffic accidents. One way to minimise these losses is the use of seat belts by passengers both in the front and rear seats of a vehicle; however, at the same time, close to nothing is known about the rates of seat belt utilisation among rear seat passengers in many developing countries. Therefore, there is a need to estimate these rates in order to know the extent of this problem and how people interact with traffic safety measures like seat belts and find demographic characteristics that contribute to wearing or non-wearing of seat belts with the aim of finding solutions to improve wearing rates. In this paper, an observational study was done to gather data on restraints use in motor vehicle rear seats in eight observational stations in a rapidly developing country, the United Arab Emirates (UAE), and estimate a use rate for the whole country. Also, a questionnaire was used in order to study demographic characteristics affecting the wearing of seatbelts in rear seats. Results of the observational study showed that the overall wearing/usage rate was 12.3%, which is considered very low when compared to other countries. Survey results show that single, male, less educated passengers from Arab and South Asian backgrounds use seat belts reportedly less than others. Finally, solutions are put forward to improve this wearing rate based on the results of this study.Keywords: Seat belts, traffic crashes, United Arab Emirates, rear seats
Procedia PDF Downloads 25014895 Motivational Interviewing as a Framework for Coaching Physicians through ACGME Milestones
Authors: Michael Olson
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The Accreditation Council for Graduate Medical Education (ACGME) in the U.S. has established core competencies and milestones for family physicians in residency training programs. These competencies are intended to guide preceptors as they work with physician trainees toward independent practice. This conceptual paper describes a framework for coaching trainees toward these milestones using motivational interviewing as an evidence-based approach. The main objective of applying the motivational interviewing framework to the residency training setting is to facilitate clinical behavior change that meets higher level competencies/rubric. This is a work in progress and there is no manuscript/paper prepared to date. A conceptual paper/framework will be completed by the conference deadline. This is based on a separate but related development of work we have completed and published elsewhere.Keywords: coaching, motivational interviewing, physicians, competencies
Procedia PDF Downloads 17514894 Exploratory Research on Outsourcing Practices and Benefits on Telecommunication Industry in Oman
Authors: Alyamama Alsaidi
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This research has been conducted in order to analyse the impact of outsourcing on telecommunication industry in Oman. The research is conducted by collecting qualitative and quantitative data in order to widen the area of comprehension. The data has been collected from genuine sources which showcased that results were reliable and possess validity. The outsourcing is very important because it helps the organisation in saving the cost and efforts of the workers. In Oman, the telecommunication industry largely uses the outsourcing service which is provided by the third party. The third party is responsible for providing outsourcing to the telecommunication companies. This research gives an overall view of the outsourcing in the telecommunication companies of Oman. The IT companies of Oman give their work to the outsourcing services as this will help in reducing the cost the project. Rather employing the experts to do the projects, the organization can easily give their products to the outsourcing services in which they complete the work for a cheaper rate for the telecommunication company of Oman. It will help in reducing the work load on the staffs and management of the telecommunication companies in Oman. The IT outsourcing in Oman is very common because some of the staff are not well experienced to do the IT work. The outsourcing has positive as well as negative impact on the telecommunication industry in Oman. The research has been done while considering ethical aspect in an effective and efficient manner. Furthermore, the literature is adequately reviewed so that views of various specialists can be considered for future guidance.Keywords: IT outsourcing, client company, services company, telecommunication
Procedia PDF Downloads 18614893 Employability Skills: Students' Perspectives Post Work Placement Experience
Authors: Mamie Y. Griffin, Pedro Coelhoso
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Employability skills of university graduates remain an ongoing topic for discussion and debate. Numerous studies highlight the expressed concerns of governments and industries about higher education’s ability to develop workforce-ready graduates. An often cited solution is the use of internships to equip students with necessary employability skills. The literature is well documented with studies from the perspectives of multiple entities including employers and university faculty, mostly in the western world. Fewer studies examine the perception of students, and even fewer studies are based on students in Gulf countries. This paper assesses the status of employability skills from the perspective of students within a United Arab Emirates (UAE) institution based on their completion of a semester-long work placement experience. Using a largely qualitative instrument, students reported the essential skills needed in the workplace, classroom activities that most prepared students to use such skills in the workplace, and the various challenges they encountered. Implications for academic and professional practitioners are discussed. Findings and recommendations are informative for curriculum development as well as economic and workforce development agencies.Keywords: employability skills, work placement experience, Gulf countries, workforce preparedness, work placement
Procedia PDF Downloads 34914892 Security Issues in Long Term Evolution-Based Vehicle-To-Everything Communication Networks
Authors: Mujahid Muhammad, Paul Kearney, Adel Aneiba
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The ability for vehicles to communicate with other vehicles (V2V), the physical (V2I) and network (V2N) infrastructures, pedestrians (V2P), etc. – collectively known as V2X (Vehicle to Everything) – will enable a broad and growing set of applications and services within the intelligent transport domain for improving road safety, alleviate traffic congestion and support autonomous driving. The telecommunication research and industry communities and standardization bodies (notably 3GPP) has finally approved in Release 14, cellular communications connectivity to support V2X communication (known as LTE – V2X). LTE – V2X system will combine simultaneous connectivity across existing LTE network infrastructures via LTE-Uu interface and direct device-to-device (D2D) communications. In order for V2X services to function effectively, a robust security mechanism is needed to ensure legal and safe interaction among authenticated V2X entities in the LTE-based V2X architecture. The characteristics of vehicular networks, and the nature of most V2X applications, which involve human safety makes it significant to protect V2X messages from attacks that can result in catastrophically wrong decisions/actions include ones affecting road safety. Attack vectors include impersonation attacks, modification, masquerading, replay, MiM attacks, and Sybil attacks. In this paper, we focus our attention on LTE-based V2X security and access control mechanisms. The current LTE-A security framework provides its own access authentication scheme, the AKA protocol for mutual authentication and other essential cryptographic operations between UEs and the network. V2N systems can leverage this protocol to achieve mutual authentication between vehicles and the mobile core network. However, this protocol experiences technical challenges, such as high signaling overhead, lack of synchronization, handover delay and potential control plane signaling overloads, as well as privacy preservation issues, which cannot satisfy the adequate security requirements for majority of LTE-based V2X services. This paper examines these challenges and points to possible ways by which they can be addressed. One possible solution, is the implementation of the distributed peer-to-peer LTE security mechanism based on the Bitcoin/Namecoin framework, to allow for security operations with minimal overhead cost, which is desirable for V2X services. The proposed architecture can ensure fast, secure and robust V2X services under LTE network while meeting V2X security requirements.Keywords: authentication, long term evolution, security, vehicle-to-everything
Procedia PDF Downloads 16714891 Telemedicine Versus Face-to-Face Follow up in General Surgery: A Randomized Controlled Trial
Authors: Teagan Fink, Lynn Chong, Michael Hii, Brett Knowles
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Background: Telemedicine is a rapidly advancing field providing healthcare to patients at a distance from their treating clinician. There is a paucity of high-quality evidence detailing the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial – conducted prior to the COVID 19 pandemic – aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) of telephone compared to face-to-face clinic follow-up after uncomplicated general surgical procedures. Methods: Patients following uncomplicated laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic follow-up. Data points including patient demographics, perioperative details and postoperative outcomes (eg. wound healing complications, pain scores, unplanned readmission to hospital and return to daily activities) were compared between groups. Patients also completed a Likert patient satisfaction survey following their consultation. Results: 103 patients were recruited over a 12-month period (21 laparoscopic appendicectomies, 65 laparoscopic cholecystectomies, nine open umbilical hernia repairs, six laparoscopic inguinal hernia repairs and two laparoscopic umbilical hernia repairs). Baseline patient demographics and operative interventions were the same in both groups. Patient or clinician-reported concerns on postoperative pain, use of analgesia, wound healing complications and return to daily activities at clinic follow-up were not significantly different between the two groups. Of the 58 patients randomized to the telemedicine arm, 40% reported high and 60% reported very high patient satisfaction. Telemedicine clinic mean consultation times were significantly shorter than face-to-face consultation times (telemedicine 10.3 +/- 7.2 minutes, face-to-face 19.2 +/- 23.8 minutes, p-value = 0.014). Rates of failing to attend clinic were not significantly different (telemedicine 3%, control 6%). There was no increased rate of postoperative complications in patients followed up by telemedicine compared to in-person. There were no unplanned readmissions, return to theatre, or mortalities in this study. Conclusion: Telemedicine follow-up of patients undergoing uncomplicated general surgery is safe and does not result in any missed diagnosis or higher rates of complications. Telemedicine provides high patient satisfaction and steps to implement this modality in inpatient care should be undertaken.Keywords: general surgery, telemedicine, patient satisfaction, patient safety
Procedia PDF Downloads 11814890 Buoyant Gas Dispersion in a Small Fuel Cell Enclosure: A Comparison Study Using Plain and Pressed Louvre Vent Passive Ventilation Schemes
Authors: T. Ghatauray, J. Ingram, P. Holborn
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The transition from a ‘carbon rich’ fossil fuel dependent to a ‘sustainable’ and ‘renewable’ hydrogen based society will see the deployment of hydrogen fuel cells (HFC) in transport applications and in the generation of heat and power for buildings, as part of a decentralised power network. Many deployments will be low power HFCs for domestic combined heat and power (CHP) and commercial ‘transportable’ HFCs for environmental situations, such as lighting and telephone towers. For broad commercialisation of small fuel cells to be achieved there needs to be significant confidence in their safety in both domestic and environmental applications. Low power HFCs are housed in protective steel enclosures. Standard enclosures have plain rectangular ventilation openings intended for thermal management of electronics and not the dispersion of a buoyant gas. Degradation of the HFC or supply pipework in use could lead to a low-level leak and a build-up of hydrogen gas in the enclosure. Hydrogen’s wide flammable range (4-75%) is a significant safety concern, with ineffective enclosure ventilation having the potential to cause flammable mixtures to develop with the risk of explosion. Mechanical ventilation is effective at managing enclosure hydrogen concentrations, but drains HFC power and is vulnerable to failure. This is undesirable in low power and remote installations and reliable passive ventilation systems are preferred. Passive ventilation depends upon buoyancy driven flow, with the size, shape and position of ventilation openings critical for producing predictable flows and maintaining low buoyant gas concentrations. With environmentally sited enclosures, ventilation openings with pressed horizontal and angled louvres are preferred to protect the HFC and electronics inside. There is an economic cost to adding louvres, but also a safety concern. A question arises over whether the use of pressed louvre vents impairs enclosure passive ventilation performance, when compared to same opening area plain vents. Comparison small enclosure (0.144m³) tests of same opening area pressed louvre and plain vents were undertaken. A displacement ventilation arrangement was incorporated into the enclosure with opposing upper and lower ventilation openings. A range of vent areas were tested. Helium (used as a safe analogue for hydrogen) was released from a 4mm nozzle at the base of the enclosure to simulate a hydrogen leak at leak rates from 1 to 10 lpm. Helium sensors were used to record concentrations at eight heights in the enclosure. The enclosure was otherwise empty. These tests determined that the use of pressed and angled louvre ventilation openings on the enclosure impaired the passive ventilation flow and increased helium concentrations in the enclosure. High-level stratified buoyant gas layers were also found to be deeper than with plain vent openings and were within the flammable range. The presence of gas within the flammable range is of concern, particularly as the addition of the fuel cell and electronics in the enclosure would further reduce the available volume and increase concentrations. The opening area of louvre vents would need to be greater than equivalent plain vents to achieve comparable ventilation flows or alternative schemes would need to be considered.Keywords: enclosure, fuel cell, helium, hydrogen safety, louvre vent, passive ventilation
Procedia PDF Downloads 27414889 A Neural Network Approach for an Automatic Detection and Localization of an Open Phase Circuit of a Five-Phase Induction Machine Used in a Drivetrain of an Electric Vehicle
Authors: Saad Chahba, Rabia Sehab, Ahmad Akrad, Cristina Morel
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Nowadays, the electric machines used in urban electric vehicles are, in most cases, three-phase electric machines with or without a magnet in the rotor. Permanent Magnet Synchronous Machine (PMSM) and Induction Machine (IM) are the main components of drive trains of electric and hybrid vehicles. These machines have very good performance in healthy operation mode, but they are not redundant to ensure safety in faulty operation mode. Faced with the continued growth in the demand for electric vehicles in the automotive market, improving the reliability of electric vehicles is necessary over the lifecycle of the electric vehicle. Multiphase electric machines respond well to this constraint because, on the one hand, they have better robustness in the event of a breakdown (opening of a phase, opening of an arm of the power stage, intern-turn short circuit) and, on the other hand, better power density. In this work, a diagnosis approach using a neural network for an open circuit fault or more of a five-phase induction machine is developed. Validation on the simulator of the vehicle drivetrain, at reduced power, is carried out, creating one and more open circuit stator phases showing the efficiency and the reliability of the new approach to detect and to locate on-line one or more open phases of a five-induction machine.Keywords: electric vehicle drivetrain, multiphase drives, induction machine, control, open circuit (OC) fault diagnosis, artificial neural network
Procedia PDF Downloads 20914888 Safety and Feasibility of Distal Radial Balloon Aortic Valvuloplasty - The DR-BAV Study
Authors: Alexandru Achim, Tamás Szűcsborus, Viktor Sasi, Ferenc Nagy, Zoltán Jambrik, Attila Nemes, Albert Varga, Călin Homorodean, Olivier F. Bertrand, Zoltán Ruzsa
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Aim: Our study aimed to establish the safety and the technical success of distal radial access for balloon aortic valvuloplasty (DR-BAV). The secondary objective was to determine the effectiveness and appropriate role of DR-BAV within half year follow-up. Methods: Clinical and angiographic data from 32 consecutive patients with symptomatic aortic stenosis were evaluated in a prospective pilot single-center study. Between 2020 and 2021, the patients were treated utilizing dual distal radial access with 6-10F compatible balloons. The efficacy endpoint was divided into technical success (successful valvuloplasty balloon inflation at the aortic valve and absence of intra- or periprocedural major complications), hemodynamic success (a reduction of the mean invasive gradient >30%), and clinical success (an improvement of at least one clinical category in the NYHA classification). The safety endpoints were vascular complications (major and minor Valve Academic Research Consortium (VARC)-2 bleeding, diminished or lost arterial pulse or the presence of any pseudo-aneurysm or arteriovenous fistula during the clinical follow-up) and major adverse events, MAEs (the composite of death, stroke, myocardial infarction, and urgent major aortic valve replacement or implantation during the hospital stay and or at one-month follow-up). Results: 32 patients (40 % male, mean age 80 ± 8,5) with severe aortic valve stenosis were included in the study and 4 patients were excluded. Technical success was achieved in all patients (100%). Hemodynamic success was achieved in 30 patients (93,75%). Invasive max and mean gradients were reduced from 73±22 mm Hg and 49±22 mm Hg to 49±19 mm Hg and 20±13 mm Hg, respectively (p = <.001). Clinical success was achieved in 29 patients (90,6%). In total, no major adverse cardiac or cerebrovascular event nor vascular complications (according to VARC 2 criteria) occurred during the intervention. All-cause death at 6 months was 12%. Conclusion: According to our study, dual distal radial artery access is a safe and effective option for balloon aortic valvuloplasty in patients with severe aortic valve stenosis and can be performed in all patients with sufficient lumen diameter. Future randomized studies are warranted to investigate whether this technique is superior to other approaches.Keywords: mean invasive gradient, distal radial access for balloon aortic valvuloplasty (DR-BAV), aortic valve stenosis, pseudo-aneurysm, arteriovenous fistula, valve academic research consortium (VARC)-2
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