Search results for: heart failure rehospitalization

Authors: Mustafa Albayrak, Mete Onur Kaman, Ilyas Bozkurt

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In this study, the necessary material parameters were determined to be able to conduct progressive damage analysis of layered composites under low velocity impact by using the MAT162 material module in the LS-DYNA program. The material module MAT162 based on Hashin failure criterion requires 34 parameters in total. Some of these parameters were obtained directly as a result of dynamic and quasi-static mechanical tests, and the remaining part was calibrated and determined by comparing numerical and experimental results. Woven glass/epoxy was used as the composite material and it was produced by vacuum infusion method. In the numerical model, composites are modeled as three-dimensional and layered. As a result, the acquisition of MAT162 material module parameters, which will enable progressive damage analysis, is given in detail and step by step, and the selection methods of the parameters are explained. Numerical data consistent with the experimental results are given in graphics.

Keywords: Composite Impact, Finite Element Simulation, Progressive Damage Analyze, LS-DYNA, MAT162

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Authors: Sourina Bej

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Since the process of decolonization in 1940, several countries in South Asia have witnessed intra-state conflicts owing to ineffective political governance. The conflicts have remained protracted as the countries have failed to make a holistic transition to a democratic state. Nepal is one such South Asian country facing a turmultous journey from monarchy to republicanism. The paper aims to focus on the democratic transition in the context of Nepal’s political, legal and economic institutions. The presence of autocratic feudalistic and centralised state structure with entrenched socio-economic inequalities has resulted in mass uprising only to see the country slip back to the old order. Even a violent civil war led by the Maoists could not overhaul the political relations or stabilize the democratic space. The paper aims to analyse the multiple political, institutional and operational challenges in the implementation of the peace agreement with the Maoist. Looking at the historical background, the paper will examine the problematic nation-building that lies at the heart of fragile peace process in Nepal. Regional dynamics have played a big role in convoluting the peace-building. The new constitution aimed at conflict resolution brought to the open, deep seated hatred among different ethnic groups in Nepal. Apart from studying the challenges to the peace process and the role of external players like India and China in the political reconstruction, the paper will debate on a viable federal solution to the ethnic conflict in Nepal. If the current government fails to pass a constitution accepted by most ethnic groups, Nepal will remain on the brink of new conflict outbreaks.

Keywords: democratisation, ethnic conflict, Nepal, peace process

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Authors: O. P. Rahi, Manoj Kumar

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Power transformers are essential and expensive equipments in electrical power system. Dissolved gas analysis (DGA) is one of the most useful techniques to detect incipient faults in power transformers. However, the identification of the faulted location by conventional method is not always an easy task due to variability of gas data and operational variables. In this paper, an extension theory based power transformer fault diagnosis method is presented. Extension theory tries to solve contradictions and incompatibility problems. This paper first briefly introduces the basic concept of matter element theory, establishes the matter element models for three-ratio method, and then briefly discusses extension set theory. Detailed analysis is carried out on the extended relation function (ERF) adopted in this paper for transformer fault diagnosis. The detailed diagnosing steps are offered. Simulation proves that the proposed method can overcome the drawbacks of the conventional three-ratio method, such as no matching and failure to diagnose multi-fault. It enhances diagnosing accuracy.

Keywords: DGA, extension theory, ERF, fault diagnosis power transformers, fault diagnosis, fuzzy logic

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Authors: Yael Teff-Seker

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More often than not, ecosystems do not follow anthropogenic political borders. Thus, transboundary environmental protection or rehabilitation initiatives can be beneficial and at times even vital for supporting healthy ecosystems. Marine areas demand unique considerations and challenges for such initiatives, as maritime borders tend to be less defined, less fortified and less visible. In areas of recent conflict, cross-border environmental initiatives can also improve relations between states and promote peace-building efforts, in addition to their environmental benefits. The current study reviews the current literature on transboundary marine environmental protection initiatives that take place in these areas and focuses on joint initiatives in Israel-Jordan and Croatia-Slovenia. In addition to factors described in the literature such as funding and third-party involvement, findings suggest that the peripheral location of marine environmental initiatives can be beneficial for the success of such initiatives, as well as facilitating border crossing and the extent to which such initiatives advance other governmental goals. A sense of urgency, environmental or other, has also been found to be highly relevant to project success.

Keywords: environmental cooperation, environmental peacebuilding, marine environment, environmental conflict, environmental management

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Authors: Ji-Yuan Lin, Yu-Ming Liou, Yi-Ting Chen, Chen-Syuan Lin

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Soil water index obtained by tank model is now commonly used in soil and sand disaster alarm system in Japan. Comparing with the rainfall trigging index in Taiwan, the tank model is easy to predict the slope water content on large-scale landslide. Therefore, this study aims to estimate the threshold value of large-scale landslide using the soil water index Sixteen typhoons and heavy rainfall events, were selected to establish the, to relationship between landslide event and soil water index. Finally, the proposed threshold values for landslides on country road No.89 are suggested in this study. The study results show that 95% landslide cases occurred in soil water index more than 125mm, and 30% of the more serious slope failure occurred in the soil water index is greater than 250mm. Beside, this study speculates when soil water index more than 250mm and the difference value between second tank and third tank less than -25mm, it leads to large-scale landslide more probably.

Keywords: soil water index, tank model, landslide, threshold values

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Authors: I. P. Ezeugwunne, C. C. Onyenekwe, J. E. Ahaneku, G. I. Ahaneku

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Introduction: It has been reported that acute myocardial infarction (AMI) might occur at 1.5 ng/ml troponin level. HIV infection has been documented to influence antiviral drugs, stimulate the production of proteins that enhance fatty acids synthesis. Information on cardiac status in HIV-infected subjects in Nigeria is scanty. Aim: To evaluate the Apolipoprotein profile of HIV subjects in pre-and-post 12 months of antiretroviral therapy (ART) using 1.5 ng/ml troponin diagnostic cut-off for myocardial infarction (MI) in Nnewi, South Eastern, Nigeria. Methodology: A total of 30 symptomatic HIV subjects without malaria co-infection with a mean age of 40.70 ±10.56 years were randomly recruited for this prospective case-controlled study. Serum apolipoproteins (Apo A1, A2, B, C2,C3 and Apo E), troponin and CD4 counts were measured using standard laboratory methods. Parameters were re-classified based on 1.5 ng/ml troponin diagnostic cut-off for MI. Analysis of variance and student paired t-tests were used for data analyses. Results: paired-wise comparison showed that there were significantly higher levels of CD4 counts, Apo A2, Apo C2, Apo E but lower levels of ApoA1, ApoB and ApoC3 in symptomatic HIV subjects before antiretroviral therapy (ART) when compared with after therapy at p<0.05 respectively. The troponin value was significantly higher amongst the group studied at p<0.05, respectively. Conclusion: The increased values of troponin observed among the groups were higher than the diagnostic cut-off for AMI. This may imply that AMI may occur at any group of studies. But the significant reduction in the serum levels of Apo A2, Apo B, Apo C3, Apo E and a significant increase in serum levels of Apo A1, Apo C2 and blood CD4 counts as the length of therapy lengthened may indicate possible cardio-protective effects of the ART on the heart, which may connote recovery.

Keywords: ART, apolipoprotein, HIV, myocardial infarction

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Authors: Hossein Kh. Bisheh, Nan Wu

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Advanced composite materials have a great importance in engineering structures due to their high specific modulus and strength and low weight. These materials can be used in design and fabrication of automotive drive shafts to reduce the weight of the structure. Hence, an optimum design of a composite drive shaft satisfying the design criteria, can be an appropriate substitution of metallic drive shafts. The aim of this study is to design and analyze a composite automotive drive shaft with high specific strength and low weight satisfying the design criteria. Tsai-Wu criterion is chosen as the failure criterion. Various designs with different lay-ups and materials are investigated based on the design requirements and finally, an optimum design satisfying the design criteria is chosen based on the weight and cost considerations. The results of this study indicate that if the weight is the main concern, a shaft made of Carbon/Epoxy can be a good option, and if the cost is a more important parameter, a hybrid shaft made of aluminum and Carbon/Epoxy can be considered.

Keywords: Bending natural frequency, Composite drive shaft, Peak torque, Torsional buckling

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Authors: Hen Friman

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Various categories of aqueous solutions are discharged within residential, institutional, commercial, and industrial structures. To safeguard public health and preserve the environment, it is imperative to subject wastewater to treatment processes that eliminate pathogens (such as bacteria and viruses), nutrients (such as nitrogen and phosphorus), and other compounds. Failure to address untreated sewage accumulation can result in an array of adverse consequences. Israel exemplifies a special case in wastewater management. Appropriate wastewater treatment significantly benefits sectors such as agriculture, tourism, horticulture, and industry. Nevertheless, untreated sewage in settlements lacking proper sewage collection or transportation networks remains an ongoing and substantial threat. Notably, the process of wastewater treatment entails substantial energy consumption. Consequently, this study explores the integration of solar energy as a renewable power source within the wastewater treatment framework. By incorporating renewable energy sources into the process, costs can be minimized, and decentralized facilities can be established even in areas lacking adequate infrastructure for traditional treatment methods.

Keywords: renewable energy, solar energy, innovative, wastewater treatment

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Authors: Mayur Chaudhari, Ashutosh Gaikwad, Shubham Kavathale, Aditya Mule, Dilip Panchal, Puja Verma

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The purpose of this investigation was to locate restorative bio-materials for the manufacture of implants and crowns. A three-dimensional (3D) finite element analysis (FEA) was carried out to evaluate the stress distribution in the implant and abutment with several types of bio-materials and various prosthetic crowns. While the dental implant, abutment, and screw were subjected to a vertical impact force, the effects of mechanical characteristics such as Young's modulus and Poisson's ratio were evaluated and contrasted. Crowns are made from zirconia, cobalt, ceramic, acrylic resin, and porcelain materials. Implants are made from materials such as titanium, zirconia, PEEK, and CFR-PEEK. SolidWorks was used to create the 3D geometry, and Ansys Software was used to analyze it. The results show that using CFR-PEEK implants and an acrylic resin crown resulted in less bone stress than using alternative materials. In order to reduce the amount of stress on the bone and possibly prevent implant failure, the study's findings support the use of a CFR PEEK implant, abutment, and crown in bruxism patients.

Keywords: biomaterials, implant, crown, abutment

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Authors: Athina Thanou, Eirini Eleni Tsiropoulou, Symeon Papavassiliou

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The problem of museum visitor experience and congestion management – in various forms - has come increasingly under the spotlight over the last few years, since overcrowding can significantly decrease the quality of visitors’ experience. Evidence suggests that on busy days the amount of time a visitor spends inside a crowded house museum can fall by up to 60% compared to a quiet mid-week day. In this paper we consider the aforementioned problem, by treating museums as evolving social systems that induce constraints. However, in a cultural heritage space, as opposed to the majority of social environments, the momentum of the experience is primarily controlled by the visitor himself. Visitors typically behave selfishly regarding the maximization of their own Quality of Experience (QoE) - commonly expressed through a utility function that takes several parameters into consideration, with crowd density and waiting/visiting time being among the key ones. In such a setting, congestion occurs when either the utility of one visitor decreases due to the behavior of other persons, or when costs of undertaking an activity rise due to the presence of other persons. We initially investigate how visitors’ behavioral risk attitudes, as captured and represented by prospect theory, affect their decisions in resource sharing settings, where visitors’ decisions and experiences are strongly interdependent. Different from the majority of existing studies and literature, we highlight that visitors are not risk neutral utility maximizers, but they demonstrate risk-aware behavior according to their personal risk characteristics. In our work, exhibits are organized into two groups: a) “safe exhibits” that correspond to less congested ones, where the visitors receive guaranteed satisfaction in accordance with the visiting time invested, and b) common pool of resources (CPR) exhibits, which are the most popular exhibits with possibly increased congestion and uncertain outcome in terms of visitor satisfaction. A key difference is that the visitor satisfaction due to CPR strongly depends not only on the invested time decision of a specific visitor, but also on that of the rest of the visitors. In the latter case, the over-investment in time, or equivalently the increased congestion potentially leads to “exhibit failure”, interpreted as the visitors gain no satisfaction from their observation of this exhibit due to high congestion. We present a framework where each visitor in a distributed manner determines his time investment in safe or CPR exhibits to optimize his QoE. Based on this framework, we analyze and evaluate how visitors, acting as prospect-theoretic decision-makers, respond and react to the various pricing policies imposed by the museum curators. Based on detailed evaluation results and experiments, we present interesting observations, regarding the impact of several parameters and characteristics such as visitor heterogeneity and use of alternative pricing policies, on scalability, user satisfaction, museum capacity, resource fragility, and operation point stability. Furthermore, we study and present the effectiveness of alternative pricing mechanisms, when used as implicit tools, to deal with the congestion management problem in the museums, and potentially decrease the exhibit failure probability (fragility), while considering the visitor risk preferences.

Keywords: museum resource and visitor management, congestion management, propsect theory, cyber physical social systems

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Authors: T. Dubayova

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Slovak, as well as foreign authors, believe that the influence of non-cognitive factors on a student's academic success or failure is unquestionable. The aim of this paper is to establish a link between the mental vulnerability and coping strategies used by 4^th grade elementary school students in dealing with stressful situations and their academic performance, which was used as a simple quantitative indicator of academic success. The research sample consists of 320 students representing the standard population and 60 students with special education needs (SEN), who were assessed by the Strengths and Difficulties Questionnaire (SDQ) by their teachers and the Children’s Coping Strategies Checklist (CCSC-R1) filled in by themselves. Students with SEN recorded an extraordinarily high frequency of mental vulnerability (34.5 %) than students representing the standard population (7 %). The poorest academic performance of students with SEN was associated with the avoidance behavior displayed during stressful situations. Students of the standard population did not demonstrate this association. Students with SEN are more likely to display mental health problems than students of the standard population. This may be caused by the accumulation of and frequent exposure to situations that they perceive as stressful.

Keywords: coping, mental vulnerability, pupil with special education needs, school performance, school success

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Authors: Dinesh Khanduja, Sahib Sartaj Singh

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In India, among the start ups, many new ventures fail and for the few that survive and grow, there are always numerous problems. In order to make these surviving units productive and cost effective-in today’s competitive environment, the traditional ways of supporting small enterprises and the related programs of governmental assistance need to be significantly transformed. In this context, ‘Business Incubation’ is emerging as one of the most innovative instruments to support small enterprise creation and development all over the world. Incubators, by providing on the-spot diagnosis and treatment of business problems, dramatically lower the early stage failure rate. In Europe, US and countries like China, Singapore, Thailand etc., the exceptionally fast growth of business incubators has baffled even the researchers. In this direction in India, following on the world pattern, several initiatives have been taken over the last decade to encourage the concept of business incubation. Besides profiling the existing ‘Business Incubators’ in India, the paper dwells upon a case study of SMEs in state of Punjab for exploring the relevance of business incubation for enhancing their productive capacity.

Keywords: business incubation, Technology Business Incubator (TBI), Rural Business Hub (RBH), entrepreneurship, Business Development Services (BDS), technology management

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Authors: Javier A. Dominguez Caballero, Graeme A. Manson, Matthew B. Marshall

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Cutting tools with ceramic inserts are often used in the process of machining many types of superalloy, mainly due to their high strength and thermal resistance. Nevertheless, during the cutting process, the plastic flow wear generated in these inserts enhances and propagates cracks due to high temperature and high mechanical stress. This leads to a very variable failure of the cutting tool. This article explores the relationship between the continuous wear that ceramic SiAlON (solid solutions based on the Si3N4 structure) inserts experience during a high-speed machining process and the evolution of sparks created during the same process. These sparks were analysed through pictures of the cutting process recorded using an SLR camera. Features relating to the intensity and area of the cutting sparks were extracted from the individual pictures using image processing techniques. These features were then related to the ceramic insert’s crater wear area.

Keywords: ceramic cutting tools, high speed machining, image processing, tool condition monitoring, tool wear

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Authors: Desi Meriyanti, Delina Puspa Rosana Firdaus, Ristia Rinati

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Nowadays, the presence of free radicals become a big concern due to its negative impact to the body, which can triggers the formation of degenerative diseases such as cancer, heart disease cardiovascular, diabetic mellitus and others. Free radical oxidation can be prevented by the presence of antioxidants. Naturally, the human body produces its own antioxidants. Because of the free radicals exposure are so intense, especially from the environment, it is necessary to supply antioxidants needed from outside, through the consumption of functional foods with high antioxidant content. Gethuk is one of the traditional snacks in Indonesia. Gethuk is made from cassava with minimal processing such as boiling, destructing, and forming. Gethuk is classified as a familiar snack in the community, so it has a potential for developing, especially into a functional food. The low content of antioxidants in gethuk can be overcome with the development of a product called Gethuk Marillo. Gethuk Marillo is gethuk with the addition of natural antioxidants from mangosteen pericarp extract which has a high content of xanthones, these compounds are classified into flavonoids and act as antioxidants in the body. Gethuk Marillo served along with tamarillo fruit sauce which is also high in antioxidants such as anthocyanin. The combination between 300 grams gethuk Marillo and sauce contain flavonoid about 31% of human antioxidant needs per day. Gethuk Marillo called as a functional food because of high flavonoids content which can prevent degenerative diseases namely cancer, as many studies that the xanthone and anthocyanins compounds can effectively prevent the formation of cancer cells in human body.

Keywords: Gethuk marillo, xanthones, anthocyanin, high antioxidants, anti-cancer

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Authors: Jason T. Hilton

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The ‘post-truth era’ is marked by a shift toward a period in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief. Applying narrative analysis techniques to current public discourses in education that run counter to scientific findings, it becomes possible to identify weakness in modern pedagogy and suggest ways to counter false narratives in the classroom. Results of this study indicate that a failure to engage with popular narratives lessens teachers’ ability to be convincing in the classroom, even when presenting information supported by scientific evidence. This study seeks to empower teachers by illustrating the influence of story within the post-truth era and the ways in which narrative and rhetorical elements take hold in social media contexts. Equipped with this knowledge, teachers can create a shift in pedagogy, away from transmission of knowledge toward the crafting of powerful narratives, built upon evidence, and connected to the lives of modern learners.

Keywords: 21st century learner, critical pedagogy, culture, narrative, post-truth era, social media

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Authors: Furqan Farooq, Arslan Akbar, Sana Gul

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Inadequate design of seismic structures and use of Low Strength Concrete (LSC) remains the major aspect of structure failure. Parametric investigation (LSC) beams based on experimental work using externally applied Carbon Fiber Reinforce Polymer (CFRP) warp in flexural behavior is studied. The ambition is to know the behavior of beams under loading condition, and its strengthening enhancement after inducing crack is studied, Moreover comparison of results using abacus software is studied. Results show significant enhancement in load carrying capacity, experimental work is compared with abacus software. The research is based on the conclusion that various existing structure but inadequacy in seismic design could increase the load carrying capacity by applying CFRP techniques, which not only strengthened but also provide them to resist even larger potential earthquake by improving its strength as well as ductility.

Keywords: seismic design, carbon fiber, strengthening, ductility

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Authors: T. Prabakaran

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Gas Insulated Substations (GIS) are widely used as important switchgear equipment because of its high reliability, low space requirement, low risk factor and easy maintenance, yet some failures have been reported. Some of the failures are due to presence of metallic particles inside the GIS compartment. The defect can be generated in GIS during production, maintenance, installation and can be due to ageing of the component. The Ultra-High Frequency (UHF) method is used to diagnose the insulation condition of GIS by detecting the PD signals in GIS. This paper identifies PD patterns for free moving particle defect and particle fixed on cone using UHF method. As insulation failure usually starts with PD activity, this paper investigates the differences in PD characteristics in SF6 gas with different types of defects. Experimental results show that correct identification of defects can be achieved based on considered PD characteristics. The method can be applied to prove the quality of assembly work at commissioning, also on a regular basis after many years in service to detect aged and conducting particles as a part of the condition based maintenance.

Keywords: gas insulated substation, partial discharge, free moving particle defect, particle fixed on cone defect, ultra high frequency method

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Authors: A. S. Bouchikhi, A. Megueni, S. Habibi

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One major problem when using bonded Fiber Reinforced Polymer is the presence of high inter facial stresses near the end of the composite laminate which might govern the failure of the strengthening schedule. It is known that the decrease of FRP plate thickness and the fitness of adhesive reduce the stress concentration at plate ends. Another way is to use a plate with a non uniform section or tapered ends and softer adhesive at the edges. In this paper, a comprehensive finite element (FE) study has been conducted to investigate the effect of mixed adhesive joints (MAJ) and tapering plate on the inter facial stress distribution in the adhesive layer, this paper presents the results of a study of application of two adhesives with different stiffnesses (bi-adhesive) along the joint strength length between the CFRP-strengthened steel beam for tapered and untapered plate on the distribution of inter facial stresses. A stiff adhesive was applied in the middle portion of the joint strength, while a low modulus adhesive was applied towards the edges prone to stress concentrations.

Keywords: FRP, mixed adhesive joints, stresses, tapered plate, retrofitted beams bonded

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Authors: Syed Dawood M. Taimur

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Background: Peripheral arterial disease (PAD) is under diagnosed in primary care practices, yet the extent of unrecognized PAD in patients with coronary artery disease (CAD) is unknown. Objective: To assess the prevalence of previously unrecognized PAD in patients undergoing coronary angiogram and to determine the relationship between the presence of PAD and severity of CAD. Material & Methods: This five years retrospective study was conducted at an invasive lab of the department of Cardiology, Ibrahim Cardiac Hospital & Research Institute from January 2010 to December 2014. Total 77 patients were included in this study. Study variables were age, sex, risk factors like hypertension, diabetes mellitus, dyslipidaemia, smoking habit and positive family history for ischemic heart disease, coronary artery and peripheral artery profile. Results: Mean age was 56.83±13.64 years, Male mean age was 53.98±15.08 years and female mean age was 54.5±1.73years. Hypertension was detected in 55.8%, diabetes in 87%, dyslipidaemia in 81.8%, smoking habits in 79.2% and 58.4% had a positive family history. After catheterization 88.3% had peripheral arterial disease and 71.4% had coronary artery disease. Out of 77 patients, 52 had both coronary and peripheral arterial disease which was statistically significant (p < .014). Coronary angiogram revealed 28.6% (22) patients had triple vessel disease, 23.3% (18) had single vessel disease, 19.5% (15) had double vessel disease and 28.6% (22) were normal coronary arteries. The peripheral angiogram revealed 54.5% had superficial femoral artery disease, 26% had anterior tibial artery disease, 27.3% had posterior tibial artery disease, 20.8% had common iliac artery disease, 15.6% had common femoral artery disease and 2.6% had renal artery disease. Conclusion: There is a strong and definite correlation between coronary and peripheral arterial disease. We found that cardiovascular risk factors were in fact risk factors for both PAD and CAD.

Keywords: coronary artery disease (CAD), peripheral artery disease(PVD), risk, factors, correlation, cathetarization

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Authors: Mohammed Alquraish

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Saudi Arabia and other emerging nations have faced significant challenges in the sustainable construction industry. This paper presents a quantitative approach to assessing sustainability risk in the Saudi Arabian construction industry and offers insights into holistic sustainability design in industry operations. The implementation of sustainable construction industry practices in the manufacturing sector has been susceptible to several risk factors that need to be identified. In order to successfully execute sustainable building projects, decision makers in the fields of construction and industry can benefit greatly from the advice this study offers by promoting the elements that motivate sustainability implementation. Sustainability risk can be measured from combining failure probability with cumulative effects from sustainability factors: social, environmental, and economic; that affect the integrity of the construction industry. The cumulative effects of sustainability risk are measured by classifying the outcomes resulting from these consequences. Operators of industrial construction can strategically manage and minimize potential disruptions affecting long-term sustainability incentives by measuring sustainability risk. Thus, the suggested strategy greatly reinforces the crucial role of the construction industry.

Keywords: sustainability, risk, construction industry, Saudi Arabia

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Authors: Milan Podlena, Stepan Hysek, Jiri Prochazka, Martin Bohm, Jan Bomba

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Corner joints are the weakest part of windows, where the members are connected together. Since the dimensions of the windows started become bigger, the strength requirements for corner joints started to increase as well. Therefore, the aim of this study was to test the samples of corner joints of wooden windows. Moisture content of test specimens was stabilized in the climate chamber. After conditioning, test specimens were loaded in the laboratory conditions onto an universal testing machine and the failure load was measured. Data was recalculated by using goniometric, bending moment and stiffness equation to the stiffness coefficients and the bending moments were investigated. The results showed difference that was observed for the mortise with tenon joint and the dowel joint. This difference was explained by a varied adhesive bond area, which is related to the dimensions of dowels (diameter and length) as well. The bending moments and stiffness ware (except of type of corner joint) also affected by type of used adhesive, type of dowels and wood species.

Keywords: corner joint, wooden window, bending moment, stiffness

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Authors: A. M. U. P. Kumari, Vidanapathirana. J., Amarasekara J., Karunanayaka L.

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Leptospirosis is a zoonotic infection with significant morbidity and mortality. As an occupational disease, it has become a global concern due to its disease burden in endemic countries and rural areas. The aim of this study was to assess disease burden in terms of DALYs of leptospirosis. A hospital-based descriptive cross-sectional study was conducted using 450 clinically diagnosed leptospirosis patients admitted to base and above hospitals in Monaragala district, Sri Lanka, using a pretested interviewer administered questionnaire. The patients were followed up till normal day today life after discharge. Estimation of DALYs was done using laboratory confirmed leptospirosis patients. Leptospirosis disease burden in the Monaragala district was 44.9 DALYs per 100,000 population which includes 33.18 YLLs and 10.9 YLDs. The incidence of leptospirosis in the Monaragala district during the study period was 59.8 per 100,000 population, and the case fatality rate (CFR) was 1.5% due to delay in health seeking behaviour; 75% of deaths were among males due to multi organ failure. The disease burden of leptospirosis in the Moneragala district was significantly high, and urgent efforts to control and prevent leptospirosis should be a priority.

Keywords: human leptospirosis, disease burden, disability adjusted life Years, Sri Lanka

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Authors: T. Yilmaz, N. Kirac

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Beam-column elements are defined as structural members subjected to a combination of axial and bending forces. Lateral torsional buckling is one of the major failure modes in which beam-columns that are bent about its strong axis may buckle out of the plane by deflecting laterally and twisting. This study presents a compact closed-form equation that it can be used for calculating critical lateral torsional-buckling load of beam-columns with monosymmetric sections in the presence of a known axial load. Lateral-torsional buckling behavior of beam-columns subjected to constant axial force and various transverse load cases are investigated by using Ritz method in order to establish proposed equation. Lateral-torsional buckling loads calculated by presented formula are compared to finite element model results. ABAQUS software is utilized to generate finite element models of beam-columns. It is found out that lateral-torsional buckling load of beam-columns with monosymmetric sections can be determined by proposed equation and can be safely used in design.

Keywords: lateral-torsional buckling, stability, beam-column, monosymmetric section

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Authors: Devin Doos, Ashley Hughes, Trang Pham, Paul Barach, Rami Ahmed

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Over 115,000 Health Care Workers (HCWs) have died from COVID-19, and millions have been infected while caring for patients. HCWs have filed thousands of safety complaints surrounding safety concerns due to Personal Protective Equipment (PPE) shortages, which included concerns around inadequate and PPE reuse. Protocols for donning and doffing PPE remain ambiguous, lacking an evidence-base, and often result in wide deviations in practice. PPE donning and doffing protocol deviations commonly result in self-contamination but have not been thoroughly addressed. No evidence-driven protocols provide guidance on protecting HCW during periods of PPE reuse. Objective: The aim of this study was to examine safety-related threats and risks to Health Care Workers (HCWs) due to the reuse of PPE among Emergency Department personnel. Method: We conducted a prospective observational study to examine the risks of reusing PPE. First, ED personnel were asked to don and doff PPE in a simulation lab. Each participant was asked to don and doff PPE five times, according to the maximum reuse recommendation set by the Centers for Disease Control and Prevention (CDC). Each participant was videorecorded; video recordings were reviewed and coded independently by at least 2 of the 3trained coders for safety behaviors and riskiness of actions. A third coder was brought in when the agreement between the 2 coders could not be reached. Agreement between coders was high (81.9%), and all disagreements (100%) were resolved via consensus. A bowtie risk assessment chart was constructed analyzing the factors that contribute to increased risks HCW are faced with due to PPE use and reuse. Agreement amongst content experts in the field of Emergency Medicine, Human Factors, and Anesthesiology was used to select aspects of health care that both contribute and mitigate risks associated with PPE reuse. Findings: Twenty-eight clinician participants completed five rounds of donning/doffing PPE, yielding 140 PPE donning/doffing sequences. Two emerging threats were associated with behaviors in donning, doffing, and re-using PPE: (i) direct exposure to contaminant, and (ii) transmission/spread of contaminant. Protective behaviors included: hand hygiene, not touching the patient-facing surface of PPE, and ensuring a proper fit and closure of all PPE materials. 100% of participants (n= 28) deviated from the CDC recommended order, and most participants (92.85%, n=26) self-contaminated at least once during reuse. Other frequent errors included failure to tie all ties on the PPE (92.85%, n=26) and failure to wash hands after a contamination event occurred (39.28%, n=11). Conclusions: There is wide variation and regular errors in how HCW don and doffPPE while including in reusing PPE that led to self-contamination. Some errors were deemed “recoverable”, such as hand washing after touching a patient-facing surface to remove the contaminant. Other errors, such as using a contaminated mask and accidentally spreading to the neck and face, can lead to compound risks that are unique to repeated PPE use. A more comprehensive understanding of the contributing threats to HCW safety and complete approach to mitigating underlying risks, including visualizing with risk management toolsmay, aid future PPE designand workflow and space solutions.

Keywords: bowtie analysis, health care, PPE reuse, risk management

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Authors: Alex J. Summers, Jasmine P. Devadhasan, Douglas Montgomery, Brittany Fischer, Jian Gu, Frederic Zenhausern

Abstract:

Immunoassays have been utilized for several applications, including the detection of pathogens. Our laboratory is in the development of a tier 1 biothreat panel utilizing Vertical Flow Assay (VFA) technology for simultaneous detection of pathogens and toxins. One method of manufacturing VFA membranes is with non-contact piezoelectric dispensing, which provides advantages, such as low-volume and rapid dispensing without compromising the structural integrity of antibody or substrate. Challenges of this processinclude premature discontinuation of dispensing and misaligned spotting. Preliminary data revealed the Yp 11C7 mAb (11C7)reagent to exhibit a large angle of failure during printing which may have contributed to variable printing outputs. A Design of Experiment (DOE) was executed using this reagent to investigate the effects of hydrostatic pressure and reagent concentration on microarray printing outputs. A Nano-plotter 2.1 (GeSIM, Germany) was used for printing antibody reagents ontonitrocellulose membrane sheets in a clean room environment. A spotting plan was executed using Spot-Front-End software to dispense volumes of 11C7 reagent (20-50 droplets; 1.5-5 mg/mL) in a 6-test spot array at 50 target membrane locations. Hydrostatic pressure was controlled by raising the Pressure Compensation Vessel (PCV) above or lowering it below our current working level. It was hypothesized that raising or lowering the PCV 6 inches would be sufficient to cause either liquid accumulation at the tip or discontinue droplet formation. After aspirating 11C7 reagent, we tested this hypothesis under stroboscope.75% of the effective raised PCV height and of our hypothesized lowered PCV height were used. Humidity (55%) was maintained using an Airwin BO-CT1 humidifier. The number and quality of membranes was assessed after staining printed membranes with dye. The droplet angle of failure was recorded before and after printing to determine a “stroboscope score” for each run. The DOE set was analyzed using JMP software. Hydrostatic pressure and reagent concentration had a significant effect on the number of membranes output. As hydrostatic pressure was increased by raising the PCV 3.75 inches or decreased by lowering the PCV -4.5 inches, membrane output decreased. However, with the hydrostatic pressure closest to equilibrium, our current working level, membrane output, reached the 50-membrane target. As the reagent concentration increased from 1.5 to 5 mg/mL, the membrane output also increased. Reagent concentration likely effected the number of membrane output due to the associated dispensing volume needed to saturate the membranes. However, only hydrostatic pressure had a significant effect on stroboscope score, which could be due to discontinuation of dispensing, and thus the stroboscope check could not find a droplet to record. Our JMP predictive model had a high degree of agreement with our observed results. The JMP model predicted that dispensing the highest concentration of 11C7 at our current PCV working level would yield the highest number of quality membranes, which correlated with our results. Acknowledgements: This work was supported by the Chemical Biological Technologies Directorate (Contract # HDTRA1-16-C-0026) and the Advanced Technology International (Contract # MCDC-18-04-09-002) from the Department of Defense Chemical and Biological Defense program through the Defense Threat Reduction Agency (DTRA).

Keywords: immunoassay, microarray, design of experiment, piezoelectric dispensing

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Authors: Shihab Aldin Al Riyami, Khosrow Ebrahim, Sajad Ahmadizad

Abstract:

Hemodynamic changes and ventricular loading during exercise lead to left ventricular (LV) hypertrophy. In athletes, volume load induces enlargement of the LV internal diameter and a proportional increase of wall thickness; while, pressure load would induce thickening of the ventricular wall. These adaptations are not similar in all athletes and are related to the types of sport. Volleyball players have different types of activity and roles based on their playing. Therefore, their physiological adaptations and requirements are different. The aim of the current study was to investigate the LV adaptationsinelite volleyball players based on their playing position. Sixty male elite volleyball players (age, 30.55±3.64 years)from Brazil, Serbia, Poland, Iran, Colombia, Cameroon, Japan, Egypt, Qatar, and Tunisia were investigated (from all five volleyball play positions). All participants had the experience of at least 3 years of participation at a professional level and international tournaments. LV characteristics were evaluated and measured using the echocardiography technique. Statistical analyses revealed significant differences (P<0.05)among the five groups of players forLV internal dimension (LVID), posterior wall thickness (PWT), and intact ventricular septum (IVS). Post-hoc analysis showed that opposite position players had significant higher value of LVID, PWT, and IVS when compared with other players, including outside hitter, middle blocker, setter, and libero (p<0.05). Additionally, in libero players, PWT was significantly lower when compared with other players (p<0.05). Based on the findings of the present study, it is concluded that LV adaptations in volleyball players are related to their playing position and that the opposite players had the highest LV adaptations when compared to other positions.

Keywords: athletes, cardiac adaptations, echocardio graphy, heart, sport

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Authors: A. Gherbi, L. Dahmani, A. Boudjemia

Abstract:

This paper presents the Finite Element Method (FEM) for analyzing the failure pattern of rectangular slab with various edge conditions. Non-Linear static analysis is carried out using ANSYS 15 Software. Using SOLID65 solid elements, the compressive crushing of concrete is facilitated using plasticity algorithm, while the concrete cracking in tension zone is accommodated by the nonlinear material model. Smeared reinforcement is used and introduced as a percentage of steel embedded in concrete slab. The behavior of the analyzed concrete slab has been observed in terms of the crack pattern and displacement for various loading and boundary conditions. The finite element results are also compared with the experimental data. One of the other objectives of the present study is to show how similar the crack path found by ANSYS program to those observed for the yield line analysis. The smeared reinforcement method is found to be more practical especially for the layered elements like concrete slabs. The value of this method is that it does not require explicit modeling of the rebar, and thus a much coarser mesh can be defined.

Keywords: ANSYS, cracking pattern, displacements, reinforced concrete slab, smeared reinforcements

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Authors: Sarah K. Basudan, Ragad I. Al Jazzar, Zeinah Sulaihim, Hanan M. Al-Kadri

Abstract:

Background: Cesarean section has been increasing in recent years, with a wide range of etiologies contributing to this rise. This study aimed to assess the indications, outcomes, and complications in Riyadh, Saudi Arabia. Methods: A Retrospective Cohort study was conducted at King Abdulaziz medical city. The study includes two cohorts: G1 (2009) and G2 (2020) groups who met the inclusion criteria. The data was transferred to the SPSS (statistical package for social sciences) version 24 for analysis. The initial descriptive statistics were run for all variables, including numerical and categorical data. The numerical data were reported as median, and standard deviation and categorical data were reported as frequencies and percentages. Results: The data were collected from 399 women who were divided into two groups, G1(199) and G2(200). The mean age of all participants is 32+-6​; G1 and G2 had significant differences in age means with 30+-6 and 34+-5, respectively, with a p-value of <0.001, which indicates delayed fertility by four years. Moreover, a breech presentation was less likely to occur in G2 (OR 0.64, CI: 0.21-0.62. P<0.001). Nonetheless, maternal causes such as repeated C-sections and maternal medical conditions were more likely to happen in G2 (OR 1.5, CI: 1.04-2.38, p=0.03) and (OR 5.4, CI: 1.12-23.9, P=0.01), respectively. Furthermore, postpartum hemorrhage showed an increase of 12% in G2 (OR 5.4, CI: 2.2-13.4, p<0.001). G2 was more likely to be admitted to the neonatal intensive care unit (NICU) (OR 16, CI: 7.4-38.7) and to special care baby (SCB) (OR 7.2, CI: 3.9-13.1), both with a p-value<0.001 compared to regular nursery admission. Conclusion: There are multiple factors that are contributing to the increase in c section rate in a Saudi tertiary hospitals. The factors were suggested to be previous c-sections, abnormal fetal heart rate, malpresentation, and maternal or fetal medical conditions.

Keywords: cesarean sections, maternal indications, maternal complications, neonatal condition

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Authors: Fazia Rahmoune, Sofiane Ziani

Abstract:

Retrial queueing systems have been extensively used to stochastically model many problems arising in computer networks, telecommunication, telephone systems, among others. In this work, we consider a $M/G/1$ retrial queue with an unreliable server with random vacations and two types of primary customers, persistent and impatient. This model involves the unreliability of the server, which can be subject to physical breakdowns and takes into account the correctives maintenances for restoring the service when a failure occurs. On the other hand, we consider random vacations, which can model the preventives maintenances for improving system performances and preventing breakdowns. We give the necessary and sufficient stability condition of the system. Then, we obtain the joint probability distribution of the server state and the number of customers in orbit and derive the more useful performance measures analytically. Moreover, we also analyze the busy period of the system. Finally, we derive the stability condition and the generating function of the stationary distribution of the number of customers in the system when there is no vacations and impatient customers, and when there is no vacations, server failures and impatient customers.

Keywords: modeling, retrial queue, unreliable server, vacation, stochastic analysis

Procedia PDF Downloads 187

Authors: Papazafeiropoulou Olga

Abstract:

The “Athens Dramatic Company” was one of the longest-running and most widely traveled troupes in the history of modern Greek theatre. The theatre company had been established since 1887, and the following: Euthychios Vonaseras, Eleni Kotopoulis, etc., like the founder of the troupe Theodoros Pofantis, referred to the distribution of the works presented in Patras: The price of a crime, The niece of her uncle, Agathopoulos, Amphitryon, The Two Sergeants, Lawyer and Actors, The Crusaders, The Daughter of Pantopolos, He Will Kill Himself, Macbeth, The Two Orphans, The Auction, Pistis Hope and Mercy, Love Attempt, The Crusaders, The lady is in Loutra, Markos Votsaris. In 1921, after peregrinations in Cyprus, Constantinople, Romania, Crete, Thessaloniki, Volos, Smyrna, the “Athens Dramatic Company” toured in Africa, where the Greek communities flourished. In 1923, the collaborations of troupe’s members and the repertoire varied several times, such as in Johannesburg, from where they traveled via Cape Town to Australia, where they presented the works: Dikaioma o Eros, Enochos, Psychokori, Kolokotronis. Atimoi, Voskopoula, Golfo, etc., while they impressed with the tragedy Oedipus Tyrannus, which was watched by Australians. Alongside the “Athens Dramatic Company” was also touring “Vrysoula’s Pantopoulos Troupe” and most of the members of the two troupes went to America, uniting their formation. In 1927, the old leader of “Athens Dramatic Company” (Theodoros Pofantis) decided to re-establish his troupe, but after unpleasant adventures, he passed away. In the year 1934, the Greek Dramatic Troupe of Athens revived with works including: The Man of the Day, A Dying Heart, A Dream Was and Gone, An Inspection, The Two Sergeants, The Mother, the Father-in-Law and the Non-existent Son-in-law, before finally expiring in 1935, after nearly 40 years of historical passage.

Keywords: athens, dramatic, company, universal, troupe

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