Search results for: hospital capacity planning

Authors: Laila Al-Balushi, Suad Al-Kharosui

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Due to the increasing number of breast cancer cases in Oman and the impact of the novel coronavirus disease 2019 (COVID-19 on bed situation in the hospital, a policy of early discharge (ED) with drain after breast cancer surgery was initiated at one of the tertiary hospitals in Oman. The uniqueness of this policy is no home visit follow-up, conducted after discharge and the main mode of communication was Instagram media. This policy then was evaluated by conducting a quasi-experimental study using a questionnaire with ten open and closed-ended questions, five questions to explore patient experience using a five-point Likert scale. A total of 41 female patients responded to the questionnaire. Almost 96% of the participants stated being well informed about drain care pre- and post-surgery at home. 9% of the participants developed early sign of infection and was managed at out-patient clinics. Participants with bilateral drains expressed more pain than those with single drain. 90% stated satisfied being discharged with breast drain whereas 10% preferred to stay in the hospital until the drains were removed. This study found that the policy of ED with a drain after BC surgery is practical and well-accepted by most patients. The role of breast nurse and presence of family and institutional support enhanced the success of the policy implementation. To optimize patient care, conducting a training program by breast nurse for nurses at local health centres about care management of patients with drain could improve care and enhance patient satisfaction.

Keywords: breast cancer, surgery, early discharge, surgical drain

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Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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Authors: Ayodeji O. Falade, Leonard V. Mabinya, Uchechukwu U. Nwodo, Anthony I. Okoh

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Given the high utility of peroxidase in several industrial processes, the search for novel microorganisms with enhanced peroxidase production capacity is of keen interest. This study investigated the process conditions for optimum peroxidase production by Ensifer sp, new ligninolytic proteobacteria with peroxidase production potential. Also, some agricultural residues were valorized for peroxidase production under solid state fermentation. Peroxidase production was optimum at an initial medium pH 7, incubation temperature of 30 °C and agitation speed of 100 rpm using alkali lignin fermentation medium supplemented with guaiacol as the most effective inducer and ammonium sulphate as the best inorganic nitrogen. Optimum peroxidase production by Ensifer sp. was attained at 48 h with specific productivity of 12.76 ± 1.09 U mg⁻¹. Interestingly, probable laccase production was observed with optimum specific productivity of 12.76 ± 0.45 U mg⁻¹ at 72 h. The highest peroxidase yield was observed with sawdust as solid substrate under solid state fermentation. In conclusion, Ensifer sp. possesses the capacity for enhanced peroxidase production that can be exploited for various biotechnological applications.

Keywords: catalase-peroxidase, enzyme production, peroxidase, polymerase chain reaction, proteobacteria

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Authors: Mostefa Mimoune

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Test results on concrete-filled steel tubular stub columns under axial compression are presented. The study was mainly focused on square hollow section SHS columns; 27 columns were tested. The main experimental parameters considered were the thickness of the tube, columns length and cross section sizes. Existing design codes and theoretical model were used to predict load-carrying capacities of composite section to compare the accuracy of the predictions by using the recommendations of DTR-BC (Algerian code), CSA (Canadian standard), AIJ, EC4, DBJ, AISC, BS and EC4. Experimental results indicate that the studied parameters have significant influence on both the compressive load capacity and the column failure mode. All codes used in the comparison, provide higher resistance compared to those of tests. Equation method has been suggested to evaluate the axial capacity of the composite section seem to be in agreement with tests.

Keywords: axial loading, composite section, concrete-filled steel tubes, square hollow section

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Authors: Recep Keşli, Onur Türkyılmaz, Hayriye Tokay, Kasım Demir

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Objective: Coeliac disease (CD) is a primary small intestine disorder caused by high sensitivity to gluten which is present in the crops, characterized by inflammation in the small intestine mucosa. The goal of this study was to determine and to compare the sensitivity and specificity values of anti-endomysial IgA (EMA IgA) (IFA) and anti-tissue transglutaminase IgA (anti-tTG IgA) (ELISA) antibodies in the diagnosis of patients suspected with the CD. Methods: One thousand two hundred seventy three patients, who have applied to gastroenterology and pediatric disease polyclinics of Afyon Kocatepe University ANS Research and Practice Hospital were included into the study between 23.09.2010 and 30.05.2016. Sera samples were investigated by immunofluorescence method for EMA positiveness (Euroimmun, Luebeck, Germany). In order to determine quantitative value of Anti-tTG IgA (EIA) (Orgentec Mainz, Germany) fully automated ELISA device (Alisei, Seac, Firenze, Italy) were used. Results: Out of 1273 patients, 160 were diagnosed with coeliac disease according to ESPGHAN 2012 diagnosis criteria. Out of 160 CD patients, 120 were female, 40 were male. The EMA specificity and sensitivity were calculated as 98% and 80% respectively. Specificity and sensitivity of Anti-tTG IgA were determined as 99% and 96% respectively. Conclusion: The specificity of EMA for CD was excellent because all EMA-positive patients (n = 144) were diagnosed with CD. The presence of human anti-tTG IgA was found as a reliable marker for diagnosis and follow-up the CD. Diagnosis of CD should be established on both the clinical and serologic profiles together.

Keywords: anti-endomysial antibody, anti-tTG IgA, coeliac disease, immunofluorescence assay (IFA)

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Authors: Hatem Abou-Senna, Essam Radwan

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With increasing traffic and limited resources, accommodating left-turning traffic has been a challenge for traffic engineers as they seek balance between intersection capacity and safety; these are two conflicting goals in the operation of a signalized intersection that are mitigated through signal phasing techniques. Hence, to increase the left-turn capacity and reduce the delay at the intersections, the Florida Department of Transportation (FDOT) moves forward with a vision of optimizing intersection control using innovative intersection designs through the Transportation Systems Management & Operations (TSM&O) program. These alternative designs successfully eliminate the left-turn phase, which otherwise reduces the conventional intersection’s (CI) efficiency considerably, and divide the intersection into smaller networks that would operate in a one-way fashion. This study focused on the Crossover Displaced Left-turn intersections (XDL), also known as Continuous Flow Intersections (CFI). The XDL concept is best suited for intersections with moderate to high overall traffic volumes, especially those with very high or unbalanced left turn volumes. There is little guidance on determining whether partial XDL intersections are adequate to mitigate the overall intersection condition or full XDL is always required. The primary objective of this paper was to evaluate the overall intersection performance in the case of different partial XDL designs compared to a full XDL. The XDL alternative was investigated for 4 different scenarios; partial XDL on the east-west approaches, partial XDL on the north-south approaches, partial XDL on the north and east approaches and full XDL on all 4 approaches. Also, the impact of increasing volume on the intersection performance was considered by modeling the unbalanced volumes with 10% increment resulting in 5 different traffic scenarios. The study intersection, located in Orlando Florida, is experiencing recurring congestion in the PM peak hour and is operating near capacity with volume to a capacity ratio closer to 1.00 due to the presence of two heavy conflicting movements; southbound and westbound. The results showed that a partial EN XDL alternative proved to be effective and compared favorably to a full XDL alternative followed by the partial EW XDL alternative. The analysis also showed that Full, EW and EN XDL alternatives outperformed the NS XDL and the CI alternatives with respect to the throughput, delay and queue lengths. Significant throughput improvements were remarkable at the higher volume level with percent increase in capacity of 25%. The percent reduction in delay for the critical movements in the XDL scenarios compared to the CI scenario ranged from 30-45%. Similarly, queue lengths showed percent reduction in the XDL scenarios ranging from 25-40%. The analysis revealed how partial XDL design can improve the overall intersection performance at various demands, reduce the costs associated with full XDL and proved to outperform the conventional intersection. However, partial XDL serving low volumes or only one of the critical movements while other critical movements are operating near or above capacity do not provide significant benefits when compared to the conventional intersection.

Keywords: continuous flow intersections, crossover displaced left-turn, microscopic traffic simulation, transportation system management and operations, VISSIM simulation model

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Authors: B. V. Bhaskara Rao, Rodrigo Espinoza

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The rapid development of renewable energy sources has drawn great attention to energy storage devices, especially supercapacitors, because of their high power density and rate performance. This work focus on Fe₃O₄ nanoparticles synthesized by reverse co-precipitation and MWCNTs functionalized by –COOH acid functionalization. The results show that Optimized 25wt% Fe₃O₄@FMWCNT show high specific capacitance 100 mF/cm² at one mA/cm² whereas 15wt% Fe₃O₄@FMWCNT showed high stability (80% retention capacity) over 5000 cycles. The electrolyte used in the coin cell is LiPF6 and the thickness of the electrode is 30 microns. The optimized Fe₃O₄@FMWCNT bucky papers coin cell electrochemical studies suggest that 25wt% Fe₃O₄@FMWCNT could be a good candidate for high-capacity supercapacitor devices. This could be further tested for flexible and planar supercapacitor device application with gel electrolytes.

Keywords: self-standing electrode, Fe₃O4@FMWCNT, supercapacitor, symmetric coin-cell

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Authors: Xia Luo, Cheng Zeng

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Under the promotion of the Central Committee of the Communist Party of China and the State Council in 2017, Xiong'an New Area is the third crucial new area in China established after Shenzhen and Shanghai. Its constructions' significance lies in mitigating Beijing's non-capital functions and exploring a new mode of optimizing development in densely populated and economically intensive areas. For this purpose, developing underground logistics can assume the role of goods distribution in the capital, relieve the road transport pressure in Beijing-Tianjin-Hebei Urban Agglomeration, adjust and optimize the urban layout and spatial structure of it. Firstly, the construction planning of Xiong'an New Area and underground logistics development are summarized, especially the development status abroad, the development trend, and bottlenecks of underground logistics in China. This paper explores the technicality, feasibility, and necessity of four modes of transportation. There are pneumatic capsule pipeline (PCP) technology, the CargoCap technology, cable hauled mule, and automatic guided vehicle (AGV). The above technical parameters and characteristics are introduced to relevant experts or scholars. Through establishing an indicator system, carrying out a questionnaire survey with the Delphi method, the final suggestion is obtained: China should develop logistics vehicles similar to CargoCap, adopting rail mode and driverless mode. Based on China's temporal and spatial logistics demand and the geographical pattern of Xiong'an New Area, the construction scale, technical parameters, node location, and other vital parameters of underground logistics are planned. In this way, we hope to speed up the new area's construction and the logistics industry's innovation.

Keywords: the Xiong'an new area, underground logistics, contrastive analysis, CargoCap, logistics planning

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Authors: V. Mathad, S. Shivprasad, P. Shivsharannappa, M. K. Patil

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Introduction: Non-communicable diseases are emerging diseases in India. Government of India launched National Programme for Prevention and Control of Cardiovascular Diseases, Cancer and Stroke (NPCDCS) during the year 2008. The aim of the programme was to reduce the burden of non communicable diseases by health promotion and prompt treatment. Objective: The present study was intended to assess the impact of National Program for prevention and control of Cardiovascular Diseases, Diabetes, Cancer and Stroke Programme on biochemical and physiological factors influencing Type 2 diabetes in Kalaburagi District. Material and Method: NCD Clinic was established at District Hospital during April 2016. All the patients attending District Hospital Kalaburagi above the age of 30 years are screened for Non Communicable Diseases under NPCDCS Programme. A total sample of 7447 patients attending NCD Clinic situated at Kalaburagi district was assessed in this study. Pre structured and pretested schedule seeking information was obtained from all the patients by the counselor working under NPCDCS programme. All the Patients attending District Hospital were screened for Diabetes using Glucometer at NCD clinic. The suspected cases were further confirmed through Biochemical investigations like Fasting Blood glucose, HBA1c, Urine Glucose, Kidney Function test. SPSS 20 version was used for analysis of data. Chi square test, P values and odds ratio was used to study the association of factors. Results: A Total of 7447 patients attended NCD clinic during the year 2017-18 were analyzed, Diabetes was seen among 3028 individuals were as comorbidities along with Hypertension was seen among 757 individuals. The mean age of the population was 50 ± 2.84. 3440(46.2%) were males whereas Female constituted 4007(53.8%) of population. The incidence and prevalence of Diabetes being 8.6 and 12.8 respectively. Diabetes was more commonly seen during the age group of 40 to 69 years. Diabetes was significantly associated with Age group 40 to 69 years, obesity and female gender (p < 0.05). The risk of developing Hypertension and comorbidity conditions of hypertension and Diabetes was 1.224 and 1.305 times higher among males, whereas the risk of diabetes was 1.127 higher among females as compared to males. Conclusion: The screening for NCD has significantly increased after launching of NPCDCS programme. NCD was significantly associated with obesity, female gender, increased age as well as comorbid conditions like hypertension and tuberculosis.

Keywords: non-communicable diseases, NPCDCS programme, type 2 Diabetes, physiological factors

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Authors: Seyedeh Afsoon Mohseni

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The importance of the approach to the poverty definition is revealed regarding to it’s effect on the nature of planning poverty alleviation programs. This research employs the capability deprivation approach to alleviate rural poverty and seeks to develop herb’s market to alleviate capability poverty with an NGO’s intervene, Komak charity foundation. This research has employed qualitative approach; the data were collected through field observations, review of documents and interviews. Subsequently they were analyses by thematic analysis method. According to the findings, Komak charity can provide the least sustenance of the rural poor and alleviate capability poverty emergence through Herb’s market development of the village. Employing the themes, the market development is planned in two phases of empirical production and product development. Komak charity can intervene as a facilitator by providing micro credits, cooperative and supervising. Furthermore, planning on education and raising participation are prerequisites for the efficiency of the plan.

Keywords: capability poverty, Herb's market development, NGO, Komak charity foundation

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Authors: Emmanuel Ademola Anigilaje, Ibraheem Ishola

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Background: Childhood steroid-sensitive idiopathic nephrotic syndrome (SSINS) is plagued with relapses that contribute to its morbidity and the cost of treatment. Materials and Methods: This is a retrospective review of relapses among children with SSINS at the University of Abuja Teaching Hospital from January 2016 to July 2020. Triggers related to relapse incidents were noted. Chi-square test was deployed for predictors (factors at the first clinical presentations that associate with subsequent relapses) of relapses. Predictors with p-values of less than 0.05 were considered significant and 95% confidence intervals (CI) and odd ratio (OR) were described. Results: Sixty SSINS comprising 52 males (86.7%), aged 23 months to 18 years, with a mean age of 7.04±4.16 years were studied. Thirty-eight (63.3%) subjects had 126 relapses including infrequent relapses in 30 (78.9%) and frequent relapses in 8 (21.1%). The commonest triggers were acute upper respiratory tract infections (68, 53.9%) and urinary tract infections (UTIs) in 25 (19.8%) relapses. In 4 (3.2%) relapses, no trigger was identified. The time-to-first relapse ranged 14 days to 365 days with a median time of 60 days. The significant predictors were hypertension (OR=3.4, 95% CI; 1.04-11.09, p=0.038), UTIs (OR=9.9, 95% CI; 1.16-80.71, p= 0.014), malaria fever (OR=8.0, 95% CI; 2.45-26.38, p˂0.001), micro-haematuria (OR=4.9, 95% CI; 11.58-15.16, p=0.004), elevated serum creatinine (OR=12.3, 95%CI; 1.48-101.20, p=0.005) and hypercholesterolaemia (OR=4.1, 95%CI; 1.35-12.63, p=0.011). Conclusion: While the pathogenesis of relapses remains unknown, it is prudent to consider relapse-specific preventive strategies against triggers and predictors of relapses in our setting.

Keywords: Patterns, triggers, predictors, steroid-sensitive idiopathic nephrotic syndrome, relapses, Nigeria

Procedia PDF Downloads 158

Authors: Thi Huong Vu, Vijay Jayasena, Zhongxiang Fang, Gary Dykes

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Carob kibble has recently received attention due to the presence of high level of polyphenol antioxidants. The capacity of microorganisms to improve antioxidant activities and total phenolics in carob kibble was investigated in the study. Two types of microorganisms including lactic acid bacteria Lactobacillus plantarum (L. plantarum) and yeast Saccharomyces cerevisiae (S. cerevisiae) were used in single and in their combination as starters. The total phenolic content was determined by the Folin–Ciocalteu method. Antioxidant activities were assessed scavenging capacity using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid (ABTS). The study found that S. cerevisiae alone considerably improved 55% total phenolics content at 15 h, while L. plantarum caused in a loss of 20% through the process. Antioxidant capacity of the yeast-fermented samples significantly increased by 43 % and 10 % in ABTS and DPPH assays, respectively. However, reduction of 13 % and 32 % inhibition were recorded in the carob treated with L. plantarum. In the combination of S. cerevisiae and L. plantarum (1:1), both total phenolic content and antioxidant activity of carob kibble were a similar trend as these of S. cerevisiae single, but a lower improvement. The antioxidant power of the extracts was linearly correlated to their total phenolic contents (R=0.75). The results suggested that S. cerevisiae alone was the better for enhancement of both total phenolic content and antioxidant activity in carob kibble using submerged fermentation. The efficiency of fermentation reached the highest at 15h. Thus submerged fermentation with S. cerevisiae offers a tool with simple and cost effective to further increase the bioactive potential of carob kibble, which is in use for food, cosmetic and pharmaceutical industries.

Keywords: antioxidant activity, carob kibble, lactobacillus plantarum, saccharomyces cerevisiae, total phenolics

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Authors: Yehya Abdellatif, Iyad M. Muslih, Azzah Alkhalailah, Abdallah Muslih

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Hybrid Optimization Model for Electric Renewable (HOMER) software was utilized to find the optimum design of a hybrid off-Grid system, by choosing the optimal solution depending on the cost analysis of energy based on different capacity shortage percentages. A complete study for the site conditions and load profile was done to optimize the design and implementation of a hybrid off-grid power station. In addition, the solution takes into consecration the ambient temperature effect on the efficiency of the power generation and the economical aspects of selection depending on real market price. From the analysis of the HOMER model results, the optimum hybrid power station was suggested, based on wind speed, and solar conditions. The optimization function objective is to minimize the Net Price Cost (NPC) and the Cost of Energy (COE) with zero and 10 percentage of capacity shortage.

Keywords: energy modeling, HOMER, off-grid system, optimization

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Authors: Phang Moon Leng

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Automated Early Warning Scores is a newly developed clinical decision tool that is used to streamline and improve the process of obtaining a patient’s vital signs so a clinical decision can be made at an earlier stage to prevent the patient from further deterioration. This technology provides immediate update on the score and clinical decision to be taken based on the outcome. This paper aims to study the use of an automated early warning score system on whether the technology has assisted the hospital in early detection and escalation of clinical condition and improve patient outcome. The hospital adopted the Modified Early Warning Scores (MEWS) Scoring System and MEWS Clinical Response into Philips IntelliVue Guardian Automated Early Warning Score equipment and studied whether the process has been leaned, whether the use of technology improved the usage & experience of the nurses, and whether the technology has improved patient care and outcome. It was found the steps required to obtain vital signs has been significantly reduced and is used more frequently to obtain patient vital signs. The number of deaths, and length of stay has significantly decreased as clinical decisions can be made and escalated more quickly with the Automated EWS. The automated early warning score equipment has helped improve work efficiency by removing the need for documenting into patient’s EMR. The technology streamlines clinical decision-making and allows faster care and intervention to be carried out and improves overall patient outcome which translates to better care for patient.

Keywords: automated early warning score, clinical quality and safety, patient safety, medical technology

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Authors: Wennan Long, Yuhao Nie, Yunan Li, Adam Brandt

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To fight against climate change, California government issued the Senate Bill No. 100 (SB-100) in 2018 September, which aims at achieving a target of 100% renewable electricity by the end of 2045. A capacity expansion problem is solved in this case study using a binary quadratic programming model. The optimal locations and capacities of the potential renewable power plants (i.e., solar, wind, biomass, geothermal and hydropower), the phase-out schedule of existing fossil-based (nature gas) power plants and the transmission of electricity across the entire network are determined with the minimal total annualized cost measured by net present value (NPV). The results show that the renewable electricity contribution could increase to 85.9% by 2030 and reach 100% by 2035. Fossil-based power plants will be totally phased out around 2035 and solar and wind will finally become the most dominant renewable energy resource in California electricity mix.

Keywords: 100% renewable electricity, California, capacity expansion, mixed integer non-linear programming

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Authors: Seyed Abolhasan Naeini, Ali Namaei

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This study presents the effect of prefabricated vertical drain system properties on embankment behavior by calculating the settlement, lateral displacement and induced excess pore pressure by numerical method. In order to investigate this behavior, three different prefabricated vertical drains have been simulated under an embankment. The finite element software PLAXIS has been carried out for analyzing the displacements and excess pore pressures. The results showed that the consolidation time and induced excess pore pressure are highly depended to the discharge capacity of the prefabricated vertical drain. The increase in the discharge capacity leads to decrease the consolidation process and the induced excess pore pressure. Moreover, it was seen that the vertical drains spacing does not have any significant effect on the consolidation time. However, the increase in the drains spacing would decrease the system stiffness.

Keywords: vertical drain, prefabricated, consolidation, embankment

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Authors: Sateesh Kumar Pisini, Swetha Priya Darshini Thammadi, Sanjay Kumar Shukla

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Granular piles are a popular ground improvement technique in soft cohesive soils as well as for loose non-cohesive soils. The present experimental study has been carried out on granular piles in loose (Relative density = 30%) and medium dense (Relative density = 60%) sands with geogrid reinforcement within the sand bed over the granular piles. A group of five piles were installed in the sand at different spacing, s = 2d, 3d and 4d, d being the diameter of the pile. The length (L = 0.4 m) and diameter (d = 50 mm) of the piles were kept constant for all the series of experiments. The load-settlement behavior of reinforced sand bed and granular piles system was studied by applying the load on a square footing. The results show that the effect of reinforcement increases the load bearing capacity of the piles. It is also found that an increase in spacing between piles decreases the settlement for both loose and medium dense soil.

Keywords: granular pile, load-carrying capacity, settlement, geogrid reinforcement, sand

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Authors: V. S. S. Kumar, B. Vikram

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The development of effective decision support tools that adopted in the construction industry is vital in the world we live in today, since it can lead to substantial cost reduction and efficient resource consumption. Solving the time-cost trade off problems and its related variants is at the heart of scientific research for optimizing construction planning problems. In general, the classical optimization techniques have difficulties in dealing with TCT problems. One of the main reasons of their failure is that they can easily be entrapped in local minima. This paper presents an investigation on the application of meta-heuristic techniques to two particular variants of the time-cost trade of analysis, the time-cost trade off problem (TCT), and time-cost trade off optimization problem (TCO). In first problem, the total project cost should be minimized, and in the second problem, the total project cost and total project duration should be minimized simultaneously. Finally it is expected that, the optimization models developed in this paper will contribute significantly for efficient planning and management of construction project.

Keywords: fuzzy sets, uncertainty, optimization, time cost trade off problems

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Authors: Michael C. Barbecho, Romeo B. Morcilla

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This study focused on the development of a solar powered front wheel drive electric trike for personal use and short distance travel, utilizing solar power and a variable speed transmission to adapt in places where varying road grades and unavailability of plug-in charging stations are of great problems. The actual performance of the vehicle was measured in terms of duration of charging using solar power, distance travel and battery power duration, top speed developed at full power, and load capacity. This project followed the research and development process which involved planning, designing, construction, and testing. Solar charging tests revealed that the vehicle requires 6 to 8 hours sunlight exposure to fully charge the batteries. At full charge, the vehicle can travel 35 km utilizing battery power down to 42%. Vehicle showed top speed of 25 kph at 0 to 3% road grade carrying a maximum load of 122 kg. The maximum climbing grade was 23% with the vehicle carrying a maximum load of 122 kg. Technically the project was feasible and can be a potential model for possible conversion of traditional Philippine made “pedicabs” and gasoline engine powered tricycle into modern electric vehicles. Moreover, it has several technical features and advantages over a commercialized electric vehicle such as the use solar charging system and variable speed power transmission and front drive power train for adaptability in any road gradient.

Keywords: electric vehicle, solar vehicles, front drive, solar, solar power

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Authors: Asal Pournaghshband, Mohammed A. Zaki

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This paper presents a detailed numerical investigation into the structural performance of splay anchor configurations for strengthening concrete beams with Carbon Fiber Reinforced Polymer (CFRP) sheets. CFRP is widely used in retrofitting concrete structures to improve flexural strength and extend service life. However, premature debonding limits the tensile capacity of CFRP sheets, reducing the effectiveness of these applications. This study addresses this limitation by exploring the potential of splay anchors as an emerging anchorage technique that mitigates debonding issues through improved load transfer mechanisms. Building on existing experimental studies, the research uses ABAQUS software to validate different splay anchor configurations and simulate real-world performance. The parametric study examines key anchor parameters, including diameter, spacing, and embedment depth, to evaluate their effects on bond strength, load distribution, and the flexural capacity of strengthened beams. Systematic analysis of these parameters allows for identifying configurations that enhance debonding resistance and increase the load-carrying capacity of CFRP-strengthened beams. Improved debonding resistance contributes to greater structural durability, reduced maintenance costs, and extended service life for retrofitted structures, particularly relevant for aging infrastructure like bridges and buildings. This approach not only advances sustainable retrofitting practices but also provides practical solutions tailored to infrastructure demands.

Keywords: CFRP strengthening, splay anchors, concrete beams, structural retrofitting, numerical analysis

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Authors: Luksanaporn Krungkraipetch

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One hundred cataract patients with phacoemulsification were enrolled in the study to compare of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients at Burapha University Hospital, Chonburi, Thailand. Fifty patients were diabetic (type II) group and 50 patients were non-diabetic group. All cases were operated by one doctor with the same pre-operative care, operation (phacoemulsification), and post-operative care. Visual acuity and complication after surgery were assessed after the operation for two years. There were no significant differences in demographic data between the two groups. The visual outcome values ≥ 2 lines and ≥ 20/40 had no significant differences between two groups after two years of surgery. The complication rate in diabetic group had cystoid macular edema 16%, rupture posterior capsule 8%, posterior capsule opacity 2%, uveitis 2 %, and 2% endophthalmitis. The non-diabetic group had cystoid macular edema 12%, rupture posterior capsule 8%, uveitis 2%, posterior capsule opacity 2%, and 2% wound leak. Comparison of visual acuity outcome and complication after phacoemulsification between diabetic and non-diabetic patients had no statistical significant differences between these two groups. It was found that cystoid macular edema was the most common complication in both groups and 10% of retinopathy progression was seen.

Keywords: cataract, visual acuity, cataract extraction, phacoemulsification, diabetic retinopathy

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Authors: David W. Hill, Linda W. Glass, Jakob L. Vingren

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Maximal accumulated oxygen deficit (MAOD), the gold standard measure of anaerobic capacity, is the difference between the oxygen cost of exhaustive severe intensity exercise and the accumulated oxygen consumption (O2; mL·kg–1). In theory, MAOD can be estimated as the sum of independent estimates of the phosphocreatine and glycolysis contributions, which we refer to as PCr+glycolysis. Purpose: The purpose was to test the hypothesis that PCr+glycolysis provides a valid measure of anaerobic capacity in cycling and running. Methods: The participants were 27 women (mean ± SD, age 22 ±1 y, height 165 ± 7 cm, weight 63.4 ± 9.7 kg) and 25 men (age 22 ± 1 y, height 179 ± 6 cm, weight 80.8 ± 14.8 kg). They performed two exhaustive cycling and running tests, at speeds and work rates that were tolerable for ~5 min. The rate of oxygen consumption (VO2; mL·kg–1·min–1) was measured in warmups, in the tests, and during 7 min of recovery. Fingerprick blood samples obtained after exercise were analysed to determine peak blood lactate concentration (PeakLac). The VO2 response in exercise was fitted to a model, with a fast ‘primary’ phase followed by a delayed ‘slow’ component, from which was calculated the accumulated O2 and the excess O2 attributable to the slow component. The VO2 response in recovery was fitted to a model with a fast phase and slow component, sharing a common time delay. Oxygen demand (in mL·kg–1·min–1) was determined by extrapolation from steady-state VO2 in warmups; the total oxygen cost (in mL·kg–1) was determined by multiplying this demand by time to exhaustion and adding the excess O2; then, MAOD was calculated as total oxygen cost minus accumulated O2. The phosphocreatine contribution (area under the fast phase of the post-exercise VO2) and the glycolytic contribution (converted from PeakLac) were summed to give PCr+glycolysis. There was not an interaction effect involving sex, so values for anaerobic capacity were examined using a two-way ANOVA, with repeated measures across method (PCr+glycolysis vs MAOD) and mode (cycling vs running). Results: There was a significant effect only for exercise mode. There was no difference between MAOD and PCr+glycolysis: values were 59 ± 6 mL·kg–1 and 61 ± 8 mL·kg–1 in cycling and 78 ± 7 mL·kg–1 and 75 ± 8 mL·kg–1 in running. Discussion: PCr+glycolysis is a valid measure of anaerobic capacity in cycling and running, and it is as valid for women as for men.

Keywords: alactic, anaerobic, cycling, ergometer, glycolysis, lactic, lactate, oxygen deficit, phosphocreatine, running, treadmill

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Authors: Ming-Jong Yao, Chin-Sum Shui, Chih-Han Wang

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This paper is developed based on a real-world decision scenario that an industrial gas company that applies the Vendor Managed Inventory model and supplies liquid oxygen with a self-operated heterogeneous vehicle fleet to hospitals in nearby cities. We name it as a Joint Replenishment and Heterogeneous Vehicle Routing Problem with Cyclical Schedule and formulate it as a non-linear mixed-integer linear programming problem which simultaneously determines the length of the planning cycle (PC), the length of the replenishment cycle and the dates of replenishment for each customer and the vehicle routes of each day within PC, such that the average daily operation cost within PC, including inventory holding cost, setup cost, transportation cost, and overtime labor cost, is minimized. A solution method based on genetic algorithm, embedded with an encoding and decoding mechanism and local search operators, is then proposed, and the hash function is adopted to avoid repetitive fitness evaluation for identical solutions. Numerical experiments demonstrate that the proposed solution method can effectively solve the problem under different lengths of PC and number of customers. The method is also shown to be effective in determining whether the company should expand the storage capacity of a customer whose demand increases. Sensitivity analysis of the vehicle fleet composition shows that deploying a mixed fleet can reduce the daily operating cost.

Keywords: cyclic inventory routing problem, joint replenishment, heterogeneous vehicle, genetic algorithm

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Authors: Anatoliy Kharkhurin

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Modifications that the prefix ‘trans-‘ refers to start within a person. This presentation focuses on the transpersonal that goes beyond the individual (trans-personal) to encompass wider aspects of humanities, specifically peak experience as a culminating stage of the creative act. It proposes a model according to which the peak experience results from a harmonious vibration of four spheres, which transcend an individual’s capacities and bring one to a qualitatively different level of experience. Each sphere represents an aspect of creative activity: superconscious, intellectual, emotive and active. Each sphere corresponds to one of four creative functions: authenticity, novelty, aesthetics, and utility, respectively. The creative act starts in the superconscious sphere: the supreme pleasure of Creation is reflected in creative pleasure, which is realized in creative will. These three instances serve as a source of force axes, which penetrate other spheres, and in place of infiltration establish restrictive, expansive, and integrative principles, respectively; the latter balances the other two and ensures a harmonious vibration within a sphere. This Hegelian-like triad is realized within each sphere in the form of creative capacities. The intellectual sphere nurtures capacities to invent and to elaborate, which are integrated by capacity to conceptualize. The emotive sphere nurtures satiation and restrictive capacities integrated by capacity to balance. The active sphere nurtures goal orientation and stabilization capacities integrated by capacity for self-expression. All four spheres vibrate within each other – the superconscious sphere being in the core of the structure followed by intellectual, emotive, and active spheres, respectively – thereby reflecting the path of creative production. If the spheres vibrate in-phase, their amplitudes amplify the creative energy; if in antiphase – the amplitudes reduce the creative energy. Thus, creative act is perceived as continuum with perfectly harmonious vibration within and between the spheres on one side and perfectly disharmonious vibration on the other.

Keywords: creativity, model, transpersonal, peak experience

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Authors: Lingfei Sun

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Based on the significant value of ecology, the strategic planning for ecological civilization construction was mentioned in the 17th and 18th National Congress of the Communist Party of China. How to generate economic value based on the environmental capacity is not only an economic decision but also a political decision to make. Boshan took the full use of “Ecology” and transformed it as an inexhaustible green resource to benefit people, reflecting the sustainable value of new agriculture development mode. The Strawberry Harvest Festival and Blueberry Harvest Festival hosted approximately 96,000 and 54,000 leisure tourists respectively in 2014. For the Kiwi Harvest Festival in August 2014, in average, it attracted about 4600 tourists per day, which generated daily kiwi sales of 50,000 lbs and 3 million RMB (About 476,000 USD) of daily revenue. The purpose of this study is to elaborate the modes of agritourism development, by analyzing the cases in rural area of Boshan, China. Interviews with the local government officers were applied to discover operation mode of agritourism operation. The financial data was used to demonstrate the strength of government policy and improvement of the income of rural people. The result indicated that there are mainly three types of modes: the Intensive Mode, the Model Mode and the Mixed Mode, supported by case study respectively. With the boom of tourism, the development of agritourism in Boshan relies on the agriculture encouraging policy of China and the effort of local government; meanwhile, large scale of cultivation and the product differentiation are the crucial elements for the success of rural agritourism projects.

Keywords: agriculture, agritourism, economy, rural area development

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Authors: S. Abdi Goudazri, R. Ziaie Moayed, A. Nazeri

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Loose soils normally are of weak bearing capacity due to their structural nature. Being exposed to heavy traffic loads, they would fail in most cases. To tackle the aforementioned issue, geotechnical engineers have come up with different approaches; one of which is making use of geosynthetic-reinforced soil-aggregate systems. As these polymeric reinforcements have highlighted economic and environmentally-friendly features, they have become widespread in practice during the last decades. The present research investigates the efficiency of four different types of these reinforcements in increasing the bearing capacity of two-layered soil sections using a series California Bearing Ratio (CBR) test. The studied sections are comprised of a 10 cm-thick layer of no. 161 Firouzkooh sand (weak subgrade) and a 10 cm-thick layer of compacted aggregate materials (base course) classified as SP and GW according to the United Soil Classification System (USCS), respectively. The aggregate layer was compacted to the relative density (Dr) of 95% at the optimum water content (Wopt) of 6.5%. The applied reinforcements were including two kinds of geocomposites (type A and B), a geotextile, and a geogrid that were embedded at the interface of the lower and the upper layers of the soil-aggregate system. As the standard CBR mold was not appropriate in height for this study, the mold used for soaked CBR tests were utilized. To make a comparison between the results of stress-settlement behavior in the studied specimens, CBR values pertinent to the penetrations of 2.5 mm and 5 mm were considered. The obtained results demonstrated 21% and 24.5% increments in the amount of CBR value in the presence of geocomposite type A and geogrid, respectively. On the other hand, the effect of both geotextile and geocomposite type B on CBR values was generally insignificant in this research.

Keywords: geosynthetics, geogrid, geotextile, CBR test, increasing bearing capacity

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Authors: E. Cintura, M. I. Gomes

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Nowadays, sustainable development issues have a key role in the planning of the man-made environment. Ensuring this development means limiting the impact of human activity on nature. It is essential to secure healthy places and good living conditions. For these reasons, indoor air quality and building materials play a fundamental role in sustainable architectural projects. These factors significantly affect human health: they can radically change the quality of the internal environment and energy consumption. The use of natural materials such as earth has many beneficial aspects in comfort and indoor air quality. As well as advantages in the environmental impact of the construction, they ensure a low energy consumption. Since they are already present in nature, their production and use do not require a high-energy consumption. Furthermore, they have a high thermo-hygrometric capacity, being able to absorb moisture, contributing positively to indoor conditions. Indoor air quality is closely related to relative humidity. For these reasons, it can be affirmed that the use of earth materials guarantees a sustainable development and at the same time improves the health of the building users. This paper summarizes several researches that demonstrate the importance of indoor air quality for human health and how it strictly depends on the building materials used. Eco-efficient plasters are also considered: earth and ash mortar. The bibliography consulted has the objective of supporting future experimental and laboratory analyzes. It is necessary to carry on with research by the use of simulations and testing to confirm the hygrothermal properties of eco-efficient plasters and therefore their ability to improve indoor air quality.

Keywords: hygroscopicity, hygrothermal comfort, mortar, plaster

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Authors: Abiodun Ladanu Ajala, Wuyi Oke

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Mathematical simulation and optimization models packaged within interactive computer programs provide a common way for planners and managers to predict the behaviour of any proposed water resources system design or management policy before it is implemented. Modeling presents a principal technique of predicting the behaviour of the proposed infrastructural designs or management policies. Models can be developed and used to help identify specific alternative plans that best meet those objectives. This study discusses various types of models, their development, architecture, data requirements, and applications in the field of engineering. It also outlines the advantages and limitations of each the optimization and simulation models presented. The techniques explored in this review include; dynamic programming, linear programming, fuzzy optimization, evolutionary algorithms and finally artificial intelligence techniques. Previous studies carried out using some of the techniques mentioned above were reviewed, and most of the results from different researches showed that indeed optimization and simulation provides viable alternatives and predictions which form a basis for decision making in building engineering structures and also in engineering planning and management.

Keywords: linear programming, mutation, optimization, simulation

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Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour

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Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.

Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence

Procedia PDF Downloads 390

Authors: Tomohiro Uchida, Noriaki Satake, Toshimichi Nakaho, Akira Inoue, Hidemitsu Saito

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In this study, we assessed the bereavement risk of family caregivers of patients with cancer. In the palliative care unit of Tohoku University Hospital, we conducted a family psychoeducation session to support the family caregivers of patients with cancer. A total of 50 participants (8 males and 42 females; mean age = 62.98 years, SD = 11.10) were assessed after the session for bereavement risk using the Japanese version of the Bereavement Risk Assessment Tool (BRAT-J). According to the BRAT-J scores, eight participants were considered to be having no known risk (Level 1), seventeen had minimal risk (Level 2), twenty had a low risk (Level 3), four had a moderate risk (Level 4), and one had a high risk (Level 5). Of these participants, seven participants had completed the follow-up postal survey that assessed their psychological distress (the Kessler Psychological Distress Scale: K6) to compare the bereavement risk. According to the K6 scores, three-fourth of the individuals, who were considered to be at Level 3 on the BRAT-J, scored higher than the cutoff point (>10) for the detection of depressive disorder. On the other hand, one-third of the individuals, who were considered to be at Level 2 on the BRAT-J, scored higher than the cutoff point. Therefore, it appears that the BRAT-J can predict the likelihood of difficulties or complications in bereaved family caregivers. This research was approved by the Ethics Committee of Tohoku University Graduate School of Medicine and Tohoku University Hospital.

Keywords: palliative care, family caregivers, bereavement risk, BRAT, post-loss psychological distress

Procedia PDF Downloads 456