Search results for: respiratory protection
898 A Comparative Study in Acute Pancreatitis to Find out the Effectiveness of Early Addition of Ulinastatin to Current Standard Care in Indian Subjects
Authors: Dr. Jenit Gandhi, Dr. Manojith SS, Dr. Nakul GV, Dr. Sharath Honnani, Dr. Shaurav Ghosh, Dr. Neel Shetty, Dr. Nagabhushan JS, Dr. Manish Joshi
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Introduction: Acute pancreatitis is an inflammatory condition of the pancreas which begins in pancreatic acinar cells and triggers local inflammation that may progress to systemic inflammatory response (SIRS) and causing distant organ involvement and its function and ending up with multiple organ dysfunction syndromes (MODS). Aim: A comparative study in acute pancreatitis to find out the effectiveness of early addition of Ulinastatin to current standard care in Indian subjects . Methodology: A current prospective observational study is done during study period of 1year (Dec 2018 –Dec 2019) duration to evaluate the effect of early addition of Ulinastatin to the current standard treatment and its efficacy to reduce the early complication, analgesic requirement and duration of hospital stay in patients with Acute Pancreatitis. Results: In the control group 25 were males and 05 were females. In the test group 18 were males and 12 females. Majority was in the age group between 30 - 70 yrs of age with >50% in the 30-50yrs age group in both test and control groups. The VAS was median grade 3 in control group as compared to median grade 2 in test group , the pain was more in the initial 2 days in test group compared to 4 days in test group , the analgesic requirement was used for more in control group (median 6) to test group( median 3 days ). On follow up after 5 days for a period of 2 weeks none of the patients in the test group developed any complication. Where as in the control group 8 patients developed pleural effusion, 04-Pseudopancreatic cyst, 02 – patient developed portal vein and splenic vein thrombosis, 02 patients – ventilator with ARDS which were treated symptomatically whereas in test group 02 patient developed pleural effusions and 01 pseudo pancreatic cyst with splenic artery aneurysm, 01 – patient with AKI and MODS symptomatically treated. The duration of hospital stay for a median period of 4 days (2 – 7 days) in test group and 7 days (4 -10 days) in control group. All patients were able to return to normal work on an average of 5days compared 8days in control group, the difference was significant. Conclusion:The study concluded that early addition of Ulinastatin to current standard treatment of acute Pancreatitis is effective in reducing pain, early complication and duration of hospital stay in Indian subjectKeywords: Ulinastatin, VAS – visual analogue score , AKI – acute kidney injury , ARDS – acute respiratory distress syndrome
Procedia PDF Downloads 122897 Using Data Mining in Automotive Safety
Authors: Carine Cridelich, Pablo Juesas Cano, Emmanuel Ramasso, Noureddine Zerhouni, Bernd Weiler
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Safety is one of the most important considerations when buying a new car. While active safety aims at avoiding accidents, passive safety systems such as airbags and seat belts protect the occupant in case of an accident. In addition to legal regulations, organizations like Euro NCAP provide consumers with an independent assessment of the safety performance of cars and drive the development of safety systems in automobile industry. Those ratings are mainly based on injury assessment reference values derived from physical parameters measured in dummies during a car crash test. The components and sub-systems of a safety system are designed to achieve the required restraint performance. Sled tests and other types of tests are then carried out by car makers and their suppliers to confirm the protection level of the safety system. A Knowledge Discovery in Databases (KDD) process is proposed in order to minimize the number of tests. The KDD process is based on the data emerging from sled tests according to Euro NCAP specifications. About 30 parameters of the passive safety systems from different data sources (crash data, dummy protocol) are first analysed together with experts opinions. A procedure is proposed to manage missing data and validated on real data sets. Finally, a procedure is developed to estimate a set of rough initial parameters of the passive system before testing aiming at reducing the number of tests.Keywords: KDD process, passive safety systems, sled test, dummy injury assessment reference values, frontal impact
Procedia PDF Downloads 382896 Maintaining Minority Languages; Evidence from Italy
Authors: Carmela Perta
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Following the example of both International and European legislation, on 15 December 1999 the national law 482/99 Regulations regarding the protection of historic language minorities was approved, providing a national framework for the preservation and renaissance of minority languages «The Italian Republic sustains the language and culture of people speaking Albanian, Catalan, German, Greek, Slovene, Croatian, French, Francoprovençal, Friulan, Ladin, Occitan and Sard». The legislation made it possible to use these languages in education, in public offices, in local government, in the judicial system, in mass media, and allowed for the reinstatement of place and personal names. However, several practical problems have emerged, particularly those concerning the variety that should be used in education, in official documents and in other formal domains, i.e. the local variety, the standard of reference (if there is any), or an over regional koinè. In minority settings, it might seem eminently sensible to use the ready made standard of reference, accepting the Ausbausprache, rather than the language as practice, that is the local variety. However, this process seems to be pointless, as is demonstrated by the results of a fieldwork that was carried out in a small town in the South of Italy where members speak Faetar, the local variety of Francoprovençal. Here the language is largely used by the community members in all domains, moreover a deep sense of loyalty towards the variety they use and a manifested minority identity can be observed analysing the speakers’ attitudes. However, these positive attitudes are towards the vehicle for their distinctive history and culture, and not for an “external” standard, a system which local authorities and planners are trying to introduce in the community. In other words, according to the speakers' reactions, there is little point in struggling to maintain a language, if what is conserved is not the group’s language but another.Keywords: maintenance, minority languages, endangered languages, francoprovençal
Procedia PDF Downloads 435895 Studying the Temperature Field of Hypersonic Vehicle Structure with Aero-Thermo-Elasticity Deformation
Authors: Geng Xiangren, Liu Lei, Gui Ye-Wei, Tang Wei, Wang An-ling
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The malfunction of thermal protection system (TPS) caused by aerodynamic heating is a latent trouble to aircraft structure safety. Accurately predicting the structure temperature field is quite important for the TPS design of hypersonic vehicle. Since Thornton’s work in 1988, the coupled method of aerodynamic heating and heat transfer has developed rapidly. However, little attention has been paid to the influence of structural deformation on aerodynamic heating and structural temperature field. In the flight, especially the long-endurance flight, the structural deformation, caused by the aerodynamic heating and temperature rise, has a direct impact on the aerodynamic heating and structural temperature field. Thus, the coupled interaction cannot be neglected. In this paper, based on the method of static aero-thermo-elasticity, considering the influence of aero-thermo-elasticity deformation, the aerodynamic heating and heat transfer coupled results of hypersonic vehicle wing model were calculated. The results show that, for the low-curvature region, such as fuselage or center-section wing, structure deformation has little effect on temperature field. However, for the stagnation region with high curvature, the coupled effect is not negligible. Thus, it is quite important for the structure temperature prediction to take into account the effect of elastic deformation. This work has laid a solid foundation for improving the prediction accuracy of the temperature distribution of aircraft structures and the evaluation capacity of structural performance.Keywords: aerothermoelasticity, elastic deformation, structural temperature, multi-field coupling
Procedia PDF Downloads 341894 Household Wealth and Portfolio Choice When Tail Events Are Salient
Authors: Carlson Murray, Ali Lazrak
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Robust experimental evidence of systematic violations of expected utility (EU) establishes that individuals facing risk overweight utility from low probability gains and losses when making choices. These findings motivated development of models of preferences with probability weighting functions, such as rank dependent utility (RDU). We solve for the optimal investing strategy of an RDU investor in a dynamic binomial setting from which we derive implications for investing behavior. We show that relative to EU investors with constant relative risk aversion, commonly measured probability weighting functions produce optimal RDU terminal wealth with significant downside protection and upside exposure. We additionally find that in contrast to EU investors, RDU investors optimally choose a portfolio that contains fair bets that provide payo↵s that can be interpreted as lottery outcomes or exposure to idiosyncratic returns. In a calibrated version of the model, we calculate that RDU investors would be willing to pay 5% of their initial wealth for the freedom to trade away from an optimal EU wealth allocation. The dynamic trading strategy that supports the optimal wealth allocation implies portfolio weights that are independent of initial wealth but requires higher risky share after good stock return histories. Optimal trading also implies the possibility of non-participation when historical returns are poor. Our model fills a gap in the literature by providing new quantitative and qualitative predictions that can be tested experimentally or using data on household wealth and portfolio choice.Keywords: behavioral finance, probability weighting, portfolio choice
Procedia PDF Downloads 420893 A Techno-Economic Simulation Model to Reveal the Relevance of Construction Process Impact Factors for External Thermal Insulation Composite System (ETICS)
Authors: Virgo Sulakatko
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The reduction of energy consumption of the built environment has been one of the topics tackled by European Commission during the last decade. Increased energy efficiency requirements have increased the renovation rate of apartment buildings covered with External Thermal Insulation Composite System (ETICS). Due to fast and optimized application process, a large extent of quality assurance is depending on the specific activities of artisans and are often not controlled. The on-site degradation factors (DF) have the technical influence to the façade and cause future costs to the owner. Besides the thermal conductivity, the building envelope needs to ensure the mechanical resistance and stability, fire-, noise-, corrosion and weather protection, and long-term durability. As the shortcomings of the construction phase become problematic after some years, the common value of the renovation is reduced. Previous work on the subject has identified and rated the relevance of DF to the technical requirements and developed a method to reveal the economic value of repair works. The future costs can be traded off to increased the quality assurance during the construction process. The proposed framework is describing the joint simulation of the technical importance and economic value of the on-site DFs of ETICS. The model is providing new knowledge to improve the resource allocation during the construction process by enabling to identify and diminish the most relevant degradation factors and increase economic value to the owner.Keywords: ETICS, construction technology, construction management, life cycle costing
Procedia PDF Downloads 419892 Metabolic Costs and Chemical Profiles of Wax Production in Cryptolaemus montrouzieri and Tenuisvalvae notata
Authors: Nataly De La Pava, Christian S. A. Silva-Torres, Arodí P. Favaris, José Maurício S. Bento
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The lady beetles Tenuisvalve notata and Cryptolaemus montrouzieri are important predators of mealybugs (Hemiptera: Pseudococcidae). Similar to the prey, these lady beetles produce wax filaments that cover their body during the larval stage. It has been hypothesized that lady beetle body wax chemical profiles are similar to their prey as i) a mechanism of camouflage and ii) conveying protection to the lady beetle larvae against aphid-tending predatory ants. In this study, we tested those hypotheses for the predators T. notata and C. montrouzieri and two mealybug prey species, Ferissia dasyrilii, and Planococcus citri. Next, we evaluated the influence of feeding on cuticular chemistry during predator development and identified possible metabolic costs associated with wax production. Cuticular wax samples were analyzed by GC-MS and GC-FID. Also, the metabolic cost linked to wax production was evaluated in the 4th instar larvae of the two predators when subjected to body wax removal from 0 to 4 times. Results showed that predator body wax profiles are not similar to the chemical profile of prey body wax. There was a metabolic cost associated with wax removal; predators (male and female) showed a significant reduction in adult body weight when the wax was removed. This suggests the reallocation of energy to wax replacement instead of growth. In addition, it was detected effects of wax removal on fecundity and egg viability. The results do not support the hypothesis that predators mimic the cuticular wax composition of prey as a means of camouflage.Keywords: biological control, body wax, coccinellids, cuticular hydrocarbons, metabolism cost, reproduction
Procedia PDF Downloads 79891 Optimizing Groundwater Pumping for a Complex Groundwater/Surface Water System
Authors: Emery A. Coppola Jr., Suna Cinar, Ferenc Szidarovszky
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Over-pumping of groundwater resources is a serious problem world-wide. In addition to depleting this valuable resource, hydraulically connected sensitive ecological resources like wetlands and surface water bodies are often impacted and even destroyed by over-pumping. Effectively managing groundwater in a way that satisfy human demand while preserving natural resources is a daunting challenge that will only worsen with growing human populations and climate change. As presented in this paper, a numerical flow model developed for a hypothetical but realistic groundwater/surface water system was combined with formal optimization. Response coefficients were used in an optimization management model to maximize groundwater pumping in a complex, multi-layered aquifer system while protecting against groundwater over-draft, streamflow depletion, and wetland impacts. Pumping optimization was performed for different constraint sets that reflect different resource protection preferences, yielding significantly different optimal pumping solutions. A sensitivity analysis on the optimal solutions was performed on select response coefficients to identify differences between wet and dry periods. Stochastic optimization was also performed, where uncertainty associated with changing irrigation demand due to changing weather conditions are accounted for. One of the strengths of this optimization approach is that it can efficiently and accurately identify superior management strategies that minimize risk and adverse environmental impacts associated with groundwater pumping under different hydrologic conditions.Keywords: numerical groundwater flow modeling, water management optimization, groundwater overdraft, streamflow depletion
Procedia PDF Downloads 233890 Environmental Awareness on Formal Education Level: A Program Approach through Physical Education Course
Authors: Jocelyn Floresca
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This paper aimed to present the by-product of the introduction of environmental ecology awareness on a formal education level utilizing the program course of Physical Education, particularly in the tertiary level. It is based on the premise that the radical need for environmental protection may not only necessarily be the work of people in the pure sciences but also deemed necessary to look into more avenues of the school setting particularly in the field of Physical Education. In the Philippines, most schools’ Physical Education focuses on the advancement of sports, fitness and wellness which are mostly done in the confines of a closed building. The paper dwells into the introduction of Physical Education as an outdoor recreation activity where in the participants of the study had the opportunity to indulge in activities undertaken outside the confines of buildings and going into large areas of the environment. It looked into the individual participant’s environmental social behaviour and effects on the participant’s perceptions in terms of the set objectives of Physical Education before and after the study’s intervention. The study utilized the formal course in Physical Education on nature walks, mountaineering and bird watching as interventions to gain perceptions and understanding. The introduction of the environmental ecology activities as a formal Physical Education course has resulted in deeper awareness that led to understanding the need to protect the environment, appreciation of the value of natural areas and acquiring behaviour for a sustainable use of the environment during the practice of Physical Education. Also, prior to the introduction of environmental ecology in Physical Education as a formal study; participants have no knowledge of what dwells in the identified sites of intervention. Whereas after the study, participants were able to identify various species of birds and plants found in the sites of the study that may lead to further conservation of the particular species.Keywords: appreciation, conservation, environmental ecology, outdoor
Procedia PDF Downloads 294889 Reduction in Hospital Acquire Infections after Intervention of Hand Hygiene and Personal Protective Equipment at COVID Unit Indus Hospital Karachi
Authors: Aisha Maroof
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Introduction: Coronavirus Disease 2019 (COVID-19) is spreading rapidly around the world with devastating consequences on patients, health care workers and health systems. Severe 2019 novel coronavirus infectious disease (COVID-19) with pneumonia is associated with high rates of admission to the intensive care unit (ICU) and they are at high risk to obtain the hospital acquire bloodstream infection (HAIs) such as central line associated bloodstream infection (CLABSI), catheter associated urinary tract infections (CAUTI) and laboratory confirm bloodstream infection (LCBSI). The chances of infection transmission increase when healthcare worker’s (HCWs) practice is inappropriate. Risk related to hand hygiene (HH) and personal protective equipment (PPE) as regards multidrug-resistant organism transmission: use of multiple gloving instead of HH and incorrect use of PPE can lead to a significant increase of device-related infections. As it reaches low- and middle-income countries, its effects could be even more, because it will be difficult for them to react aggressively to the pandemic. HAIs are one of the biggest medical concerns, resulting in increased mortality rates. Objective: To assess the effect of intervention on compliance of hand hygiene and PPE among HCWs reduce the rate of HAI in COVID-19 patients. Method: An interventional study was done between July to December, 2020. CLABSI, CAUTI and LCBSI data were collected from the medical record and direct observation. There were total of 50 Nurses, 18 doctors and all patients with laboratory-confirmed severe COVID-19 admitted to the hospital were included in this research study. Respiratory tract specimens were obtained after the first 48 h of ICU admission. Practices were observed after and before intervention. Education was provided based on WHO guidelines. Results: During the six months of study July to December, the rate of CLABSI, CAUTI and LCBSI pre and post intervention was reported. CLABSI rate decreasedd from 22.7 to 0, CAUTI rate was decreased from 1.6 to 0, LCBSI declined from 3.3 to 0 after implementation of intervention. Conclusion: HAIs are an important cause of morbidity and mortality. Most of the device related infections occurs due to lack of correct use of PPE and hand hygiene compliance. Hand hygiene and PPE is the most important measure to protect patients, through education it can be improved the correct use of PPE and hand hygiene compliance and can reduce the bacterial infection in COVID-19 patients.Keywords: hospital acquire infection, healthcare workers, hand hygiene, personal protective equipment
Procedia PDF Downloads 129888 Intramuscular Heat Shock Protein 72 and Heme Oxygenase-1 mRNA are Reduced in Patients with Type 2 Diabetes Evidence That Insulin Resistance is Associated with a Disturbed Antioxidant Defense Mechanism
Authors: Ghibeche Abderrahmane
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To examine whether genes associated with cellular defense against oxidative stress are associated with insulin sensitivity, patients with type 2 diabetes (n=7) and age-matched (n=5) and young (n=9) control subjects underwent a euglycemic-hyperinsulinemic clamp for 120 min. Muscle samples were obtained before and after the clamp and analyzed for heat shock protein (HSP)72 and heme oxygenase (HO)-1 mRNA, intramuscular triglyceride content, and the maximal activities of β-hyroxyacyl-CoA dehydrogenase (β-HAD) and citrate synthase (CS). Basal expression of both HSP72 and HO-1 mRNA were lower (P < 0.05) by 33 and 55%, respectively, when comparing diabetic patients with age-matched and young control subjects, with no differences between the latter groups. Both basal HSP72 (r = 0.75, P < 0.001) and HO-1 (r = 0.50,P < 0.05) mRNA expression correlated with the glucose infusion rate during the clamp. Significant correlations were also observed between HSP72 mRNA and both β-HAD (r = 0.61, P < 0.01) and CS (r = 0.65, P < 0.01). HSP72 mRNA was induced (P < 0.05) by the clamp in all groups. Although HO-1 mRNA was unaffected by the clamp in both the young and age-matched control subjects, it was increased (P < 0.05) ∼70-fold in the diabetic patients after the clamp. These data demonstrate that genes involved in providing cellular protection against oxidative stress are defective in patients with type 2 diabetes and correlate with insulin-stimulated glucose disposal and markers of muscle oxidative capacity. The data provide new evidence that the pathogenesis of type 2 diabetes involves perturbations to the antioxidant defense mechanism within skeletal muscle.Keywords: euglycemic-hyperinsulinemic, HSP72, mRNA, diabete
Procedia PDF Downloads 440887 Experimental Study of the Dynamics of Sediments in Natural Channels in a Non-Stationary Flow Regime
Authors: Fourar Ali, Fourar Fatima Zohra
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Knowledge of sediment characteristics is fundamental to understanding their sedimentary functioning: sedimentation, settlement, and erosion processes of cohesive sediments are controlled by complex interactions between physical, chemical, and biological factors. Sediment transport is of primary importance in river hydraulics and river engineering. Indeed, the displacement of sediments can lead to lasting modifications of the bed in terms of its elevation, slope and roughness. The protection of a bank, for example, is likely to initiate a local incision of the river bed, which, in turn, can lead to the subsidence of the bank. The flows in the natural environment occur in general with heterogeneous boundary conditions because of the distribution of the roughnesses of the fixed or mobile bottoms and of the important deformations of the free surface, especially for the flows with a weak draft considering the irregularity of the bottom. Bedforms significantly influence flow resistance. The arrangement of particles lining the bottom of the stream bed or experimental channel generates waveforms of different sizes that lead to changes in roughness and consequently spatial variability in the turbulent characteristics of the flow. The study which is focused on the laws of friction in alluvial beds, aims to analyze the characteristics of flows and materials constituting the natural channels. Experimental results were obtained by simulating these flows on a rough bottom in an experimental channel at the Hydraulics Laboratory of the University of Batna 2. The system of equations governing the problem is solved using the program named: CLIPPER.5 and ACP.Keywords: free surface flow, heterogeneous sand, moving bottom bed, friction coefficient, bottom roughness
Procedia PDF Downloads 90886 The Agroclimatic Atlas of Croatia for the Periods 1981-2010 and 1991-2020
Authors: Višnjica Vučetić, Mislav Anić, Jelena Bašić, Petra Sviličić, Ivana Tomašević
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The Agroclimatic Atlas of Croatia (Atlas) for the periods 1981–2010 and 1991–2020 is monograph of six chapters in digital form. Detailed descriptions of particular agroclimatological data are given in separate chapters as follows: agroclimatic indices based on air temperature (degree days, Huglin heliothermal index), soil temperature, water balance components (precipitation, potential evapotranspiration, actual evapotranspiration, soil moisture content, runoff, recharge and soil moisture loss) and fire weather indices. The last chapter is a description of the digital methods for the spatial interpolations (R and GIS). The Atlas comprises textual description of the relevant climate characteristic, maps of the spatial distribution of climatological elements at 109 stations (26 stations for soil temperature) and tables of the 30-year mean monthly, seasonal and annual values of climatological parameters at 24 stations. The Atlas was published in 2021, on the seventieth anniversary of the agrometeorology development at the Meteorological and Hydrological Service of Croatia. It is intended to support improvement of sustainable system of agricultural production and forest protection from fire and as a rich source of information for agronomic and forestry experts, but also for the decision-making bodies to use it for the development of strategic plans.Keywords: agrometeorology, agroclimatic indices, soil temperature, water balance components, fire weather index, meteorological and hydrological service of Croatia
Procedia PDF Downloads 127885 Eco-Friendly Control of Bacterial Speck on Solanum lycopersicum by Azadirachta indica Extract
Authors: Navodit Goel, Prabir K. Paul
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Tomato (Solanum lycopersicum) is attacked by Pseudomonas syringae pv. tomato causing speck lesions on the leaves leading to severe economic casualty. In the present study, aqueous fruit extracts of Azadirachta indica (neem) were sprayed on a single node of tomato plants grown under controlled contamination-free conditions. The treatment of plants was performed with neem fruit extract either alone or along with the pathogen. The parameters of observation were activities of polyphenol oxidase (PPO) and lysozyme, and isoform analysis of PPO; both at the treated leaves as well as untreated leaves away from the site of extract application. Polyphenol oxidase initiates phenylpropanoid pathway resulting in the synthesis of quinines from cytoplasmic phenols and production of reactive oxygen species toxic to broad spectrum microbes. Lysozyme is responsible for the breakdown of bacterial cell wall. The results indicate the upregulation of PPO and lysozyme activities in both the treated and untreated leaves along with de novo expression of newer PPO isoenzymes (which were absent in control samples). The appearance of additional PPO isoenzymes in bioelicitor-treated plants indicates that either the isoenzymes were expressed after bioelicitor application or the already expressed but inactive isoenzymes were activated by it. Lysozyme activity was significantly increased in the plants when treated with the bioelicitor or the pathogen alone. However, no new isoenzymes of lysozyme were expressed upon application of the extract. Induction of resistance by neem fruit extract could be a potent weapon in eco-friendly plant protection strategies.Keywords: Azadirachta indica, lysozyme, polyphenol oxidase, Solanum lycopersicum
Procedia PDF Downloads 288884 The Effects of Continuous and Interval Aerobic Exercises with Moderate Intensity on Serum Levels of Glial Cell Line-Derived Neurotrophic Factor and Aerobic Capacity in Obese Children
Authors: Ali Golestani, Vahid Naseri, Hossein Taheri
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Recently, some of studies examined the effect of exercise on neurotrophic factors influencing the growth, protection, plasticity and function in central and peripheral nerve cells. The aim of this study was to investigate the effects of continuous and interval aerobic exercises with moderate intensity on serum levels of glial cell line-derived neurotrophic factor (GDNF) and aerobic capacity in obese children. 21 obese students with an average age of 13.6 ± 0.5 height 171 ± 5 and BMI 32 ± 1.2 were divided randomly to control, continuous aerobic and interval aerobic groups. Training protocol included continuous or interval aerobic exercises with moderate intensity 50-65%MHR, three times per week for 10 weeks. 48 hours before and after executing of protocol, blood samples were taken from the participants and their GDNF serum levels were measured by ELISA. Aerobic power was estimated using Shuttle-run test. T-test results indicated a small increase in their GDNF serum levels, which was not statistically significant (p =0.11). In addition, the results of ANOVA did not show any significant difference between continuous and interval aerobic training on the serum levels of their GDNF but their aerobic capacity significantly increased (p =0.012). Although continuous and interval aerobic exercise improves aerobic power in obese children, they had no significant effect on their serum levels of GDNF.Keywords: aerobic power, continuous aerobic training, glial cell line-derived neurotrophic factor (GDNF), interval aerobic training, obese children
Procedia PDF Downloads 177883 The Impact of Surface Roughness and PTFE/TiF3/FeF3 Additives in Plain ZDDP Oil on the Friction and Wear Behavior Using Thermal and Tribological Analysis under Extreme Pressure Condition
Authors: Gabi N. Nehme, Saeed Ghalambor
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The use of titanium fluoride and iron fluoride (TiF3/FeF3) catalysts in combination with polutetrafluoroethylene (PTFE) in plain zinc dialkyldithiophosphate (ZDDP) oil is important for the study of engine tribocomponents and is increasingly a strategy to improve the formation of tribofilm and to provide low friction and excellent wear protection in reduced phosphorus plain ZDDP oil. The influence of surface roughness and the concentration of TiF3/FeF3/PTFE were investigated using bearing steel samples dipped in lubricant solution @100°C for two different heating time durations. This paper addresses the effects of water drop contact angle using different surface finishes after treating them with different lubricant combination. The calculated water drop contact angles were analyzed using Design of Experiment software (DOE) and it was determined that a 0.05 μm Ra surface roughness would provide an excellent TiF3/FeF3/PTFE coating for antiwear resistance as reflected in the scanning electron microscopy (SEM) images and the tribological testing under extreme pressure conditions. Both friction and wear performance depend greatly on the PTFE/and catalysts in plain ZDDP oil with 0.05% phosphorous and on the surface finish of bearing steel. The friction and wear reducing effects, which was observed in the tribological tests, indicated a better micro lubrication effect of the 0.05 μm Ra surface roughness treated at 100°C for 24 hours when compared to the 0.1 μm Ra surface roughness with the same treatment.Keywords: scanning electron microscopy, ZDDP, catalysts, PTFE, friction, wear
Procedia PDF Downloads 350882 Al-Ti-W Metallic Glass Thin Films Deposited by Magnetron Sputtering Technology to Protect Steel Against Hydrogen Embrittlement
Authors: Issam Lakdhar, Akram Alhussein, Juan Creus
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With the huge increase in world energy consumption, researchers are working to find other alternative sources of energy instead of fossil fuel one causing many environmental problems as the production of greenhouse effect gases. Hydrogen is considered a green energy source, which its combustion does not cause environmental pollution. The transport and the storage of the gas molecules or the other products containing this smallest chemical element in metallic structures (pipelines, tanks) are crucial issues. The dissolve and the permeation of hydrogen into the metal lattice lead to the formation of hydride phases and the embrittlement of structures. To protect the metallic structures, a surface treatment could be a good solution. Among the different techniques, magnetron sputtering is used to elaborate micrometric coatings capable of slowing down or stop hydrogen permeation. In the plasma environment, the deposition parameters of new thin-film metallic glasses Al-Ti-W were optimized and controlled in order to obtain, hydrogen barrier. Many characterizations were carried out (SEM, XRD and Nano-indentation…) to control the composition and understand the influence of film microstructure and chemical composition on the hydrogen permeation through the coatings. The coating performance was evaluated under two hydrogen production methods: chemical and electrochemical (cathodic protection) techniques. The hydrogen quantity absorbed was experimentally determined using the Thermal-Desorption Spectroscopy method (TDS)). An ideal ATW thin film was developed and showed excellent behavior against the diffusion of hydrogen.Keywords: thin films, hydrogen, PVD, plasma technology, electrochemical properties
Procedia PDF Downloads 185881 Encapsulation of Probiotic Bacteria in Complex Coacervates
Authors: L. A. Bosnea, T. Moschakis, C. Biliaderis
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Two probiotic strains of Lactobacillus paracasei subsp. paracasei (E6) and Lactobacillus paraplantarum (B1), isolated from traditional Greek dairy products, were microencapsulated by complex coacervation using whey protein isolate (WPI, 3% w/v) and gum arabic (GA, 3% w/v) solutions mixed at different polymer ratio (1:1, 2:1 and 4:1). The effect of total biopolymer concentration on cell viability was assessed using WPI and GA solutions of 1, 3 and 6% w/v at a constant ratio of 2:1. Also, several parameters were examined for optimization of the microcapsule formation, such as inoculum concentration and the effect of ionic strength. The viability of the bacterial cells during heat treatment and under simulated gut conditions was also evaluated. Among the different WPI/GA weight ratios tested (1:1, 2:1, and 4:1), the highest survival rate was observed for the coacervate structures made with the ratio of 2:1. The protection efficiency at low pH values is influenced by both concentration and the ratio of the added biopolymers. Moreover, the inoculum concentration seems to affect the efficiency of microcapsules to entrap the bacterial cells since an optimum level was noted at less than 8 log cfu/ml. Generally, entrapment of lactobacilli in the complex coacervate structure enhanced the viability of the microorganisms when exposed to a low pH environment (pH 2.0). Both encapsulated strains retained high viability in simulated gastric juice (>73%), especially in comparison with non-encapsulated (free) cells (<19%). The encapsulated lactobacilli also exhibited enhanced viability after 10–30 min of heat treatment (65oC) as well as at different NaCl concentrations (pH 4.0). Overall, the results of this study suggest that complex coacervation with WPI/GA has a potential to deliver live probiotics in low pH food systems and fermented dairy products; the complexes can dissolve at pH 7.0 (gut environment), releasing the microbial cells.Keywords: probiotic, complex coacervation, whey, encapsulation
Procedia PDF Downloads 297880 Effect of Miconazole Nitrate on Immunological Response and Its Preventive Efficacy in Labeo rohita Fingerlings against Oomycetes Saprolegnia parasitica
Authors: Mukta Singh, Ratan Kumar Saha, Himadri Saha, Paramveer Singh
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The present study evaluated the effect of sub-lethal doses of antifungal drug miconazole nitrate (MCZ) on immunological responses including immune-related gene expression and its role as a prophylactic drug against S. parasitica in Labeo rohita fingerlings. Fish were fed with sub lethal doses of MCZ i.e., T1- 6.30 mg MCZ kgBW⁻¹, T2- 12.61 mg MCZ kgBW⁻¹ and T3- 25.22 mg MCZ kgBW⁻¹ and sampling was done at different time intervals for 240 h. Immunological parameters viz. lysozyme activity, oxygen radical production and plasma anti-protease activity showed significant enhancement (p < 0.05) in fish fed with T2 and T3 doses. Significant reduction in plasma protein content was observed in all the dietary groups as compared to control. Expression of immune-relevant genes like TLR-22 and β2-M showed significantly higher expression at six h and 24 h of sampling in both liver and head-kidney. However, these genes showed a down-regulation after 120 h of sampling in both the tissues. Preventive efficacy study showed that single dose of MCZ provides protection against oomycetes up to the fourth day of infection. Significantly higher mortality was observed in control diet-fed fish as compared to fish fed with MCZ medicated diet. Thus, from the study, it can be concluded that the MCZ can act as a potent antifungal agent for preventing oomycetes infection as well as to enhance the immune response.Keywords: antifungal, immune gene, immunological, miconazole nitrate, prophylactic
Procedia PDF Downloads 246879 Application of Value Engineering Approach for Improving the Quality and Productivity of Ready-Mixed Concrete Used in Construction and Hydraulic Projects
Authors: Adel Mohamed El-Baghdady, Walid Sayed Abdulgalil, Ahmad Asran, Ibrahim Nosier
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This paper studies the effectiveness of applying value engineering to actual concrete mixtures. The study was conducted in the State of Qatar on a number of strategic construction projects with international engineering specifications for the 2022 World Cup projects. The study examined the concrete mixtures of Doha Metro project and the development of KAHRAMAA’s (Qatar Electricity and Water Company) Abu Funtas Strategic Desalination Plant, in order to generally improve the quality and productivity of ready-mixed concrete used in construction and hydraulic projects. The application of value engineering to such concrete mixtures resulted in the following: i) improving the quality of concrete mixtures and increasing the durability of buildings in which they are used; ii) reducing the waste of excess materials of concrete mixture, optimizing the use of resources, and enhancing sustainability; iii) reducing the use of cement, thus reducing CO₂ emissions which ensures the protection of environment and public health; iv) reducing actual costs of concrete mixtures and, in turn, reducing the costs of construction projects; and v) increasing the market share and competitiveness of concrete producers. This research shows that applying the methodology of value engineering to ready-mixed concrete is an effective way to save around 5% of the total cost of concrete mixtures supplied to construction and hydraulic projects, improve the quality according to the technical requirements and as per the standards and specifications for ready-mixed concrete, improve the environmental impact, and promote sustainability.Keywords: value management, cost of concrete, performance, optimization, sustainability, environmental impact
Procedia PDF Downloads 354878 Severe Infestation of Laspeyresia Koenigana Fab. and Alternaria Leaf Spot on Azadirachta Indica (Neem)
Authors: Shiwani Bhatnagar, K. K. Srivastava, Sangeeta Singh, Ameen Ullah Khan, Bundesh Kumar, Lokendra Singh Rathore
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From the instigation of the world medicinal plants are treated as part and parcel of human society to fight against diseases. Azadirachta indica (Neem) a herbal plant has been used as an Indian traditional medicine since ages and its products are acknowledged to solve agricultural, forestry and public health related problems, owing to its beneficial medicinal properties. Each part of the neem tree is known for its medicinal property. Bark & leaf extracts of neem have been used to control leprosy, respiratory disorders, constipation and also as blood purifier and a general health tonic. Neem is still regarded as ' rural community dispensary' in India or a tree for solving medical problems. Use of Neem as pesticides for the management of insect pest of agriculture crops and forestry has been seen as a shift in the use of synthetic pesticides to ecofriendly botanicals. Neem oil and seed extracts possess germicidal and anti-bacterial properties which when sprayed on the plant helps in protecting them from foliage pests. Azadirachtin, the main active ingredient found in neem tree, acts as an insect repellent and antifeedant. However the young plants are susceptible to many insect pest and foliar diseases. Recently, in the avenue plantation, planted by Arid Forest Research Institute, Jodhpur, around the premises of IIT Jodhpur, two years old neem plants were found to be severely infested with tip borer Laspeyresia koenigana (Family: Eucosmidae). The adult moth of L. koenigana lays eggs on the tender shoots and the young larvae tunnel into the shoot and feed inside. A small pinhole can be seen at the entrance point, from where the larva enters in to the stem. The severely attached apical shoots exhibit profuse gum exudation resulting in development of a callus structure. The internal feeding causes the stem to wilt and the leaves to dry up from the tips resulting in growth retardation. Alternaria Leaf spot and blight symptoms were also recorded on these neem plants. For the management of tip borer and Alternaria Leaf spot, foliar spray of monocrotophos @0.05% and Dithane M-45 @ 0.15% and powermin @ 2ml/lit were found efficient in managing the insect pest and foliar disease problem. No Further incidence of pest/diseases was noticed.Keywords: azadirachta indica, alternaria leaf spot, laspeyresia koenigana, management
Procedia PDF Downloads 477877 Economic Impact of Mediation: Analyzing the Strengths and Weaknesses of Portuguese Mediation System
Authors: M. L. Mesquita, V. H. Ferreira, C. M. Cebola
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Mediation is an increasingly important mechanism, particularly in the European context, as demonstrated, for example, by the publication by the European Union of the Directive 2008/52/EC on certain aspects of mediation in civil and mercantile matters. Developments in international trade and globalization in this new century have led to an increase of the number of litigations, often cross-border, and the courts have failed to respond adequately. From the economic point of view, competitive negotiation can generate negative external effects in social terms. Not always the solution found in court is the most efficient solution taking into account all elements of society. On the other hand, the administration of justice adds in economic terms transaction costs that can be mitigated by the application of other forms of conflict resolution, such as mediation. In this paper, the economic benefits of mediation will be analysed in the light of various studies on the functioning of justice. Several theoretical arguments will be confronted with empirical studies to demonstrate that mediation has significant positive economic effects. In the Portuguese legal system, legislative frameworks for mediation display a state committed to creating a new architecture for the administration of justice, based on the construction of a multi-faceted legal system for dispute resolution mechanisms. Understanding the way in which the system of mediation in Portugal was introduced, allows us to point out that our internal ordering is creating the legal instruments which can assist citizens in the effective protection of their rights. However, data on the use of mediation in concrete proceedings and the consequent effectiveness of mediation in settling disputes, reveal a mechanism that is still far from the ideal results that were initially sought.Keywords: access to justice, alternative dispute resolution, mediation, litigation
Procedia PDF Downloads 167876 Supplier Selection Using Sustainable Criteria in Sustainable Supply Chain Management
Authors: Richa Grover, Rahul Grover, V. Balaji Rao, Kavish Kejriwal
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Selection of suppliers is a crucial problem in the supply chain management. On top of that, sustainable supplier selection is the biggest challenge for the organizations. Environment protection and social problems have been of concern to society in recent years, and the traditional supplier selection does not consider about this factor; therefore, this research work focuses on introducing sustainable criteria into the structure of supplier selection criteria. Sustainable Supply Chain Management (SSCM) is the management and administration of material, information, and money flows, as well as coordination among business along the supply chain. All three dimensions - economic, environmental, and social - of sustainable development needs to be taken care of. Purpose of this research is to maximize supply chain profitability, maximize social wellbeing of supply chain and minimize environmental impacts. Problem statement is selection of suppliers in a sustainable supply chain network by ranking the suppliers against sustainable criteria identified. The aim of this research is twofold: To find out what are the sustainable parameters that can be applied to the supply chain, and to determine how these parameters can effectively be used in supplier selection. Multicriteria decision making tools will be used to rank both criteria and suppliers. AHP Analysis will be used to find out ratings for the criteria identified. It is a technique used for efficient decision making. TOPSIS will be used to find out rating for suppliers and then ranking them. TOPSIS is a MCDM problem solving method which is based on the principle that the chosen option should have the maximum distance from the negative ideal solution (NIS) and the minimum distance from the ideal solution.Keywords: sustainable supply chain management, sustainable criteria, MCDM tools, AHP analysis, TOPSIS method
Procedia PDF Downloads 325875 Coral Reef Fishes in the Marine Protected Areas in Southern Cebu, Philippines
Authors: Christine M. Corrales, Gloria G. Delan, Rachel Luz V. Rica, Alfonso S. Piquero
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Marine protected areas (MPAs) in the study sites were established 8-13 years ago and are presently operational. This study was conducted to gather baseline information on the diversity, density and biomass of coral reef fishes inside and outside the four marine protected areas (MPAs) of Cawayan, Dalaguete; Daan-Lungsod Guiwang, Alcoy; North Granada, Boljoon and Sta. Cruz, Ronda. Coral reef fishes in the MPAs were identified using Fish Visual Census Method. Results of the t-test showed that the mean diversity (fish species/250m2) of target and non-target reef fish species found inside and outside the MPAs were significantly different. Density (ind./1,000m2) of target species inside and outside the MPAs showed no significant difference. Similarly, density of non-target species inside and outside the MPAs also showed no significant difference. This is an indication that fish density inside and outside the MPAs were more or less of the same condition. The mean biomass (kg/1,000m2) of target species inside and outside the MPAs showed a significant difference in contrast with non-target species inside and outside the MPAs which showed a no significant difference. Higher biomass of target fish species belonging to family Caesonidae (fusiliers) and Scaridae (parrotfishes) were commonly observed inside the MPAs. Results showed that fish species were more diverse with higher density and biomass inside the MPAs than the outside area. However, fish diversity and density were mostly contributed by non-target species. Hence, long term protection and management of MPAs is needed to effectively increase fish diversity, density and biomass specifically on target fish species.Keywords: biomass, density, diversity, marine protected area, target fish species
Procedia PDF Downloads 397874 Health and Safety of Red Cross Workers in Long-Term Homes during Early Days of the COVID-19 Pandemic: A Human Performance Perspective
Authors: Douglas J. Kube
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At the beginning of the COVID-19 pandemic, the Canadian Red Cross deployed workers into long-term care homes across Canada to support our most vulnerable citizens. It began by recruiting and training small teams of workers to provide non-clinical services for facilities in outbreak. Deployed workers were trained on an approach based on successful Red Cross deployments used with Ebola in which zones were established, levels of protection used, and strict protocols followed to prevent exposure. This paper addresses aspects of human performance through a safety culture lens. The Red Cross deployments highlight valuable insights and are an excellent case study in the principles of human performance and organizational culture. This paper looks at human performance principles, including human fallibility, predictability of error-likely situations, avoiding events by understanding reasons mistakes occur, and the influence on behaviour by organizational factors. This study demonstrates how the Red Cross’s organizational culture and work design positively influenced performance to protect workers and residents/clients. Lastly, this paper shares lessons that can be applied in many workplaces to improve worker health and safety and safety culture. This critical examination is based on the author’s experience as a Senior Occupational Health and Safety Advisor with the Red Cross during the pandemic as part of the team responsible for developing and implementing biological safety practices in long-term care deployments.Keywords: COVID, human performance, organizational culture, work design
Procedia PDF Downloads 58873 In-Situ Determination of Radioactivity Levels and Radiological Hazards in and around the Gold Mine Tailings of the West Rand Area, South Africa
Authors: Paballo M. Moshupya, Tamiru A. Abiye, Ian Korir
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Mining and processing of naturally occurring radioactive materials could result in elevated levels of natural radionuclides in the environment. The aim of this study was to evaluate the radioactivity levels on a large scale in the West Rand District in South Africa, which is dominated by abandoned gold mine tailings and the consequential radiological exposures to members of the public. The activity concentrations of ²³⁸U, ²³²Th and 40K in mine tailings, soil and rocks were assessed using the BGO Super-Spec (RS-230) gamma spectrometer. The measured activity concentrations for ²³⁸U, ²³²Th and 40K in the studied mine tailings were found to range from 209.95 to 2578.68 Bq/kg, 19.49 to 108.00 Bq/kg and 31.30 to 626.00 Bq/kg, respectively. In surface soils, the overall average activity concentrations were found to be 59.15 Bq/kg, 34.91 and 245.64 Bq/kg for 238U, ²³²Th and 40K, respectively. For the rock samples analyzed, the mean activity concentrations were 32.97 Bq/kg, 32.26 Bq/kg and 351.52 Bg/kg for ²³⁸U, ²³²Th and 40K, respectively. High radioactivity levels were found in mine tailings, with ²³⁸U contributing significantly to the overall activity concentration. The external gamma radiation received from surface soil in the area is generally low, with an average of 0.07 mSv/y. The highest annual effective doses were estimated from the tailings dams and the levels varied between 0.14 mSv/y and 1.09 mSv/y, with an average of 0.51 mSv/y. In certain locations, the recommended dose constraint of 0.25 mSv/y from a single source to the average member of the public within the exposed population was exceeded, indicating the need for further monitoring and regulatory control measures specific to these areas to ensure the protection of resident members of the public.Keywords: activity concentration, gold mine tailings, in-situ gamma spectrometry, radiological exposures
Procedia PDF Downloads 127872 Arbuscular Mycorrhizal Symbiosis Modulates Antioxidant Capacity of in vitro Propagated Hyssop, Hyssopus officinalis L.
Authors: Maria P. Geneva, Ira V. Stancheva, Marieta G. Hristozkova, Roumiana D. Vasilevska-Ivanova, Mariana T. Sichanova, Janet R. Mincheva
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Hyssopus officinalis L., Lamiaceae, commonly called hyssop, is an aromatic, semi-evergreen, woody-based, shrubby perennial plant. Hyssop is a good expectorant and antiviral herb commonly used to treat respiratory conditions such as influenza, sinus infections, colds, and bronchitis. Most of its medicinal properties are attributed to the essential oil of hyssop. The study was conducted to evaluate the influence of inoculation with arbuscular mycorrhizal fungi of in vitro propagated hyssop plants on the: activities of antioxidant enzymes superoxide dismutase, catalase, guaiacol peroxidase and ascorbate peroxidase; accumulation of non-enzymatic antioxidants total phenols and flavonoid, water-soluble soluble antioxidant metabolites expressed as ascorbic acid; the antioxidant potential of hyssop methanol extracts assessed by two common methods: free radical scavenging activity using free stable radical (2,2-diphenyl-1-picrylhydrazyl, DPPH• and ferric reducing antioxidant power FRAP in flowers and leaves. The successfully adapted to field conditions in vitro plants (survival rate 95%) were inoculated with arbuscular mycorrhizal fungi (Claroideoglomus claroideum, ref. EEZ 54). It was established that the activities of enzymes with antioxidant capacity (superoxide dismutase, catalase, guaiacol peroxidase and ascorbate peroxidase) were significantly higher in leaves than in flowers in both control and mycorrhized plants. In flowers and leaves of inoculated plants, the antioxidant enzymes activity were lower than in non-inoculated plants, only in SOD activity, there was no difference. The content of low molecular metabolites with antioxidant capacity as total phenols, total flavonoids, and water soluble antioxidants was higher in inoculated plants. There were no significant differences between control and inoculated plants both for FRAP and DPPH antioxidant activity. According to plant essential oil content, there was no difference between non-inoculated and inoculated plants. Based on our results we could suggest that antioxidant capacity of in vitro propagated hyssop plant under conditions of cultivation is determined by the phenolic compounds-total phenols and flavonoids as well as by the levels of water-soluble metabolites with antioxidant potential. Acknowledgments: This study was conducted with financial support from National Science Fund at the Bulgarian Ministry of Education and Science, Project DN06/7 17.12.16.Keywords: antioxidant enzymes, antioxidant metabolites, arbuscular mycorrhizal fungi, Hyssopus officinalis L.
Procedia PDF Downloads 327871 Heritage Impact Assessment Policy within Western Balkans, Albania
Authors: Anisa Duraj
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As usually acknowledged, cultural heritage is the weakest component in EIA studies. The role of heritage impact assessment (HIA) in development projects is not often accounted for, and in those cases where it is, HIA is considered as a reactive response and not as a solutions provider. Because of continuous development projects, in most cases, heritage is unconsidered and often put under threat. Cultural protection and development challenges ask for prudent legal regulation and appropriate policy implementation. The challenges become even more peculiar in underdeveloped countries or endangered areas, which are generally characterized by numerous legal constraints. Therefore, the need for strategic proposals for HIA is of high importance. In order to trigger HIA as a proactive operation in the IA process and make sure to cover cultural heritage in the whole EIA framework, an appropriate system of evaluation of impacts should be provided. To obtain the required results for HIA, this last must be part of a regional policy, which will address and guide development projects toward a proper evaluation of their impacts affecting heritage. In order to get a clearer picture of existing gabs but also new possibilities for HIA, this paper will focus on the Western Balkans region and the undergoing changes that it faces. Concerning continuous development pressure in the region and within the aspiration of the Western Balkans countries to join the European Union (EU) as member states, attention should be paid to new development policies under the EU directives for conducting EIAs, and accurate support is required for the restructuration of existing policies as well as for the implementation of the UN Agenda for SDGs. In the framework of new emerging needs, if HIA is taken into account, the outcome would be an inclusive regional program that would help to overcome marginality issues of spaces and people.Keywords: cultural heritage, impact assessment, SDGs, urban development, western Balkans, regional policy, HIA, EIA
Procedia PDF Downloads 114870 Design and Manufacture of a Hybrid Gearbox Reducer System
Authors: Ahmed Mozamel, Kemal Yildizli
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Due to mechanical energy losses and a competitive of minimizing these losses and increases the machine efficiency, the need for contactless gearing system has raised. In this work, one stage of mechanical planetary gear transmission system integrated with one stage of magnetic planetary gear system is designed as a two-stage hybrid gearbox system. The permanent magnets internal energy in the form of the magnetic field is used to create meshing between contactless magnetic rotors in order to provide self-system protection against overloading and decrease the mechanical loss of the transmission system by eliminating the friction losses. Classical methods, such as analytical, tabular method and the theory of elasticity are used to calculate the planetary gear design parameters. The finite element method (ANSYS Maxwell) is used to predict the behaviors of a magnetic gearing system. The concentric magnetic gearing system has been modeled and analyzed by using 2D finite element method (ANSYS Maxwell). In addition to that, design and manufacturing processes of prototype components (a planetary gear, concentric magnetic gear, shafts and the bearings selection) of a gearbox system are investigated. The output force, the output moment, the output power and efficiency of the hybrid gearbox system are experimentally evaluated. The viability of applying a magnetic force to transmit mechanical power through a non-contact gearing system is presented. The experimental test results show that the system is capable to operate continuously within the range of speed from 400 rpm to 3000 rpm with the reduction ratio of 2:1 and maximum efficiency of 91%.Keywords: hybrid gearbox, mechanical gearboxes, magnetic gears, magnetic torque
Procedia PDF Downloads 152869 Evidence-Triggers for Care of Patients with Cleft Lip and Palate in Srinagarind Hospital: The Tawanchai Center and Out-Patients Surgical Room
Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen
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Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.Keywords: evidence-triggers, cleft lip, cleft palate, problems of care
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