Search results for: hospital capacity planning

Authors: Vivek Anand, Rainer Naegele

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Industry 4.0 envisages 'smart' manufacturing and services, taking the automation of the 3rd Industrial Revolution to the autonomy of the 4th Industrial Revolution. Powered by innovations in technology and business models, this disruptive transformation is revitalising industry by integrating silos across and beyond value chains. Motivated by the challenges faced by SMEs and Startups in understanding and adopting Industry 4.0, this paper aims to analyse the concept of Growth Poles and evaluate the possibility of its application to Innovation Clusters that strive to propel Industry 4.0 adoption and capacity building. The proposed paper applies qualitative research methodologies including focus groups and survey questionnaires to identify the various factors that affect formation and development of Innovation Clusters. Employing content analysis, the interaction between SMEs and other ecosystem players in such clusters is studied. A strong collaborative culture is a key driver of digital transformation and technology adoption across sectors, value chains and supply chains; and will position these cluster-based growth poles at the forefront of industrial renaissance. Motivated by this argument, and based on the results of the qualitative research, a roadmap will be proposed to position Innovation Clusters as Growth Poles and effective ecosystems to support Industry 4.0 adoption in a region in the medium to long term. This paper will contribute to the current understanding of the role of Innovation Clusters in capacity building. Relevant management and policy implications stem from the analysis. Furthermore, the findings will be helpful for academicians and policymakers alike, who can leverage an ‘innovation cluster policy’ to enable Industry 4.0 Growth Poles in their regions.

Keywords: digital transformation, fourth industrial revolution, growth poles, industry 4.0, innovation clusters, innovation policy, SMEs and startups

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Authors: Cristina Galiana Carballo, Ibon Doval Martínez

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Urban boundaries often result in a controversial limit between countryside and city in Europe. This territory is normally defined by the very limited land uses and the abundance of open space. The dimension and dynamics of peri-urbanization in the last decades have increased this land stock, which has influenced/impacted in several factors in terms of economic costs (maintenance, transport), ecological disturbances of the territory and changes in inhabitant´s behaviour. In an increasingly urbanised world and a growing urban population, cities also face challenges such as Climate Change. In this context, new near-future corrective trends including circular economies for local food supply or decentralised waste management became key strategies towards more sustainable urban models. Those new solutions need to be planned and implemented considering the potential conflict with current land uses. The city of Vitoria-Gasteiz (Basque Country, Spain) has triplicated land consumption per habitant in 10 years, resulting in a vast extension of low-density urban type confronting rural land and threatening agricultural uses, landscape and urban sustainability. Urban planning allows managing and optimum use allocation based on soil vocation and socio-ecosystem needs, while peri-urban space arises as an opportunity for developing different uses which do not match either within the compact city, not in open agricultural lands, such as medium-size agrocomposting systems or biomass plants. Therefore, a qualitative multi-criteria methodology has been developed for Vitoria-Gasteiz city to assess the spatial definition of peri-urban land. Therefore, a qualitative multi-criteria methodology has been developed for Vitoria-Gasteiz city to assess the spatial definition of peri-urban land. Climate change and circular economy were identified as frameworks where to determine future land, soil vocation and urban planning requirements which eventually become estimations of required local food and renewable energy supply along with alternative waste management system´s implementation. By means of it, it has been developed an urban planning proposal which overcomes urban-non urban dichotomy in Vitoria-Gasteiz. The proposal aims to enhance rural system and improve urban sustainability performance through the normative recognition of an agricultural peri-urban belt.

Keywords: landscape ecology, land-use management, periurban, urban planning

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Authors: Chanasit Chaocharoenphat

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Hibiscus sabdariffa is a herbal plant that is commonly used for home remedies in Thailand. This study aims to determine the antioxidant activity of polyphenols, as oxidative stress plays a vital role in the development of cancer, and H. sabdariffa was used in this study. The total flavonoids content was determined using the aluminium chloride colourimetric method and expressed as quercetin equivalents (QE)/g and the antioxidant capacity of the flavonoids using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical scavenging capacity assays. The IC50 values of H. sabdariffa extract were 167.14 μg/mL ± 0.843 and 77.59 μg/mL ± 0.798, respectively. In the DPPH assay, vitamin C was used as a positive control, whereas Trolox was used as a positive control in the ABTS assay. To summarise, H. sabdariffa extract contains a high concentration of total flavonoids and exhibits potent antioxidant activity. However, additional antioxidant activity assays such as superoxide dismutase (SOD), reactive oxygen species (ROS), and reactive nitrogen species (RNS) scavenging assays and in vitro antioxidant experiments should be carried out to investigate the molecular mechanism of the compound.

Keywords: ABTS assay, antioxidant activity, Gracilaria fisheri, DPPH assays, total flavonoid content

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Authors: Nadia Arikat, Katharine Blain

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During the worst of the COVID pandemic, only essential treatment was provided for patients needing urgent care. With the prolonged extent of the pandemic, there has been a return to more routine referrals for paediatric dentistry advice and treatment for specialist conditions. However, some of these patients and/or their carers may have significant medical issues meaning that attending in-person appointments carries additional risks. This poses an ethical dilemma for clinicians. This project looks at how a secure video conferencing platform (“Near Me”) has been used to assess the need and urgency for in-person new patient visits, particularly for patients and families with additional risks. “Near Me” is a secure online video consulting service used by NHS Scotland. In deciding whether to bring a new patient to the hospital for an appointment, the clinical condition of the teeth together with the urgency for treatment need to be assessed. This is not always apparent from the referral letter. In addition, it is important to judge the risks to the patients and carers of such visits, particularly if they have medical issues. The use and effectiveness of “Near Me” consultations to help decide whether vulnerable paediatric patients should have in-person appointments will be illustrated and discussed using two families: one where the child is medically compromised (Alagille syndrome with previous liver transplant), and the other where there is a medically compromised parent (undergoing chemotherapy and a bone marrow transplant). In both cases, it was necessary to take into consideration the risks and moral implications of requesting that they attend the dental hospital during a pandemic. The option of remote consultation allowed further clinical information to be evaluated and the families take part in the decision-making process about whether and when such visits should be scheduled. These cases will demonstrate how medically compromised patients (or patients with vulnerable carers), could have their dental needs assessed in a socially distanced manner by video consultation. Together, the clinician and the patient’s family can weigh up the risks, with regards to COVID-19, of attending for in-person appointments against the benefit of having treatment. This is particularly important for new paediatric patients who have not yet had a formal assessment. The limitations of this technology will also be discussed. It is limited by internet availability, the strength of the connection, the video quality and families owning a device which allows video calls. For those from a lower socio-economic background or living in some rural areas, this may not be possible or limit its usefulness. For the two patients discussed in this project, where the urgency of their dental condition was unclear, video consultation proved beneficial in deciding an appropriate outcome and preventing unnecessary exposure of vulnerable people to a hospital environment during a pandemic, demonstrating the usefulness of such technology when it is used appropriately.

Keywords: COVID-19, paediatrics, triage, video consultations

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Authors: Choonoh Lee, Seyeon Park, Dongyun Kang, Jaehyeong Choi, Soojee Kim, Younggeun Kim

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Market Kurly is the first South Korean online grocery retailer that guarantees same-day, overnight shipping. More than 1.6 million customers place an average of 4.7 million orders and add 3 to 14 products into a cart per month. The company has sold almost 30,000 kinds of various products in the past 6 months, including food items, cosmetics, kitchenware, toys for kids/pets, and even flowers. The company is operating and expanding multiple dry, cold, and frozen fulfillment centers in order to store and ship these products. Due to the scale and complexity of the fulfillment, pick-pack-ship processes are planned and operated in batches, and thus, the planning that decides the batch of the customers’ orders is a critical factor in overall productivity. This paper introduces a metaheuristic optimization method that reduces the complexity of batch processing in a fulfillment center. The method is an iterative genetic algorithm with heuristic creation and evolution strategies; it aims to group similar orders into pick-pack-ship batches to minimize the total number of distinct products. With a well-designed approach to create initial genes, the method produces streamlined plans, up to 13.5% less complex than the actual plans carried out in the company’s fulfillment centers in the previous months. Furthermore, our digital-twin simulations show that the optimized plans can reduce 3% of operation time for packing, which is the most complex and time-consuming task in the process. The optimization method implements a multithreading design on the Spring framework to support the company’s warehouse management systems in near real-time, finding a solution for 4,000 orders within 5 to 7 seconds on an AWS c5.2xlarge instance.

Keywords: fulfillment planning, genetic algorithm, online grocery retail, optimization

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Authors: M. Mana, M. S. Ouali, L. C. de Menorval

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A spent bleaching earth from an edible oil refinery has been treated by impregnation with a normal sodium hydroxide solution followed by mild thermal treatment (100°C). The obtained material (TSBE) was washed, dried and characterized by X-ray diffraction, FTIR, SEM, BET, and thermal analysis. The clay structure was not apparently affected by the treatment and the impregnated organic matter was quantitatively removed. We have investigated the comparative sorption of safranine and methylene blue on this material, the spent bleaching earth (SBE) and the virgin bleaching earth (VBE). The kinetic results fit the pseudo second order kinetic model and the Weber & Morris, intra-particle diffusion model. The pH had no effect on the sorption efficiency. The sorption isotherms followed the Langmuir model for various sorbent concentrations with good values of determination coefficient. A linear relationship was found between the calculated maximum removal capacity and the solid/solution ratio. A comparison between the results obtained with this material and those of the literature highlighted the low cost and the good removal capacity of the treated spent bleaching earth.

Keywords: basic dyes, isotherms, sorption, spent bleaching earth

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Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

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Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

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Authors: Mojeed A. Oladele

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The original zoning system in Louisville promoted social segregation among groups and remained a tool for social exclusion that strengthened preexisting inequalities. The current residential zoning system in Louisville is predominantly single-family residential housing. Of the 75% of total land allocated for residential purposes, 55% comprises single-family housing, constituting one form of development and ruminant problems of social segregation within the city. The zoning reform initiative birthed the spatial improvement and development of additional middle housing as a more generic and inclusive housing form. The paper investigates the basis of zoning reform relative to the interconnectedness amongst the discursive objects of analysis and the extensiveness as a strategic tool of structural adjustment. Qualitative methodological assessment generated by collective planning professionals reflects the effectiveness of the new zoning design in strengthening the socio-spatial interactions within the city. The zoning reform is currently at the early stage of implementation and requires more professional/public inputs and constant iterative processes for a more promising urban planning outcome.

Keywords: zoning reform, viability, urban inequality, housing affordability, Louisville

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Authors: Ubaka Chukwuemeka Michael, Ukwe Chinwe Victoria

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Background: The use of antipsychotic monotherapy remains the standard for schizophrenic disorders so also a prescription switch from older typical to newer atypical classes of antipsychotics on the basis of better efficacy and tolerability. However, surveys on the quality of antipsychotic drug use and substitution in developing countries are very scarce. This study was intended to evaluate quality and factors that drive the prescription and substitution of antipsychotic drugs among schizophrenic patients visiting a regional psychiatric hospital. Methods: Case files of patients visiting a federal government funded Neuropsychiatric Hospital between July 2012 and July 2014 were systematically retrieved. Patient demographic characteristics, clinical details and drug management data were collected and subjected to descriptive and inferential data analysis to determine quality and predictors of utilization. Results: Of the 600 case files used, there were more male patients (55.3%) with an overall mean age of 33.7±14.4 years. Typical antipsychotic agents accounted for over 85% of prescriptions, with majority of the patients receiving more than 2 drugs in at least a visit (80.9%). Fluphenazine (25.2%) and Haloperidol (18.8%) were mostly given as antipsychotics for treatment initiation while Olazenpine (23.0%) and Benzhexol (18.3%) were the most currently prescribed antipsychotics. Nearly half (42%, 252/600) of these patients were switched from one class to another, with 34.5% (207/600) of them switched from typical to atypical drug classes. No demographic or clinical factors influenced drug substitutions but a younger age and being married influenced being prescribed a polypharmacy regimen (more than 2 drugs) and an injectable antipsychotic agent. Conclusion: The prevalence of antipsychotic polypharmacy and use of typical agents among these patients was high. However, only age and marital status affected the quality of antipsychotic prescriptions among these patients.

Keywords: antipsychotics, drug substitution, pharmacoepidemiology, polypharmacy

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Authors: Ririt Aprilin Sumarsono

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Composite member (concrete and steel) has been widely advanced for structural utilization due to its best performance in resisting load, reducing the total weight of the structure, increasing stiffness, and other available advantages. On the other hand, the environment load such as corrosion (e.g. chloride ingress) creates significant time-dependent degradation for steel. Analysis performed in this paper is mainly considered uniform corrosion for evaluating the composite beam without examining the pit corrosion as the initial corrosion formed. Corrosion level in terms of weight loss is modified in yield stress and modulus elasticity of steel. Those two mechanical properties are utilized in this paper for observing the stresses due to corrosion attacked. As corrosion level increases, the effective width of the composite beam in the concrete section will be wider. The position of a neutral axis of composite section will indicate the composite action due to corrosion of composite beam so that numerous shear connectors provided must be reconsidered. Flexure capacity quantification provides stresses, and shear capacity calculation derives connectors needed in overcoming the shear problem for composite beam under corrosion. A model of simply supported composite beam examined in this paper under uniform corrosion where the stresses as the focus of the evaluation. Principal stress at the first stage of composite construction decline as the corrosion level incline, parallel for the second stage stress analysis where the tension region held by the steel undergoes lower capacity due to corrosion. Total stresses of the composite section for steel to be born significantly decreases particularly in the outermost fiber of tension side. Whereas, the available compression side is smaller as the corrosion level increases so that the stress occurs on the compression side shows reduction as well. As a conclusion, the increment of corrosion level will degrade both compression and tension side of stresses.

Keywords: composite beam, modulus of elasticity, stress analysis, yield strength, uniform corrosion

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Authors: A. Dinelka Panagoda, Bathiya Bandara, Chamod Wijetunga, Chathura Malinda, Lakmal Rupasinghe, Chethana Liyanapathirana

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This research takes us forward with the concepts of Federated Learning and Software-Defined Networking (SDN) to introduce an efficient malware detection technique and provide a mitigation mechanism to give birth to a resilient and automated healthcare sector network system by also adding the feature of extended privacy preservation. Due to the daily transformation of new malware attacks on hospital Integrated Clinical Environment (ICEs), the healthcare industry is at an undefinable peak of never knowing its continuity direction. The state of blindness by the array of indispensable opportunities that new medical device inventions and their connected coordination offer daily, a factor that should be focused driven is not yet entirely understood by most healthcare operators and patients. This solution has the involvement of four clients in the form of hospital networks to build up the federated learning experimentation architectural structure with different geographical participation to reach the most reasonable accuracy rate with privacy preservation. While the logistic regression with cross-entropy conveys the detection, SDN comes in handy in the second half of the research to stack up the initial development phases of the system with malware mitigation based on policy implementation. The overall evaluation sums up with a system that proves the accuracy with the added privacy. It is no longer needed to continue with traditional centralized systems that offer almost everything but not privacy.

Keywords: software-defined network, federated learning, privacy, integrated clinical environment, decentralized learning, malware detection, malware mitigation

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Authors: Md. Soebur Rahman, Mahbuba Begum, Raquib Ahsan

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Composite column is a structural member that uses a combination of structural steel shapes, pipes or tubes with or without reinforcing steel bars and reinforced concrete to provide adequate load carrying capacity to sustain either axial compressive loads alone or a combination of axial loads and bending moments. Composite construction takes the advantages of the speed of construction, light weight and strength of steel, and the higher mass, stiffness, damping properties and economy of reinforced concrete. The most usual types of composite columns are the concrete filled steel tubes and the partially or fully encased steel profiles. Fully encased composite column (FEC) provides compressive strength, stability, stiffness, improved fire proofing and better corrosion protection. This paper reports experimental and numerical investigations of the behaviour of concrete encased steel composite columns subjected to short-term axial load. In this study, eleven short FEC columns with square shaped cross section were constructed and tested to examine the load-deflection behavior. The main variables in the test were considered as concrete compressive strength, cross sectional size and percentage of structural steel. A nonlinear 3-D finite element (FE) model has been developed to analyse the inelastic behaviour of steel, concrete, and longitudinal reinforcement as well as the effect of concrete confinement of the FEC columns. FE models have been validated against the current experimental study conduct in the laboratory and published experimental results under concentric load. It has been observed that FE model is able to predict the experimental behaviour of FEC columns under concentric gravity loads with good accuracy. Good agreement has been achieved between the complete experimental and the numerical load-deflection behaviour in this study. The capacities of each constituent of FEC columns such as structural steel, concrete and rebar's were also determined from the numerical study. Concrete is observed to provide around 57% of the total axial capacity of the column whereas the steel I-sections contributes to the rest of the capacity as well as ductility of the overall system. The nonlinear FE model developed in this study is also used to explore the effect of concrete strength and percentage of structural steel on the behaviour of FEC columns under concentric loads. The axial capacity of FEC columns has been found to increase significantly by increasing the strength of concrete.

Keywords: composite, columns, experimental, finite element, fully encased, strength

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Authors: Abdelkarim Mahdhi, Fdhila Kais, Faouzi Lamari, Zeineb Hmila, Fathi Kamoun, Maria Ángeles Esteban, Amina Bakhrouf

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Pathogenic bacteria are considered to be responsible for several infectious diseases in aquaculture. To overcome diseases in fish culture, the use of antimicrobial drugs as strategy, have been adopted. The use of probiotic was a promising approach to avoid the risk associated to pathogenic bacteria. To find a biological control treatment against pathogens, we undertook this investigation to study the maintain of the probiotic properties of Bacillus sp., such as viability, adhesive ability to abiotic surface, antibacterial activity and pathogenicity/toxicity, under marine starvation conditions. Our data revealed that the tested strains maintained their capacity to inhibit pathogens in vivo and in vitro conditions. These strains maintain their adhesive capacity to polystyrene and do not demonstrate the pathogenic or toxic effect to the host. The obtained results give insight about the effect of starvation conditions on the physiological responses of these Bacillus strains that can be considered as a potential candidate’s probiotic.

Keywords: bacillus, probiotic, cell viability, starvation conditions

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Authors: Eun-Young Kwon, Myung-Sook Choi, Su-Jung Cho, Ji-Young Choi, So Young Kim, Youngji Han

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Overweight and obesity have been linked to a low-grade chronic inflammatory response and an increased risk of developing metabolic syndrome including insulin resistance, type 2 diabetes mellitus and certain types of cancers. Luteolin is a dietary flavonoid with anti-inflammatory, anti-oxidant, anti-cancer and anti-diabetic properties. However, little is known about the detailed mechanism associated with the effect of luteolin on inflammation-related obesity and its complications. The aim of the present study was to reveal the anti-diabetic effect of luteolin in diet-induced obesity mice using “transcriptomics” tool. Thirty-nine male C57BL/6J mice (4-week-old) were randomly divided into 3 groups and were fed normal diet, high-fat diet (HFD, 20% fat) and HFD+0.005% (w/w) luteolin for 16 weeks. Luteolin improved insulin resistance, as measured by HOMA-IR and glucose tolerance, along with preservation action of pancreatic β-cells, compared to the HFD group. Luteoiln was significantly decreased the levels of leptin and ghrelin that play a pivotal role in energy balance, and the macrophage low-grade inflammation marker sCD163 (soluble Cd antigen 163) in plasma. Activities of hepatic anti-oxidant enzymes (catalase and glutathione peroxidase) were increased, while the levels of plasma transaminase (GOT and GPT) and oxidative damage markers (hepatic mitochondria H2O2 and TBARS) were markedly decreased by luteolin supplementation. In addition, luteolin increased oxidative capacity and fatty acid utilization by presenting decrease in enzyme activities of citrate synthase, cytochrome C oxidase and β-hydroxyacyl CoA dehydrogenase and UCP3 gene expression compared to high-fat diet. Moreover, our microarray results of muscle also revealed down-regulated gene expressions associated with TCA cycle by HFD were reversed to normal level by luteolin treatment. Taken together, our results indicate that luteolin is one of bioactive components for improving insulin resistance by increasing oxidative capacity, modulating anti-oxidant metabolism and suppressing inflammatory signaling cascades in diet-induced obese mice. These results provide possible therapeutic targets for prevention and treatment of diet-induced obesity and its complications.

Keywords: anti-oxidant metabolism, diabetes, luteolin, oxidative capacity

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Authors: Asmaa Benbaba

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A series of action plans motivated this work within the city of mobile as the big category and the Peninsula more particularly. Most of the projects sought to educate about the historical and environmental assets of the place, to improve aesthetics, to preserve the natural resources on the Bayou, spread awareness, and reach out to the community. This study was conducted to preserve significant heritage landscapes, and significant historic buildings in the neighborhood of the Peninsula of Mobile at the state of Alabama, while simultaneously strengthen the cultural and historical resources. The purpose of this planning action was to provide planning regulations for the suburban areas of Mobile in Alabama. The plan attempted to overlap three main layers: community, environment, and history. The method that was used to collect data and conduct research was mainly qualitative. The Geographic Information System (GIS) was the tool used to represent this complexity. Results from this study revealed several interventions made to 'neighborhood marina.' The interventions were strategic scenarios to preserve the water landscape, create affordable leisure, connect the Dauphin Island Parkway to the water, preserve all the environmental layers, and add value to the neighborhoods of the Peninsula.

Keywords: community outreach, education, historic preservation, peninsula

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Authors: Diyono Harun

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Indonesia aims to reduce carbon emissions from energy generation by reaching 23% and 31% of the national energy supply from renewable energy sources (RES) in 2025 and 2030. The potential for RES in Indonesia is enormous, but not all province has the same potential for RES. Yogyakarta, one of the most travel-destinated provinces in Indonesia, has less potential than its neighbour, Central Java. Consequently, Yogyakarta must meet its electricity demand by importing electricity from Central Java if this province only wants to use electricity from RES. Thus, achieving the objective is balancing the electricity supply between an importer (Yogyakarta) and an exporter province (Central Java). This research aims to explore the RES potential and the current capacity of RES for electricity generation in both provinces. The results show that the present capacity of RES meets the annual domestic electricity demand in both provinces only with an extension of the RES potential. The renewable energy mixes in this research also can lower CO2 emissions compared to gas-fired power plants. This research eventually provides insights into exploring and using the domestic RES potentials between two areas with different RES capacities.

Keywords: energy mix, renewable energy sources, domestic electricity, electricity generation

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Authors: Ismail Akkaya, Mucip Tapan, Ali Ozvan

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Some of the industrially prefabricated buildings located on clayey soils were damaged due to soil conditions. The reasons of these damages are generally due to different settlement capacity, the different plasticity of soils and the level of ground water. The aim of this study is to determine the source of these building damages by conducting in situ tests. Therefore, pressuremeter test, which is one of the borehole loading test conducted to determine the properties of soils under the foundations and Standart Penetration Test (SPT). The results of these two field tests were then used to accurately obtain the consistency and firmness of soils. Pressuremeter Deformation Module (EM) and Net Limiting Pressure (PL) of soils were calculated after the pressuremeter tests. These values were then compared with the SPT (N30) and SPT (N60) results. An empirical equation was developed to obtain EM and PL values of such soils from SPT test results. These values were then used to calculate soil bearing capacity as well as the soil settlement. Finally, the relationship between the foundation settlement and the damage of these buildings were checked. It was found that calculated settlement values were almost the same as measured settlement values.

Keywords: damaged building, pressuremeter, standard penetration test, low and high plasticity clay

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Authors: Angeliki Vassila, Dimitrios Kalogeropoulos, Rania Rawashdeh, Nigel Hall, Najiha Rahman, Mark Fabian, Suresh Thulasidharan, Hossain Parwez

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Introduction: Necrotising scleritis is a severe form of scleritis and poses a significant threat to vision. It can manifest in various systemic autoimmune disorders, systemic vasculitis, or as a consequence of microbial infections. The objective of this study is to present a case of necrotizing scleritis associated with scleroderma, which was further complicated by a secondary Staphylococcus epidermidis infection. Methods: This is a retrospective analysis that examines the medical records of a patient who was hospitalised in the Eye Unit at University Hospital Southampton. Results: A 78-year-old woman presented at the eye casualty department of our unit with a two-week history of progressively worsening pain in her left eye. She received a diagnosis of necrotising scleritis and was admitted to the hospital for further treatment. It was decided to commence a three-day course of intravenous methylprednisolone followed by a tapering regimen of oral steroids. Additionally, a conjunctival swab was taken, and two days later, it revealed the presence of S. epidermidis, indicating a potential secondary infection. Given this finding, she was also prescribed topical (Ofloxacin 0.3% - four times daily) and oral (Ciprofloxacin 750mg – twice daily) antibiotics. The inflammation and symptoms gradually improved, leading to the patient being scheduled for a scleral graft and applying an amniotic membrane to cover the area of scleral thinning. Conclusions: Rheumatoid arthritis and granulomatosis with polyangiitis are the most commonly identifiable systemic diseases associated with necrotising scleritis. Although association with scleroderma is extremely rare, early identification and treatment are necessary to prevent scleritis-related complications.

Keywords: scleritis, necrotizing scleritis, scleroderma, autoimmune disease

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Authors: Pranee Suecharoen, Jaturat Kanpittaya

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Background: The incidence of adverse reactions to iodinated contrast media has risen. The dearth of reports on reactions to the administration of iso- and low-osmolar contrast media should be addressed. We, therefore, studied the profile of adverse reactions to iodinated contrast media; viz., (a) the body systems affected (b) causality, (c) severity, and (d) preventability. Objective: To study adverse reactions (causes and severity) to iodinated contrast media at Srinagarind Hospital. Method: Between March and July, 2015, 1,101 patients from the Department of Radiology were observed and interviewed for the occurrence of adverse reactions. The patients were classified per Naranjo’s algorithm and through use of an adverse reactions questionnaire. Results: A total of 105 cases (9.5%) reported adverse reactions (57% male; 43% female); among whom 2% were iso-osmolar vs. 98% low-osmolar. Diagnoses included hepatoma and cholangiocarcinoma (24.8%), colorectal cancer (9.5%), breast cancer (5.7%), cervical cancer (3.8%), lung cancer (2.9%), bone cancer (1.9%), and others (51.5%). Underlying diseases included hypertension and diabetes mellitus type 2. Mild, moderate, and severe adverse reactions accounted for 92, 5 and 3%, respectively. The respective groups of escalating symptoms included (a) mild urticaria, itching, rash, nausea, vomiting, dizziness, and headache; (b) moderate hypertension, hypotension, dyspnea, tachycardia and bronchospasm; and (c) severe laryngeal edema, profound hypotension, and convulsions. All reactions could be anticipated per Naranjo’s algorithm. Conclusion: Mild to moderate adverse reactions to low-osmolar contrast media were most common and these occurred immediately after administration. For patient safety and better outcomes, improving the identification of patients likely to have an adverse reaction is essential.

Keywords: adverse reactions, contrast media, computed tomography, iodinated contrast agents

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Authors: Ghulam Mustafa Halepota, Zaib Dahar

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Background: Low acceptance of FP services, particularly in hard to reach areas where geographic, economic, or social barriers limit-service uptake. Moreover, limited resources appeared to be a reflection of dismal contraceptive use in Pakistan. People’s Primary Health Care Initiative (PPHI) is a Public Private Partnership Program of Government of Sindh which aims to improve maternal child health through accessible family planning services in far flung areas. In 2015 PPHI launched special family planning camps to have achieved a rapid improvement in CPR. On quarterly basis, these camps focus on Long Acting Reversible Contraceptives (LARC). These camps are arranged at 250 BHU Plus (24/7 MCHCs). The Organization manages 1140 primary health care facilities all over Sindh province and focuses on maternal, newborn and child health which includes antenatal care, labor/delivery, postnatal care, family planning, immunization, nutrition, BEmONC, CEmONC, diagnostic laboratories, ambulance services. Under the FPRH program, the organization launched special family planning camps in far flung areas to achieve a rapid improvement in CPR-committed to FP 2020 goal. Objective: To assess the performance of special FP camps for the improvement of long acting reversible contraceptive in hard to reach areas. Methodology: Outreach camps are organized on quarterly basis in 250 BHUs and maternal and child health centers (available-24/7). Using observational study design, the study reports 2 years data of special FP camps conducted in 23 various districts of Sindh during April 2015-April 2017. These special camps served a range of modern contraceptive methods including IUCDs, implants, condoms, pills, and injections. Moreover, 125 male medical officers are trained across Sindh in LARC and 554 female have been trained in implants and IUCD insertions. MSI Impact calculator was used to determine health and demographic impact of services. Results: This intervention has brought exceptional results, and the response has been overwhelming in time. Total 2048 special camps during 2015 till April 2017 have been carried out. 231796 MWRAs visited camps 91% opted modern FP, of which 45% opted Implants, 6% selected IUCDs from LARC (long term reversible contraceptive) from short term, 17% opted injectable 18% choose pills, and 12% used condoms. This intervention created a high contraceptive impact in rural Sindh an estimated 125048 FP users have been created, of this 111846 LARC users and 13498 are SARC users, through this intervention an estimated 55774 unintended pregnancies, 36299 live births, 9394, 80 maternal deaths, 926 and 6077 unsafe abortion have been averted. Moreover, the intervention created an economic impact and saved 2,409,563 direct health expenditure on each woman with reproductive age. Conclusion: Special FP Camps along with routine services is an effective and acceptable model for increase in provision of long-acting and permanent methods in hard to reach areas. This innovative approach by PHHI-Sindh has also been adopted in other provinces of Pakistan.

Keywords: inequalities, special camps, family planning services, hard to reach areas

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Authors: Marie-Helena Docherty, Sion Edryd Williams

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The prevalence of diabetes mellitus is increasing worldwide. In Sub-Saharan Africa, type 2 diabetes represents over 90% of all types of diabetes with the number of diabetic patients expected to rise. This represents a huge economic burden in an area already contending with high rates of other significant diseases, including the highest worldwide prevalence of HIV. Diabetic complications considerably impact on morbidity and mortality. The epidemiological data for the region quotes high rates of retinopathy (7-63%), neuropathy (27-66%) and microalbuminuria (10-83%). It is therefore imperative that diabetic screening programmes are established. It is recognised that in many parts of the developing world the implementation and management of such programmes is limited by a lack of available resources. The International Diabetes Federation produced guidelines in 2012 taking these limitations into account suggesting that all diabetic patients should have access to basic screening. These guidelines are consistent with the national diabetic guidelines produced by the Lesotho Medical Council. However, diabetic care in Lesotho is delivered at the local level, with variable levels of quality. A cross sectional study was performed in the outpatient department of Maluti Hospital in Mapoteng, Lesotho, a busy rural hospital in the Berea district. Demographic data on gender, age and modality of treatment were collected over a six-week time period. Information regarding 3 basic screening parameters was obtained. These parameters included eye screening (defined as a documented ophthalmology review within the last 12 months), foot screening (defined as a documented foot health assessment by any health care professional within the last 12 months) and secondary prevention (defined as a documented blood pressure and lipid profile reading within the last 12 months). These parameters were selected on the basis of the absolute minimum level of resources in Maluti Hospital. Renal screening was excluded, as the hospital does not have access to reliable renal profile checks or urinalysis. There is however a fully functioning on-site ophthalmology department run by a senior ophthalmologist with the ability to provide retinal photography, retinal surgery and photocoagulation therapy. Data was collected on 183 type 2 diabetics. 112 patients were male and 71 were female. The average age was 43 years. 4 patients were diet controlled, 140 patients were on oral hypoglycaemic agents (metformin and/or glibenclamide), and 39 patients were on a combination of insulin and oral hypoglycaemics. In the preceding 12 months, 5 patients had undergone eye screening (3%), 24 patients had undergone foot screening (13%), and 31 patients had lipid profile testing (17%). All patients had a documented blood pressure reading (100%). Our results show that screening is poorly performed in the basic indicators suggested by the IDF and the Lesotho Medical Council. On the basis of these results, a screening programme was developed using the mnemonic SaFE; secondary prevention, foot and eye care. This is simple, memorable and transferable between healthcare professionals. In the future, the expectation would be to expand upon this current programme to include renal screening, and to further develop screening pertaining to secondary prevention.

Keywords: Africa, complications, rural, screening

Procedia PDF Downloads 286

Authors: Vimal Jasoliya, Purnank Bhatt, Mit Shah

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The Injection Moulding is one of the principle methods of conversions of plastics into various end products using a very wide range of plastics materials from commodity plastics to specialty engineering plastics. Injection Moulding Machines are rated as per the tonnage force applied. The work present includes Design & Finite Element Analysis of a structure component of injection moulding machine i.e. clamp cylinder. The work of the project is to upgrade the 1300T clamp cylinder to 1500T clamp cylinder for injection moulding machine. The design of existing clamp cylinder of 1300T is checked. Finite Element analysis is carried out for 1300T clamp cylinder in ANSYS Workbench, and the stress values are compared with acceptance criteria and theoretical calculation. The relation between the clamp cylinder diameter and the tonnage capacity has been derived and verified for 1300T clamp cylinder. The same correlation is used to find out the thickness for 1500T clamp cylinder. The detailed design of 1500T cylinder is carried out based on calculated thickness.

Keywords: clamp cylinder, fatigue analysis, finite element analysis, injection moulding machines

Procedia PDF Downloads 335

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 subject

Keywords: Ulinastatin, VAS – visual analogue score , AKI – acute kidney injury , ARDS – acute respiratory distress syndrome

Procedia PDF Downloads 122

Authors: Milad Nooshadi, Alessandro Manzardo

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CO₂ emissions in the atmosphere continue to rise, mostly as a result of the combustion of fossil fuels. CO₂ injection into the oceans and geological formation as a process of physical carbon capture are two of the most promising emerging strategies for mitigating climate change and global warming. The purpose of this research is to evaluate the two mentioned methods of CO₂ sequestration and to assess information on previous and current advancements, limitations, and uncertainties associated with carbon sequestration in order to identify possible prospects for ensuring the timely implementation of the technology, such as determining how governments and companies can gain a better understanding of CO₂ storage in terms of which media have the most applicable capacity, which type of injection has the fewer environmental impact, and how much carbon sequestration and storage will cost. The behavior of several forms is characterized as a near field, a far field, and a see-floor in ocean storage, and three medias in geological formations as an oil and gas reservoir, a saline aquifer, and a coal bed. To determine the capacity of various forms of media, an analysis of some models and practical experiments are necessary. Additionally, as a major component of sequestration, the various injection methods into diverse media and their monitoring are associated with a variety of environmental impacts and financial consequences.

Keywords: carbon sequestration, ocean storage, geologic storage, carbon transportation

Procedia PDF Downloads 102

Authors: Chisom N. Nwaigwe, Blessing N. Egbulefu, Angela Uwakwem

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A study on Stress and its’ effect on the health of workers in Federal Medical Centres in Nigeria is presented. The aim is to evaluate how much stress related hazards health workers in our tertiary health institutions are exposed to and to create awareness and reduce the rate at which stress affect the health of the working population in Nigeria, using workers in Federal Medical Centre, Umuahia as a case study. The descriptive survey design was adopted with the aid of 100 questionnaires delivered to the respondents in order to obtain first-hand information. From the findings, the major causes of stress were identified as inadequate staffing, unresolved family problems and psychological/cultural factors like the return of a lactating mother to work after three months post-delivery. The effects of stress on the workers were identified as hypertension, poor job performances, depression, asthma, and peptic ulcers. The study recommended instituting counseling units for stress management, holding seminars on stress management and increasing the salary scale (remuneration) and proper roster planning as solutions to stress reduction in our hospitals. This study is important to management in planning staffing, roaster, and a rehabilitation programme for her staff.

Keywords: stress, causes, effects, workers

Procedia PDF Downloads 475

Authors: N. Bekenova, A. Aitkaliyev, B. Kassiyeva, T. Vochshenkova

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Cardiac autonomic neuropathy is not always detected in diabetes, and its phenotypic manifestations may not be evident. Therefore, the study of genetic markers predisposing to the disease is gaining increasing relevance. Research Objective: The goal is to investigate the association of polymorphisms in the APOE and FTO genes with cardiac autonomic neuropathy among individuals of Kazakh nationality. Materials and Methods: A case-control study included 147 patients with cardiac autonomic neuropathy (cases) and 153 patients without cardiac autonomic neuropathy (controls). 300 individuals of Kazakh nationality were recruited from a hospital affiliated with the RSE ‘Medical Centre Hospital of the President's Affairs Administration of the Republic of Kazakhstan.’ Patients were genotyped for 5 FTO gene polymorphisms (rs17817449, rs1121980, rs11075995, rs9939609, rs12149832) and 2 APOE gene polymorphisms (rs429358, rs7412) using real-time PCR. Statistical analysis involved Chi-square methods and calculation of odds ratios (OR) with 95% confidence intervals (CI) and was performed using the Gen Expert genetic calculator. Results. Our research revealed an association between cardiac autonomic neuropathy and rs12149832 (FTO) and rs429358 (APOE). The AA genotype of the rs12149832 polymorphism was found to double the risk of neuropathy development, while the GA genotype decreased the risk of autonomic neuropathy (2.21 (1.38-3.52) and 0.61 (0.38-0.96), respectively, p=0.003). Additionally, we identified that the TC genotype of rs429358 predisposes individuals to the development of cardiac autonomic neuropathy, while the CC genotype decreases the risk (2.23 (1.18-4.22) and 0.26 (0.03-2.31), respectively). Conclusion. Thus, polymorphisms in the APOE and FTO genes (rs429358 and rs12149832) are associated with a predisposition to cardiac autonomic neuropathy and may play a significant role in the pathogenesis of the disease. Further research with a larger sample size and an assessment of their impact on the phenotype is necessary.

Keywords: polymorphisms, APOE gene, FTO gene, automatic neuropathy, Kazakh population.

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Authors: Tabrej Khan, Tamer A. Sebaey, Balbir Singh, M. A. Umarfarooq

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Spread-tow thin-ply-based technology has resulted in the progress of optimized reinforced composite plies with ultra-low thicknesses. There is wide use of composite bolted joints in the aircraft industry for load-bearing structures, and they are regarded as the primary source of stress concentration. The purpose of this study is to look into the bearing strength and structural performance of single shear bolt joint configurations in composite laminates, which are basically a combination of conventional thin-plies and thick-plies in some specific stacking sequence. The placement effect of thin-ply within the configured stack on bearing strength, as well as the potential damages, were investigated. Mechanical tests were used to understand the disfigurement mechanisms of the plies and their reciprocity, as well as to reflect on the single shear bolt joint properties and its load-bearing capacity. The results showed that changing the configuration of laminates by inserting the thin plies inside improved the bearing strength by up to 19%.

Keywords: hybrid composites, delamination, stress concentrations, mechanical testing, single bolt joint, thin-plies

Procedia PDF Downloads 64

Authors: Jun Ha Whang

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As New York City weathers a swelling 'affordability crisis' marked by rapid transformation in land development and urban culture, much of the associated scholarly debate has turned to questions of the underlying mechanisms of gentrification. Though classically approached from the point of view of urban planning, increasingly these questions have been addressed with an eye to understanding the role of cultural capital in neighborhood valuation. This paper will examine the construction of an artist-specific affordable housing development in the Spanish Harlem neighborhood of Manhattan in order to identify and discuss several cultural parameters of gentrification. This study’s goal is not to argue that the development in question, named Art space PS 109, straightforwardly increases or decreases the rate of gentrification in Spanish Harlem, but rather to study dynamics present in the construction of Art space PS 109 as a case study considered against the broader landscape of gentrification in New York, particularly with respect to the impact of artist communities on housing supply. In the end, what Art space PS 109 most valuably offers us is a reference point for a comparative analysis of affordable housing strategies currently being pursued within municipal government. Our study of Art space PS 109 has allowed us to examine a microcosm of the city’s response and evaluate its overall strategy accordingly. As a base line, the city must aggressively pursue an affordability strategy specifically suited to the needs of each of its neighborhoods. It must also conduct this in such a way so as not to undermine its own efforts by rendering them susceptible to the exploitative involvement of real estate developers seeking to identify successive waves of trendy neighborhoods. Though Art space PS 109 offers an invaluable resource for the city’s legitimate aim of preserving its artist communities, with such a high inclusion rate of artists from outside of the community the project risks additional displacement, strongly suggesting the need for further study of the implications of sites of cultural capital for neighborhood planning.

Keywords: artist housing, displacement, east Harlem, urban planning

Procedia PDF Downloads 163

Authors: Dubravka Štajner, Boris M. Popović, Saša Orlović, Ružica Ždero, Milan Popović, Aleksandra Popović

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Many plants possess antioxidant ingredients that provides efficacy by additive or synergistic activities. Present article highlights an antioxidant capacity of Serbian conifer plants. Antioxidant activities of the crude extracts were assessed using different assays. In this study, quantities of phenolic compounds (total phenols, flavonoids, tannins and proanthocyanidins), contents of photosynthetic pigments (chlorophyll a and b and carotenoids), soluble proteins and proline were examined. MDA quantities and ability of extracts to remove reactive nitrogen and oxygen species (RNOS) were also investigated. Furthermore, antioxidant activities of extracts against DPPH∙, ferric reducing antioxidant power, permanganate reducing antioxidant capacity were also determined. According to almost all used assays, antioxidant and scavenging capacities of silver fir (Abies alba Mill.), and Douglas fir (Pseudotsuga menziesii) were superior compared to spruce. Presented results implicated that leaves of Douglas fir and silver fir possessed outstanding antioxidant characteristics that could diminish damage caused by oxygen radicals which are responsible for many of the bodily changes and susceptibility to different diseases.

Keywords: conifers, antioxidant activity, reducing power, lipid peroxidation

Procedia PDF Downloads 348

Authors: Moataz Ammar, Ahdab Elmorshedy

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The distributed generation hosting capacity of a distribution network is typically limited at a given connection point by the upper voltage limit that can be violated due to the injection of active power into the distribution network. The upper voltage limit violation concern becomes more important as the network equivalent resistance increases with respect to its equivalent reactance. This paper investigates the impact of modifying the distribution network equivalent reactance at the point of connection such that the upper voltage limit is violated at a higher distributed generation penetration, than it would without the addition of series reactive compensation. The results show that series reactive compensation proves efficient in certain situations (based on the ratio of equivalent network reactance to equivalent network resistance at the point of connection). As opposed to the conventional case of capacitive compensation of a distribution network to reduce voltage drop, inductive compensation is seen to be more appropriate for alleviation of distributed-generation-induced voltage rise.

Keywords: distributed generation, distribution networks, series compensation, voltage rise

Procedia PDF Downloads 395