Search results for: innovative teaching and learning methods
846 Transducers for Measuring Displacements of Rotating Blades in Turbomachines
Authors: Pavel Prochazka
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The study deals with transducers for measuring vibration displacements of rotating blade tips in turbomachines. In order to prevent major accidents with extensive economic consequences, it shows an urgent need for every low-pressure steam turbine stage being equipped with modern non-contact measuring system providing information on blade loading, damage and residual lifetime under operation. The requirement of measuring vibration and static characteristics of steam turbine blades, therefore, calls for the development and operational verification of both new types of sensors and measuring principles and methods. The task is really demanding: to measure displacements of blade tips with a resolution of the order of 10 μm by speeds up to 750 m/s, humidity 100% and temperatures up to 200 °C. While in gas turbines are used primarily capacitive and optical transducers, these transducers cannot be used in steam turbines. The reason is moisture vapor, droplets of condensing water and dirt, which disable the function of sensors. Therefore, the most feasible approach was to focus on research of electromagnetic sensors featuring promising characteristics for given blade materials in a steam environment. Following types of sensors have been developed and both experimentally and theoretically studied in the Institute of Thermodynamics, Academy of Sciences of the Czech Republic: eddy-current, Hall effect, inductive and magnetoresistive. Eddy-current transducers demand a small distance of 1 to 2 mm and change properties in the harsh environment of steam turbines. Hall effect sensors have relatively low sensitivity, high values of offset, drift, and especially noise. Induction sensors do not require any supply current and have a simple construction. The magnitude of the sensors output voltage is dependent on the velocity of the measured body and concurrently on the varying magnetic induction, and they cannot be used statically. Magnetoresistive sensors are formed by magnetoresistors arranged into a Wheatstone bridge. Supplying the sensor from a current source provides better linearity. The MR sensors can be used permanently for temperatures up to 200 °C at lower values of the supply current of about 1 mA. The frequency range of 0 to 300 kHz is by an order higher comparing to the Hall effect and induction sensors. The frequency band starts at zero frequency, which is very important because the sensors can be calibrated statically. The MR sensors feature high sensitivity and low noise. The symmetry of the bridge arrangement leads to a high common mode rejection ratio and suppressing disturbances, which is important, especially in industrial applications. The MR sensors feature high sensitivity, high common mode rejection ratio, and low noise, which is important, especially in industrial applications. Magnetoresistive transducers provide a range of excellent properties indicating their priority for displacement measurements of rotating blades in turbomachines.Keywords: turbines, blade vibration, blade tip timing, non-contact sensors, magnetoresistive sensors
Procedia PDF Downloads 129845 Ventilator Associated Pneumonia in a Medical Intensive Care Unit, Incidence and Risk Factors: A Case Control Study
Authors: Ammar Asma, Bouafia Nabiha, Ben Cheikh Asma, Ezzi Olfa, Mahjoub Mohamed, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour
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Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia
Procedia PDF Downloads 395844 Negative Changes in Sexual Behavior of Pregnant Women
Authors: Glauberto S. Quirino, Emanuelly V. Pereira, Amana S. Figueiredo, Antonia T. F. Santos, Paulo R. A. Firmino, Denise F. F. Barbosa, Caroline B. Q. Aquino, Eveliny S. Martins, Cinthia G. P. Calou, Ana K. B. Pinheiro
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Introduction: During pregnancy there are adjustments in the physical, emotional, existential and sexual areas, which may contribute to changes in sexual behavior. The objective was to analyze the sexual behavior of pregnant women. Methods: Quantitative, exploratory-descriptive study, approved by the Ethics and Research Committee of the Regional University of Cariri. For data collection, it was used the Sexuality Questionnaire in Gestation and Sexual Quotient - Female Version. It was carried out in public institutions in the urban and rural areas of three municipalities of the Metropolitan Region of Cariri, south of Ceará, Brazil from February to September 2016. The sampling was proportional stratified by convenience. A total of 815 pregnant women who were literate and aged 20 years or over were broached. 461 pregnant women were excluded because of high risk, adolescence, saturation of the extract, incomplete filling of the instrument, mental and physical handicap, without sexual partner, and the sample was 354 pregnant. The data were grouped, organized and analyzed in the statistical program R Studio (version 386 3.2.4). Descriptive frequency statistics and non-parametric tests were used to analyze the variables, and the results were shown in graphs and tables. Results: The women presented a minimum age of 20, maximum 35 and average of 26.9 years, predominantly urban area residents, with a monthly income of up to one minimum wage (US$ 275,00), high school, catholic, with fixed partner, heterosexuals, multiparous, multiple sexual partners throughout life and with the beginning of sexual life in adolescence (median age 17 years). There was a reduction in sexual practices (67%) and when they were performed, they were more frequent in the first trimester (79.7%) and less frequent in the third trimester (30.5%). Preliminary sexual practices did not change and were more frequent in the second trimester (46.6%). Throughout the gestational trimesters, the partner was referred as the main responsible for the sexual initiative. The women performed vaginal sex (97.7%) and provided greater pleasure (42.8%) compared to non-penetrative sex (53.9%) (oral sex and masturbation). There was also a reduction in the sexual disposition of pregnant women (90.7%) and partner (72.9%), mainly in the first trimester (78.8%), and sexual positions. Sexual performance ranged from regular to good (49.7%). Level of schooling, marital status, sexual orientation of the pregnant woman and the partner, sexual practices and positions, preliminaries, frequency of sexual practices and importance attributed to them were variables that influenced negatively sexual performance and satisfaction. It is concluded that pregnancy negatively changes the sexual behavior of the women and it is suggested to further investigations and approach of the partner, in order to clarify the influence of these variables on the sexual function and subsidize intervention strategies, with a view to the integrality of sexual and reproductive health.Keywords: obstetric nursing, pregnant women, sexual behavior, women's health
Procedia PDF Downloads 319843 Life Cycle Assessment Applied to Supermarket Refrigeration System: Effects of Location and Choice of Architecture
Authors: Yasmine Salehy, Yann Leroy, Francois Cluzel, Hong-Minh Hoang, Laurence Fournaison, Anthony Delahaye, Bernard Yannou
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Taking into consideration all the life cycle of a product is now an important step in the eco-design of a product or a technology. Life cycle assessment (LCA) is a standard tool to evaluate the environmental impacts of a system or a process. Despite the improvement in refrigerant regulation through protocols, the environmental damage of refrigeration systems remains important and needs to be improved. In this paper, the environmental impacts of refrigeration systems in a typical supermarket are compared using the LCA methodology under different conditions. The system is used to provide cold at two levels of temperature: medium and low temperature during a life period of 15 years. The most commonly used architectures of supermarket cold production systems are investigated: centralized direct expansion systems and indirect systems using a secondary loop to transport the cold. The variation of power needed during seasonal changes and during the daily opening/closure periods of the supermarket are considered. R134a as the primary refrigerant fluid and two types of secondary fluids are considered. The composition of each system and the leakage rate of the refrigerant through its life cycle are taken from the literature and industrial data. Twelve scenarios are examined. They are based on the variation of three parameters, 1. location: France (Paris), Spain (Toledo) and Sweden (Stockholm), 2. different sources of electric consumption: photovoltaic panels and low voltage electric network and 3. architecture: direct and indirect refrigeration systems. OpenLCA, SimaPro softwares, and different impact assessment methods were compared; CML method is used to evaluate the midpoint environmental indicators. This study highlights the significant contribution of electric consumption in environmental damages compared to the impacts of refrigerant leakage. The secondary loop allows lowering the refrigerant amount in the primary loop which results in a decrease in the climate change indicators compared to the centralized direct systems. However, an exhaustive cost evaluation (CAPEX and OPEX) of both systems shows more important costs related to the indirect systems. A significant difference between the countries has been noticed, mostly due to the difference in electric production. In Spain, using photovoltaic panels helps to reduce efficiently the environmental impacts and the related costs. This scenario is the best alternative compared to the other scenarios. Sweden is a country with less environmental impacts. For both France and Sweden, the use of photovoltaic panels does not bring a significant difference, due to a less sunlight exposition than in Spain. Alternative solutions exist to reduce the impact of refrigerating systems, and a brief introduction is presented.Keywords: eco-design, industrial engineering, LCA, refrigeration system
Procedia PDF Downloads 189842 Effects of Soil Neutron Irradiation in Soil Carbon Neutron Gamma Analysis
Authors: Aleksandr Kavetskiy, Galina Yakubova, Nikolay Sargsyan, Stephen A. Prior, H. Allen Torbert
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The carbon sequestration question of modern times requires the development of an in-situ method of measuring soil carbon over large landmasses. Traditional chemical analytical methods used to evaluate large land areas require extensive soil sampling prior to processing for laboratory analysis; collectively, this is labor-intensive and time-consuming. An alternative method is to apply nuclear physics analysis, primarily in the form of pulsed fast-thermal neutron-gamma soil carbon analysis. This method is based on measuring the gamma-ray response that appears upon neutron irradiation of soil. Specific gamma lines with energies of 4.438 MeV appearing from neutron irradiation can be attributed to soil carbon nuclei. Based on measuring gamma line intensity, assessments of soil carbon concentration can be made. This method can be done directly in the field using a specially developed pulsed fast-thermal neutron-gamma system (PFTNA system). This system conducts in-situ analysis in a scanning mode coupled with GPS, which provides soil carbon concentration and distribution over large fields. The system has radiation shielding to minimize the dose rate (within radiation safety guidelines) for safe operator usage. Questions concerning the effect of neutron irradiation on soil health will be addressed. Information regarding absorbed neutron and gamma dose received by soil and its distribution with depth will be discussed in this study. This information was generated based on Monte-Carlo simulations (MCNP6.2 code) of neutron and gamma propagation in soil. Received data were used for the analysis of possible induced irradiation effects. The physical, chemical and biological effects of neutron soil irradiation were considered. From a physical aspect, we considered neutron (produced by the PFTNA system) induction of new isotopes and estimated the possibility of increasing the post-irradiation gamma background by comparisons to the natural background. An insignificant increase in gamma background appeared immediately after irradiation but returned to original values after several minutes due to the decay of short-lived new isotopes. From a chemical aspect, possible radiolysis of water (presented in soil) was considered. Based on stimulations of radiolysis of water, we concluded that the gamma dose rate used cannot produce gamma rays of notable rates. Possible effects of neutron irradiation (by the PFTNA system) on soil biota were also assessed experimentally. No notable changes were noted at the taxonomic level, nor was functional soil diversity affected. Our assessment suggested that the use of a PFTNA system with a neutron flux of 1e7 n/s for soil carbon analysis does not notably affect soil properties or soil health.Keywords: carbon sequestration, neutron gamma analysis, radiation effect on soil, Monte-Carlo simulation
Procedia PDF Downloads 142841 Initial Resistance Training Status Influences Upper Body Strength and Power Development
Authors: Stacey Herzog, Mitchell McCleary, Istvan Kovacs
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Purpose: Maximal strength and maximal power are key athletic abilities in many sports disciplines. In recent years, velocity-based training (VBT) with a relatively high 75-85% 1RM resistance has been popularized in preparation for powerlifting and various other sports. The purpose of this study was to discover differences between beginner/intermediate and advanced lifters’ push/press performances after a heavy resistance-based BP training program. Methods: A six-week, three-workouts per week program was administered to 52 young, physically active adults (age: 22.4±5.1; 12 female). The majority of the participants (84.6%) had prior experience in bench pressing. Typical workouts began with BP using 75-95% 1RM in the 1-5 repetition range. The sets in the lower part of the range (75-80% 1RM) were performed with velocity-focus as well. The BP sets were followed by seated dumbbell presses and six additional upper-body assistance exercises. Pre- and post-tests were conducted on five test exercises: one-repetition maximum BP (1RM), calculated relative strength index: BP/BW (RSI), four-repetition maximal-effort dynamic BP for peak concentric velocity with 80% 1RM (4RV), 4-repetition ballistic pushups (BPU) for height (4PU), and seated medicine ball toss for distance (MBT). For analytic purposes, the participant group was divided into two subgroups: self-indicated beginner or intermediate initial resistance training status (BITS) [n=21, age: 21.9±3.6; 10 female] and advanced initial resistance training status (ATS) [n=31, age: 22.7±5.9; 2 female]. Pre- and post-test results were compared within subgroups. Results: Paired-sample t-tests indicated significant within-group improvements in all five test exercises in both groups (p < 0.05). BITS improved 18.1 lbs. (13.0%) in 1RM, 0.099 (12.8%) in RSI, 0.133 m/s (23.3%) in 4RV, 1.55 in. (27.1%) in BPU, and 1.00 ft. (5.8%) in MBT, while the ATS group improved 13.2 lbs. (5.7%) in 1RM, 0.071 (5.8%) in RSI, 0.051 m/s (9.1%) in 4RV, 1.20 in. (13.7%) in BPU, and 1.15 ft. (5.5%) in MBT. Conclusion: While the two training groups had different initial resistance training backgrounds, both showed significant improvements in all test exercises. As expected, the beginner/intermediate group displayed better relative improvements in four of the five test exercises. However, the medicine ball toss, which had the lightest resistance among the tests, showed similar relative improvements between the two groups. These findings relate to two important training principles: specificity and transfer. The ATS group had more specific experiences with heavy-resistance BP. Therefore, fewer improvements were detected in their test performances with heavy resistances. On the other hand, while the heavy resistance-based training transferred to increased power outcomes in light-resistance power exercises, the difference in the rate of improvement between the two groups disappeared. Practical applications: Based on initial training status, S&C coaches should expect different performance gains in maximal strength training-specific test exercises. However, the transfer from maximal strength to a non-training-specific performance category along the F-v curve continuum (i.e., light resistance and high velocity) might not depend on initial training status.Keywords: exercise, power, resistance training, strength
Procedia PDF Downloads 70840 Evaluation of Some Serum Proteins as Markers for Myeloma Bone Disease
Authors: V. T. Gerov, D. I. Gerova, I. D. Micheva, N. F. Nazifova-Tasinova, M. N. Nikolova, M. G. Pasheva, B. T. Galunska
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Multiple myeloma (MM) is the most frequent plasma cell (PC) dyscrasia that involves the skeleton. Myeloma bone disease (MBD) is characterized by osteolytic bone lesions as a result of increased osteoclasts activity not followed by reactive bone formation due to osteoblasts suppression. Skeletal complications cause significant adverse effects on quality of life and lead to increased morbidity and mortality. Last decade studies revealed the implication of different proteins in osteoclast activation and osteoblast inhibition. The aim of the present study was to determine serum levels of periostin, sRANKL and osteopontin and to evaluate their role as bone markers in MBD. Materials and methods. Thirty-two newly diagnosed MM patients (mean age: 62.2 ± 10.7 years) and 33 healthy controls (mean age: 58.9 ± 7.5 years) were enrolled in the study. According to IMWG criteria 28 patients were with symptomatic MM and 4 with monoclonal gammopathy of undetermined significance (MGUS). In respect to their bone involvement all symptomatic patients were divided into two groups (G): 9 patients with 0-3 osteolytic lesions (G1) and 19 patients with >3 osteolytic lesions and/or pathologic fractures (G2). Blood samples were drawn for routine laboratory analysis and for measurement of periostin, sRANKL and osteopontin serum levels by ELISA kits (Shanghai Sunred Biological Technology, China). Descriptive analysis, Mann-Whitney test for assessment the differences between groups and non-parametric correlation analysis were performed using GraphPad Prism v8.01. Results. The median serum levels of periostin, sRANKL and osteopontin of ММ patients were significantly higher compared to controls (554.7pg/ml (IQR=424.0-720.6) vs 396.9pg/ml (IQR=308.6-471.9), p=0.0001; 8.9pg/ml (IQR=7.1-10.5) vs 5.6pg/ml (IQR=5.1-6.4, p<0.0001 and 514.0ng/ml (IQR=469.3-754.0) vs 387.0ng/ml (IQR=335.9-441.9), p<0.0001, respectively). for assessment of differences between groups and non-parametric correlation analysis were performed using GraphPad Prism v8.01. Statistical significance was found for all tested bone markers between symptomatic MM patients and controls: G1 vs controls (p<0.03), G2 vs controls (p<0.0001) for periostin; G1 vs controls (p<0.0001), G2 vs controls (p<0.0001) for sRANKL; G1 vs controls (p=0.002), G2 vs controls (p<0.0001) for osteopontin, as well between symptomatic MM patients and MGUS patients: G1 vs MGUS (p<0.003), G2 vs MGUS (p=0.003) for periostin; G1 vs MGUS (p<0.05), G2 vs MGUS (p<0.001) for sRANKL; G1 vs MGUS (p=0.011), G2 vs MGUS (p=0.0001) for osteopontin. No differences were detected between MGUS and controls and between patients in G1 and G2 groups. Spearman correlation analysis revealed moderate positive correlation between periostin and beta-2-microglobulin (r=0.416, p=0.018), percentage bone marrow myeloma PC (r=0.432, p=0.014), and serum total protein (r=0.427, p=0.015). Osteopontin levels were also positively related to beta-2-microglobulin (r=0.540, p=0.0014), percentage bone marrow myeloma PC (r=0.423, p=0.016), and serum total protein (r=0.413, p=0.019). Serum sRANKL was only related to beta-2-microglobulin levels (r=0.398, p=0.024). Conclusion: In the present study, serum levels of periostin, sRANKL and osteopontin in newly diagnosed MM patients were evaluated. They gradually increased from MGUS to more advanced stages of MM reflecting the severity of bone destruction. These results support the idea that some new protein markers could be used in monitoring the MBD as a most severe complication of MM.Keywords: myeloma bone disease, periostin, sRANKL, osteopontin
Procedia PDF Downloads 55839 Automated Evaluation Approach for Time-Dependent Question Answering Pairs on Web Crawler Based Question Answering System
Authors: Shraddha Chaudhary, Raksha Agarwal, Niladri Chatterjee
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This work demonstrates a web crawler-based generalized end-to-end open domain Question Answering (QA) system. An efficient QA system requires a significant amount of domain knowledge to answer any question with the aim to find an exact and correct answer in the form of a number, a noun, a short phrase, or a brief piece of text for the user's questions. Analysis of the question, searching the relevant document, and choosing an answer are three important steps in a QA system. This work uses a web scraper (Beautiful Soup) to extract K-documents from the web. The value of K can be calibrated on the basis of a trade-off between time and accuracy. This is followed by a passage ranking process using the MS-Marco dataset trained on 500K queries to extract the most relevant text passage, to shorten the lengthy documents. Further, a QA system is used to extract the answers from the shortened documents based on the query and return the top 3 answers. For evaluation of such systems, accuracy is judged by the exact match between predicted answers and gold answers. But automatic evaluation methods fail due to the linguistic ambiguities inherent in the questions. Moreover, reference answers are often not exhaustive or are out of date. Hence correct answers predicted by the system are often judged incorrect according to the automated metrics. One such scenario arises from the original Google Natural Question (GNQ) dataset which was collected and made available in the year 2016. Use of any such dataset proves to be inefficient with respect to any questions that have time-varying answers. For illustration, if the query is where will be the next Olympics? Gold Answer for the above query as given in the GNQ dataset is “Tokyo”. Since the dataset was collected in the year 2016, and the next Olympics after 2016 were in 2020 that was in Tokyo which is absolutely correct. But if the same question is asked in 2022 then the answer is “Paris, 2024”. Consequently, any evaluation based on the GNQ dataset will be incorrect. Such erroneous predictions are usually given to human evaluators for further validation which is quite expensive and time-consuming. To address this erroneous evaluation, the present work proposes an automated approach for evaluating time-dependent question-answer pairs. In particular, it proposes a metric using the current timestamp along with top-n predicted answers from a given QA system. To test the proposed approach GNQ dataset has been used and the system achieved an accuracy of 78% for a test dataset comprising 100 QA pairs. This test data was automatically extracted using an analysis-based approach from 10K QA pairs of the GNQ dataset. The results obtained are encouraging. The proposed technique appears to have the possibility of developing into a useful scheme for gathering precise, reliable, and specific information in a real-time and efficient manner. Our subsequent experiments will be guided towards establishing the efficacy of the above system for a larger set of time-dependent QA pairs.Keywords: web-based information retrieval, open domain question answering system, time-varying QA, QA evaluation
Procedia PDF Downloads 101838 Use of a Business Intelligence Software for Interactive Visualization of Data on the Swiss Elite Sports System
Authors: Corinne Zurmuehle, Andreas Christoph Weber
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In 2019, the Swiss Federal Institute of Sport Magglingen (SFISM) conducted a mixed-methods study on the Swiss elite sports system, which yielded a large quantity of research data. In a quantitative online survey, 1151 elite sports athletes, 542 coaches, and 102 Performance Directors of national sports federations (NF) have submitted their perceptions of the national support measures of the Swiss elite sports system. These data provide an essential database for the further development of the Swiss elite sports system. The results were published in a report presenting the results divided into 40 Olympic summer and 14 winter sports (Olympic classification). The authors of this paper assume that, in practice, this division is too unspecific to assess where further measures would be needed. The aim of this paper is to find appropriate parameters for data visualization in order to identify disparities in sports promotion that allow an assessment of where further interventions by Swiss Olympic (NF umbrella organization) are required. Method: First, the variable 'salary earned from sport' was defined as a variable to measure the impact of elite sports promotion. This variable was chosen as a measure as it represents an important indicator for the professionalization of elite athletes and therefore reflects national level sports promotion measures applied by Swiss Olympic. Afterwards, the variable salary was tested with regard to the correlation between Olympic classification [a], calculating the Eta coefficient. To estimate the appropriate parameters for data visualization, the correlation between salary and four further parameters was analyzed by calculating the Eta coefficient: [a] sport; [b] prioritization (from 1 to 5) of the sports by Swiss Olympic; [c] gender; [d] employment level in sports. Results & Discussion: The analyses reveal a very small correlation between salary and Olympic classification (ɳ² = .011, p = .005). Gender demonstrates an even small correlation (ɳ² = .006, p = .014). The parameter prioritization was correlating with small effect (ɳ² = .017, p = .001) as did employment level (ɳ² = .028, p < .001). The highest correlation was identified by the parameter sport with a moderate effect (ɳ² = .075, p = .047). The analyses show that the disparities in sports promotion cannot be determined by a particular parameter but presumably explained by a combination of several parameters. We argue that the possibility of combining parameters for data visualization should be enabled when the analysis is provided to Swiss Olympic for further strategic decision-making. However, the inclusion of multiple parameters massively multiplies the number of graphs and is therefore not suitable for practical use. Therefore, we suggest to apply interactive dashboards for data visualization using Business Intelligence Software. Practical & Theoretical Contribution: This contribution provides the first attempt to use Business Intelligence Software for strategic decision-making in national level sports regarding the prioritization of national resources for sports and athletes. This allows to set specific parameters with a significant effect as filters. By using filters, parameters can be combined and compared against each other and set individually for each strategic decision.Keywords: data visualization, business intelligence, Swiss elite sports system, strategic decision-making
Procedia PDF Downloads 89837 Enhancing Efficiency of Building through Translucent Concrete
Authors: Humaira Athar, Brajeshwar Singh
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Generally, the brightness of the indoor environment of buildings is entirely maintained by the artificial lighting which has consumed a large amount of resources. It is reported that lighting consumes about 19% of the total generated electricity which accounts for about 30-40% of total energy consumption. One possible way is to reduce the lighting energy by exploiting sunlight either through the use of suitable devices or energy efficient materials like translucent concrete. Translucent concrete is one such architectural concrete which allows the passage of natural light as well as artificial light through it. Several attempts have been made on different aspects of translucent concrete such as light guiding materials (glass fibers, plastic fibers, cylinder etc.), concrete mix design and manufacturing methods for use as building elements. Concerns are, however, raised on various related issues such as poor compatibility between the optical fibers and cement paste, unaesthetic appearance due to disturbance occurred in the arrangement of fibers during vibration and high shrinkage in flowable concrete due to its high water/cement ratio. Need is felt to develop translucent concrete to meet the requirement of structural safety as OPC concrete with the maximized saving in energy towards the power of illumination and thermal load in buildings. Translucent concrete was produced using pre-treated plastic optical fibers (POF, 2mm dia.) and high slump white concrete. The concrete mix was proportioned in the ratio of 1:1.9:2.1 with a w/c ratio of 0.40. The POF was varied from 0.8-9 vol.%. The mechanical properties and light transmission of this concrete were determined. Thermal conductivity of samples was measured by a transient plate source technique. Daylight illumination was measured by a lux grid method as per BIS:SP-41. It was found that the compressive strength of translucent concrete increased with decreasing optical fiber content. An increase of ~28% in the compressive strength of concrete was noticed when fiber was pre-treated. FE-SEM images showed little-debonded zone between the fibers and cement paste which was well supported with pull-out bond strength test results (~187% improvement over untreated). The light transmission of concrete was in the range of 3-7% depending on fiber spacing (5-20 mm). The average daylight illuminance (~75 lux) was nearly equivalent to the criteria specified for illumination for circulation (80 lux). The thermal conductivity of translucent concrete was reduced by 28-40% with respect to plain concrete. The thermal load calculated by heat conduction equation was ~16% more than the plain concrete. Based on Design-Builder software, the total annual illumination energy load of a room using one side translucent concrete was 162.36 kW compared with the energy load of 249.75 kW for a room without concrete. The calculated energy saving on an account of the power of illumination was ~25%. A marginal improvement towards thermal comfort was also noticed. It is concluded that the translucent concrete has the advantages of the existing concrete (load bearing) with translucency and insulation characteristics. It saves a significant amount of energy by providing natural daylight instead of artificial power consumption of illumination.Keywords: energy saving, light transmission, microstructure, plastic optical fibers, translucent concrete
Procedia PDF Downloads 128836 The Involvement of the Homing Receptors CCR7 and CD62L in the Pathogenesis of Graft-Versus-Host Disease
Authors: Federico Herrera, Valle Gomez García de Soria, Itxaso Portero Sainz, Carlos Fernández Arandojo, Mercedes Royg, Ana Marcos Jimenez, Anna Kreutzman, Cecilia MuñozCalleja
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Introduction: Graft-versus-host disease (GVHD) still remains the major complication associated with allogeneic stem cell transplantation (SCT). The pathogenesis involves migration of donor naïve T-cells into recipient secondary lymphoid organs. Two molecules are important in this process: CD62L and CCR7, which are characteristically expressed in naïve/central memory T-cells. With this background, we aimed to study the influence of CCR7 and CD62L on donor lymphocytes in the development and severity of GVHD. Material and methods: This single center study included 98 donor-recipient pairs. Samples were collected prospectively from the apheresis product and phenotyped by flow cytometry. CCR7 and CD62L expression in CD4+ and CD8+ T-cells were compared between patients who developed acute (n=40) or chronic GVHD (n=33) and those who did not (n=38). Results: The patients who developed acute GVHD were transplanted with a higher percentage of CCR7+CD4+ T-cells (p = 0.05) compared to the no GVHD group. These results were confirmed when these patients were divided in degrees according to the severity of the disease; the more severe disease, the higher percentage of CCR7+CD4+ T-cells. Conversely, chronic GVHD patients received a higher percentage of CCR7+CD8+ T-cells (p=0.02) in comparison to those who did not develop the complication. These data were also confirmed when patients were subdivided in degrees of the disease severity. A multivariable analysis confirmed that percentage of CCR7+CD4+ T-cells is a predictive factor of acute GVHD whereas the percentage of CCR7+CD8+ T-cells is a predictive factor of chronic GVHD. In vitro functional assays (migration and activation assays) supported the idea of CCR7+ T-cells were involved in the development of GVHD. As low levels of CD62L expression were detected in all apheresis products, we tested the hypothesis that CD62L was shed during apheresis procedure. Comparing CD62L surface levels in T-cells from the same donor immediately before collecting the apheresis product, and the final apheresis product we found that this process down-regulated CD62L in both CD4+ and CD8+ T cells (p=0.008). Interestingly, when CD62L levels were analysed in days 30 or 60 after engraftment, they recovered to baseline (p=0.008). However, to investigate the relation between CD62L expression and the development of GVHD in the recipient samples after the engraftment, no differences were observed comparing patients with GVHD to those who did not develop the disease. Discussion: Our prospective study indicates that the CCR7+ T-cells from the donor, which include naïve and central memory T-cells, contain the alloreactive cells with a high ability to mediate GVHD (in the case of both migration and activation). Therefore we suggest that the proportion and functional properties of CCR7+CD4+ and CCR7+CD8+ T-cells in the apheresis could act as a predictive biomarker to both acute and chronic GVHD respectively. Importantly, our study precludes that CD62L is lost in the apheresis and therefore it is not a reliable biomarker for the development of GVHD.Keywords: CCR7, CD62L, GVHD, SCT
Procedia PDF Downloads 287835 Progress Towards Optimizing and Standardizing Fiducial Placement Geometry in Prostate, Renal, and Pancreatic Cancer
Authors: Shiva Naidoo, Kristena Yossef, Grimm Jimm, Mirza Wasique, Eric Kemmerer, Joshua Obuch, Anand Mahadevan
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Background: Fiducial markers effectively enhance tumor target visibility prior to Stereotactic Body Radiation Therapy or Proton therapy. To streamline clinical practice, fiducial placement guidelines from a robotic radiosurgery vendor were examined with the goals of optimizing and standardizing feasible geometries for each treatment indication. Clinical examples of prostate, renal, and pancreatic cases are presented. Methods: Vendor guidelines (Accuray, Sunnyvale, Ca) suggest implantation of 4–6 fiducials at least 20 mm apart, with at least a 15-degree angular difference between fiducials, within 50 mm or less from the target centroid, to ensure that any potential fiducial motion (e.g., from respiration or abdominal/pelvic pressures) will mimic target motion. Also recommended is that all fiducials can be seen in 45-degree oblique views with no overlap to coincide with the robotic radiosurgery imaging planes. For the prostate, a standardized geometry that meets all these objectives is a 2 cm-by-2 cm square in the coronal plane. The transperineal implant of two pairs of preloaded tandem fiducials makes the 2 cm-by-2 cm square geometry clinically feasible. This technique may be applied for renal cancer, except repositioned in a sagittal plane, with the retroperitoneal placement of the fiducials into the tumor. Pancreatic fiducial placement via endoscopic ultrasound (EUS) is technically more challenging, as fiducial placement is operator-dependent, and lesion access may be limited by adjacent vasculature, tumor location, or restricted mobility of the EUS probe in the duodenum. Fluoroscopically assisted fiducial placement during EUS can help ensure fiducial markers are deployed with optimal geometry and visualization. Results: Among the first 22 fiducial cases on a newly installed robotic radiosurgery system, live x-ray images for all nine prostatic cases had excellent fiducial visualization at the treatment console. Renal and pancreatic fiducials were not as clearly visible due to difficult target access and smaller caliber insertion needle/fiducial usage. The geometry of the first prostate case was used to ensure accurate geometric marker placement for the remaining 8 cases. Initially, some of the renal and pancreatic fiducials were closer than the 20 mm recommendation, and interactive feedback with the proceduralists led to subsequent fiducials being too far to the edge of the tumor. Further feedback and discussion of all cases are being used to help guide standardized geometries and achieve ideal fiducial placement. Conclusion: The ideal tradeoffs of fiducial visibility versus the thinnest possible gauge needle to avoid complications needs to be systematically optimized among all patients, particularly in regards to body habitus. Multidisciplinary collaboration among proceduralists and radiation oncologists can lead to improved outcomes.Keywords: fiducial, prostate cancer, renal cancer, pancreatic cancer, radiotherapy
Procedia PDF Downloads 93834 Leveraging Remote Assessments and Central Raters to Optimize Data Quality in Rare Neurodevelopmental Disorders Clinical Trials
Authors: Pamela Ventola, Laurel Bales, Sara Florczyk
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Background: Fully remote or hybrid administration of clinical outcome measures in rare neurodevelopmental disorders trials is increasing due to the ongoing pandemic and recognition that remote assessments reduce the burden on families. Many assessments in rare neurodevelopmental disorders trials are complex; however, remote/hybrid trials readily allow for the use of centralized raters to administer and score the scales. The use of centralized raters has many benefits, including reducing site burden; however, a specific impact on data quality has not yet been determined. Purpose: The current study has two aims: a) evaluate differences in data quality between administration of a standardized clinical interview completed by centralized raters compared to those completed by site raters and b) evaluate improvement in accuracy of scoring standardized developmental assessments when scored centrally compared to when scored by site raters. Methods: For aim 1, the Vineland-3, a widely used measure of adaptive functioning, was administered by site raters (n= 52) participating in one of four rare disease trials. The measure was also administered as part of two additional trials that utilized central raters (n=7). Each rater completed a comprehensive training program on the assessment. Following completion of the training, each clinician completed a Vineland-3 with a mock caregiver. Administrations were recorded and reviewed by a neuropsychologist for administration and scoring accuracy. Raters were able to certify for the trials after demonstrating an accurate administration of the scale. For site raters, 25% of each rater’s in-study administrations were reviewed by a neuropsychologist for accuracy of administration and scoring. For central raters, the first two administrations and every 10th administration were reviewed. Aim 2 evaluated the added benefit of centralized scoring on the accuracy of scoring of the Bayley-3, a comprehensive developmental assessment widely used in rare neurodevelopmental disorders trials. Bayley-3 administrations across four rare disease trials were centrally scored. For all administrations, the site rater who administered the Bayley-3 scored the scale, and a centralized rater reviewed the video recordings of the administrations and also scored the scales to confirm accuracy. Results: For aim 1, site raters completed 138 Vineland-3 administrations. Of the138 administrations, 53 administrations were reviewed by a neuropsychologist. Four of the administrations had errors that compromised the validity of the assessment. The central raters completed 180 Vineland-3 administrations, 38 administrations were reviewed, and none had significant errors. For aim 2, 68 administrations of the Bayley-3 were reviewed and scored by both a site rater and a centralized rater. Of these administrations, 25 had errors in scoring that were corrected by the central rater. Conclusion: In rare neurodevelopmental disorders trials, sample sizes are often small, so data quality is critical. The use of central raters inherently decreases site burden, but it also decreases rater variance, as illustrated by the small team of central raters (n=7) needed to conduct all of the assessments (n=180) in these trials compared to the number of site raters (n=53) required for even fewer assessments (n=138). In addition, the use of central raters dramatically improves the quality of scoring the assessments.Keywords: neurodevelopmental disorders, clinical trials, rare disease, central raters, remote trials, decentralized trials
Procedia PDF Downloads 172833 The Cost of Beauty: Insecurity and Profit
Authors: D. Cole, S. Mahootian, P. Medlock
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This research contributes to existing knowledge of the complexities surrounding women’s relationship to beauty standards by examining their lived experiences. While there is much academic work on the effects of culturally imposed and largely unattainable beauty standards, the arguments tend to fall into two paradigms. On the one hand is the radical feminist perspective that argues that women are subjected to absolute oppression within the patriarchal system in which beauty standards have been constructed. This position advocates for a complete restructuring of social institutions to liberate women from all types of oppression. On the other hand, there are liberal feminist arguments that focus on choice, arguing that women’s agency in how to present themselves is empowerment. These arguments center around what women do within the patriarchal system in order to liberate themselves. However, there is very little research on the lived experiences of women negotiating these two realms: the complex negotiation between the pressure to adhere to cultural beauty standards and the agency of self-expression and empowerment. By exploring beauty standards through the intersection of societal messages (including macro-level processes such as social media and advertising as well as smaller-scale interactions such as families and peers) and lived experiences, this study seeks to provide a nuanced understanding of how women navigate and negotiate their own presentation and sense of self-identity. Current research sees a rise in incidents of body dysmorphia, depression and anxiety since the advent of social media. Approximately 91% of women are unhappy with their bodies and resort to dieting to achieve their ideal body shape, but only 5% of women naturally possess the body type often portrayed by Americans in movies and media. It is, therefore, crucial we begin talking about the processes that are affecting self-image and mental health. A question that arises is that, given these negative effects, why do companies continue to advertise and target women with standards that very few could possibly attain? One obvious answer is that keeping beauty standards largely unattainable enables the beauty and fashion industries to make large profits by promising products and procedures that will bring one up to “standard”. The creation of dissatisfaction for some is profit for others. This research utilizes qualitative methods: interviews, questionnaires, and focus groups to investigate women’s relationships to beauty standards and empowerment. To this end, we reached out to potential participants through a video campaign on social media: short clips on Instagram, Facebook, and TikTok and a longer clip on YouTube inviting users to take part in the study. Participants are asked to react to images, videos, and other beauty-related texts. The findings of this research have implications for policy development, advocacy and interventions aimed at promoting healthy inclusivity and empowerment of women.Keywords: women, beauty, consumerism, social media
Procedia PDF Downloads 61832 A Study for Effective CO2 Sequestration of Hydrated Cement by Direct Aqueous Carbonation
Authors: Hyomin Lee, Jinhyun Lee, Jinyeon Hwang, Younghoon Choi, Byeongseo Son
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Global warming is a world-wide issue. Various carbon capture and storage (CCS) technologies for reducing CO2 concentration in the atmosphere have been increasingly studied. Mineral carbonation is one of promising method for CO2 sequestration. Waste cement generating from aggregate recycling processes of waste concrete is potentially a good raw material containing reactive components for mineral carbonation. The major goal of our long-term project is to developed effective methods for CO2 sequestration using waste cement. In the present study, the carbonation characteristics of hydrated cement were examined by conducting two different direct aqueous carbonation experiments. We also evaluate the influence of NaCl and MgCl2 as additives to increase mineral carbonation efficiency of hydrated cement. Cement paste was made with W:C= 6:4 and stored for 28 days in water bath. The prepared cement paste was pulverized to the size less than 0.15 mm. 15 g of pulverized cement paste and 200 ml of solutions containing additives were reacted in ambient temperature and pressure conditions. 1M NaCl and 0.25 M MgCl2 was selected for additives after leaching test. Two different sources of CO2 was applied for direct aqueous carbonation experiment: 0.64 M NaHCO3 was used for CO2 donor in method 1 and pure CO2 gas (99.9%) was bubbling into reacting solution at the flow rate of 20 ml/min in method 2. The pH and Ca ion concentration were continuously measured with pH/ISE Multiparameter to observe carbonation behaviors. Material characterization of reacted solids was performed by TGA, XRD, SEM/EDS analyses. The carbonation characteristics of hydrated cement were significantly different with additives. Calcite was a dominant calcium carbonate mineral after the two carbonation experiments with no additive and NaCl additive. The significant amount of aragonite and vaterite as well as very fine calcite of poorer crystallinity was formed with MgCl2 additive. CSH (calcium silicate hydrate) in hydrated cement were changed to MSH (magnesium silicate hydrate). This transformation contributed to the high carbonation efficiency. Carbonation experiment with method 1 revealed that that the carbonation of hydrated cement took relatively long time in MgCl2 solution compared to that in NaCl solution and the contents of aragonite and vaterite were increased as increasing reaction time. In order to maximize carbonation efficiency in direct aqueous carbonation with CO2 gas injection (method 2), the control of solution pH was important. The solution pH was decreased with injection of CO2 gas. Therefore, the carbonation efficiency in direct aqueous carbonation was closely related to the stability of calcium carbonate minerals with pH changes. With no additive and NaCl additive, the maximum carbonation was achieved when the solution pH was greater than 11. Calcium carbonate form by mineral carbonation seemed to be re-dissolved as pH decreased below 11 with continuous CO2 gas injection. The type of calcium carbonate mineral formed during carbonation in MgCl2 solution was closely related to the variation of solution pH caused by CO2 gas injection. The amount of aragonite significantly increased with decreasing solution pH, whereas the amount of calcite decreased.Keywords: CO2 sequestration, Mineral carbonation, Cement and concrete, MgCl2 and NaCl
Procedia PDF Downloads 379831 Prevalent Features of Human Infections with Highly Pathogenic Avian Influenza A(H7N9) Virus, China, 2017
Authors: Lei Zhou, Dan Li, Ruiqi Ren, Chao Li, Yali Wang, Daxin Ni, Zijian Feng, Timothy M. Uyeki, Qun Li
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Since the first human infections with avian influenza A(H7N9) virus were identified in early 2013, 1533 cases of laboratory-confirmed A(H7N9) virus infections were reported and confirmed as of September 13, 2017. The fifth epidemic was defined as starting from September 1, 2016, and the number of A(H7N9) cases has surged since the end of December in 2016. On February 18, 2017, the A(H7N9) cases who were infected with highly pathogenic avian influenza (HPAI) virus was reported from Southern China. The HPAI A(H7N9) cases were identified and then an investigation and analyses were conducted to assess whether disease severity in humans has changed with HPAI A(H7N9) compared with low pathogenic avian influenza (LPAI) A(H7N9) virus infection. Methods: All confirmed cases with A(H7N9) virus infections reported throughout mainland China from September 1, 2016, to September 13, 2017, were included. Cases' information was extracted from field investigation reports and the notifiable infectious surveillance system to describe the demographic, clinical, and epidemiologic characteristics. Descriptive statistics were used to compare HPAI A(H7N9) cases with all LPAI A(H7N9) cases reported during the fifth epidemic. Results: A total of 27 cases of HPAI A(H7N9) virus were identified infection from five provinces, including Guangxi (44%), Guangdong (33%), Hunan (15%), Hebei (4%) and Shangxi (4%). The median age of cases of HPAI A(H7N9) virus infection was 60 years (range, 15 to 80) and most of them were male (59%) and lived in rural areas (78%). All 27 cases had live poultry related exposures within 10 days before their illness onset. In comparison with LPAI A(H7N9) case-patients, HPAI A(H7N9) case-patients were significantly more likely to live in rural areas (78% vs. 51%; p = 0.006), have exposure to the sick or dead poultry (56% vs. 19%; p = 0.000), and be hospitalized earlier (median 3 vs. 4 days; p = 0.007). No significant differences were observed in median age, sex, prevalence of underlying chronic medical conditions, median time from illness onset to first medical service seeking, starting antiviral treatment, and diagnosis. Although the median time from illness onset to death (9 vs. 13 days) was shorter and the overall case-fatality proportion (48% vs. 38%) was higher for HPAI A(H7N9) case-patients than for LPAI A(H7N9) case-patients, these differences were not statistically significant. Conclusions: Our findings indicate that HPAI A(H7N9) virus infection was associated with exposure to sick and dead poultry in rural areas when visited live poultry market or in the backyard. In the fifth epidemic in mainland China, HPAI A (H7N9) case-patients were hospitalized earlier than LPAI A(H7N9) case-patients. Although the difference was not statistically significant, the mortality of HPAI A (H7N9) case-patients was obviously higher than that of LPAI A(H7N9) case-patients, indicating a potential severity change of HPAI A(H7N9) virus infection.Keywords: Avian influenza A (H7N9) virus, highly pathogenic avian influenza (HPAI), case-patients, poultry
Procedia PDF Downloads 166830 Clinical Response of Nuberol Forte® (Paracetamol 650 MG+Orphenadrine 50 MG) For Pain Management with Musculoskeletal Conditions in Routine Pakistani Practice (NFORTE-EFFECT)
Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir
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Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population
Procedia PDF Downloads 169829 Study on Electromagnetic Plasma Acceleration Using Rotating Magnetic Field Scheme
Authors: Takeru Furuawa, Kohei Takizawa, Daisuke Kuwahara, Shunjiro Shinohara
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In the field of a space propulsion, an electric propulsion system has been developed because its fuel efficiency is much higher than a conventional chemical one. However, the practical electric propulsion systems, e.g., an ion engine, have a problem of short lifetime due to a damage of generation and acceleration electrodes of the plasma. A helicon plasma thruster is proposed as a long-lifetime electric thruster which has non-direct contact electrodes. In this system, both generation and acceleration methods of a dense plasma are executed by antennas from the outside of a discharge tube. Development of the helicon plasma thruster has been conducting under the Helicon Electrodeless Advanced Thruster (HEAT) project. Our helicon plasma thruster has two important processes. First, we generate a dense source plasma using a helicon wave with an excitation frequency between an ion and an electron cyclotron frequencies, fci and fce, respectively, applied from the outside of a discharge using a radio frequency (RF) antenna. The helicon plasma source can provide a high-density (~1019 m-3), a high-ionization ratio (up to several tens of percent), and a high particle generation efficiency. Second, in order to achieve high thrust and specific impulse, we accelerate the dense plasma by the axial Lorentz force fz using the product of the induced azimuthal current jθ and the static radial magnetic field Br, shown as fz = jθ × Br. The HEAT project has proposed several kinds of electrodeless acceleration schemes, and in our particular case, a Rotating Magnetic Field (RMF) method has been extensively studied. The RMF scheme was originally developed as a concept to maintain the Field Reversed Configuration (FRC) in a magnetically confined fusion research. Here, RMF coils are expected to generate jθ due to a nonlinear effect shown below. First, the rotating magnetic field Bω is generated by two pairs of RMF coils with AC currents, which have a phase difference of 90 degrees between the pairs. Due to the Faraday’s law, an axial electric field is induced. Second, an axial current is generated by the effects of an electron-ion and an electron-neutral collisions through the Ohm’s law. Third, the azimuthal electric field is generated by the nonlinear term, and the retarding torque generated by the collision effects again. Then, azimuthal current jθ is generated as jθ = - nₑ er ∙ 2π fRMF. Finally, the axial Lorentz force fz for plasma acceleration is generated. Here, jθ is proportional to nₑ and frequency of RMF coil current fRMF, when Bω is fully penetrated into the plasma. Our previous study has achieved 19 % increase of ion velocity using the 5 MHz and 50 A of the RMF coil power supply. In this presentation, we will show the improvement of the ion velocity using the lower frequency and higher current supplied by RMF power supply. In conclusion, helicon high-density plasma production and electromagnetic acceleration by the RMF scheme with a concept of electrodeless condition have been successfully executed.Keywords: electric propulsion, electrodeless thruster, helicon plasma, rotating magnetic field
Procedia PDF Downloads 261828 Paramedic Strength and Flexibility: Findings of a 6-Month Workplace Exercise Randomised Controlled Trial
Authors: Jayden R. Hunter, Alexander J. MacQuarrie, Samantha C. Sheridan, Richard High, Carolyn Waite
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Workplace exercise programs have been recommended to improve the musculoskeletal fitness of paramedics with the aim of reducing injury rates, and while they have shown efficacy in other occupations, they have not been delivered and evaluated in Australian paramedics to our best knowledge. This study investigated the effectiveness of a 6-month workplace exercise program (MedicFit; MF) to improve paramedic fitness with or without health coach (HC) support. A group of regional Australian paramedics (n=76; 43 male; mean ± SD 36.5 ± 9.1 years; BMI 28.0 ± 5.4 kg/m²) were randomised at the station level to either exercise with remote health coach support (MFHC; n=30), exercise without health coach support (MF; n=23), or no-exercise control (CON; n=23) groups. MFHC and MF participants received a 6-month, low-moderate intensity resistance and flexibility exercise program to be performed ƒ on station without direct supervision. Available exercise equipment included dumbbells, resistance bands, Swiss balls, medicine balls, kettlebells, BOSU balls, yoga mats, and foam rollers. MFHC and MF participants were also provided with a comprehensive exercise manual including sample exercise sessions aimed at improving musculoskeletal strength and flexibility which included exercise prescription (i.e. sets, reps, duration, load). Changes to upper-body (push-ups), lower-body (wall squat) and core (plank hold) strength and flexibility (back scratch and sit-reach tests) after the 6-month intervention were analysed using repeated measures ANOVA to compare changes between groups and over time. Upper-body (+20.6%; p < 0.01; partial eta squared = 0.34 [large effect]) and lower-body (+40.8%; p < 0.05; partial eta squared = 0.08 (moderate effect)) strength increased significantly with no interaction or group effects. Changes to core strength (+1.4%; p=0.17) and both upper-body (+19.5%; p=0.56) and lower-body (+3.3%; p=0.15) flexibility were non-significant with no interaction or group effects observed. While upper- and lower-body strength improved over the course of the intervention, providing a 6-month workplace exercise program with or without health coach support did not confer any greater strength or flexibility benefits than exercise testing alone (CON). Although exercise adherence was not measured, it is possible that participants require additional methods of support such as face-to-face exercise instruction and guidance and individually-tailored exercise programs to achieve adequate participation and improvements in musculoskeletal fitness. This presents challenges for more remote paramedic stations without regular face-to-face access to suitably qualified exercise professionals, and future research should investigate the effectiveness of other forms of exercise delivery and guidance for these paramedic officers such as remotely-facilitated digital exercise prescription and monitoring.Keywords: workplace exercise, paramedic health, strength training, flexibility training
Procedia PDF Downloads 139827 Processing of Flexible Dielectric Nanocomposites Using Nanocellulose and Recycled Alum Sludge for Wearable Technology Applications
Authors: D. Sun, L. Saw, A. Onyianta, D. O’Rourke, Z. Lu, C. See, C. Wilson, C. Popescu, M. Dorris
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With the rapid development of wearable technology (e.g., smartwatch, activity trackers and health monitor devices), flexible dielectric materials with environmental-friendly, low-cost and high-energy efficiency characteristics are in increasing demand. In this work, a flexible dielectric nanocomposite was processed by incorporating two components: cellulose nanofibrils and alum sludge in a polymer matrix. The two components were used in the reinforcement phase as well as for enhancing the dielectric properties; they were processed using waste materials that would otherwise be disposed to landfills. Alum sludge is a by-product of the water treatment process in which aluminum sulfate is prevalently used as the primary coagulant. According to the data from a project partner-Scottish Water: there are approximately 10k tons of alum sludge generated as a waste from the water treatment work to be landfilled every year in Scotland. The industry has been facing escalating financial and environmental pressure to develop more sustainable strategies to deal with alum sludge wastes. In the available literature, some work on reusing alum sludge has been reported (e.g., aluminum recovery or agriculture and land reclamation). However, little work can be found in applying it to processing energy materials (e.g., dielectrics) for enhanced energy density and efficiency. The alum sludge was collected directly from a water treatment plant of Scottish Water and heat-treated and refined before being used in preparing composites. Cellulose nanofibrils were derived from water hyacinth, an invasive aquatic weed that causes significant ecological issues in tropical regions. The harvested water hyacinth was dried and processed using a cost-effective method, including a chemical extraction followed by a homogenization process in order to extract cellulose nanofibrils. Biodegradable elastomer polydimethylsiloxane (PDMS) was used as the polymer matrix and the nanocomposites were processed by casting raw materials in Petri dishes. The processed composites were characterized using various methods, including scanning electron microscopy (SEM), rheological analysis, thermogravimetric and X-ray diffraction analysis. The SEM result showed that cellulose nanofibrils of approximately 20nm in diameter and 100nm in length were obtained and the alum sludge particles were of approximately 200um in diameters. The TGA/DSC analysis result showed that a weight loss of up to 48% can be seen in the raw material of alum sludge and its crystallization process has been started at approximately 800°C. This observation coincides with the XRD result. Other experiments also showed that the composites exhibit comprehensive mechanical and dielectric performances. This work depicts that it is a sustainable practice of reusing such waste materials in preparing flexible, lightweight and miniature dielectric materials for wearable technology applications.Keywords: cellulose, biodegradable, sustainable, alum sludge, nanocomposite, wearable technology, dielectric
Procedia PDF Downloads 84826 Chronic Care Management for the Medically Vulnerable during the Pandemic: Experiences of Family Caregivers of Youth with Substance Use Disorders in Zambia
Authors: Ireen Manase Kabembo, Patrick Chanda
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Background: Substance use disorders are among the chronic conditions that affect all age groups. Worldwide, there is an increase in young people affected by SUDs, which implies that more family members are transitioning into the caregiver role. Family caregivers play a buffering role in the formal healthcare system due to their involvement in caring for persons with acute and chronic conditions in the home setting. Family carers of youth with problematic alcohol and marijuana use experience myriad challenges in managing daily care for this medically vulnerable group. In addition, the poor health-seeking behaviours of youth with SUDs characterized by eluding treatment and runaway tendencies coupled with the effects of the pandemic made caregiving a daunting task for most family caregivers. Issues such as limited and unavailable psychotropic medications, social stigma and discrimination, financial hurdles, systemic barriers in adolescent and young adult mental healthcare services, and the lack of a perceived vulnerability to Covid-19 by youth with SUDs are experiences of family caretakers. Methods: A qualitative study with 30 family caregivers of youth aged 16-24 explored their lived experiences and subjective meanings using two in-depth semi-structured interviews, a caregiving timeline, and participant observation. Findings: Results indicate that most family caregivers had challenges managing care for treatment elusive youth, let alone having them adhere to Covid-19 regulations. However, youth who utilized healthcare services and adhered to treatment regimens had positive outcomes and sustained recovery. The effects of the pandemic, such as job losses and the closure of businesses, further exacerbated the financial challenges experienced by family caregivers, making it difficult to purchase needed medications and daily necessities for the youth. The unabated stigma and discrimination of families of substance-dependent youth in Zambian communities further isolated family caregivers, leaving them with limited support. Conclusion: Since young people with SUDs have a compromised mental capacity due to the cognitive impairments that come with continued substance abuse, they often have difficulties making sound judgements, including the need to utilize SUD recovery services. Also, their tendency to not adhere to the Covid-19 pandemic requirements places them at a higher risk for adverse health outcomes in the (post) pandemic era. This calls for urgent implementation of robust youth mental health services that address prevention and recovery for these emerging adults grappling with substance use disorders. Support for their family caregivers, often overlooked, cannot be overemphasized.Keywords: chronic care management, Covid-19 pandemic, family caregivers, youth with substance use disorders
Procedia PDF Downloads 104825 Sustainable Solid Waste Management Solutions for Asian Countries Using the Potential in Municipal Solid Waste of Indian Cities
Authors: S. H. Babu Gurucharan, Priyanka Kaushal
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Majority of the world's population is expected to live in the Asia and Pacific region by 2050 and thus their cities will generate the maximum waste. India, being the second populous country in the world, is an ideal case study to identify a solution for Asian countries. Waste minimisation and utilisation have always been part of the Indian culture. During rapid urbanisation, our society lost the art of waste minimisation and utilisation habits. Presently, Waste is not considered as a resource, thus wasting an opportunity to tap resources. The technologies in vogue are not suited for effective treatment of large quantities of generated solid waste, without impacting the environment and the population. If not treated efficiently, Waste can become a silent killer. The article is trying to highlight the Indian municipal solid waste scenario as a key indicator of Asian waste management and recommend sustainable waste management and suggest effective solutions to treat the Solid Waste. The methods followed during the research were to analyse the solid waste data on characteristics of solid waste generated in Indian cities, then evaluate the current technologies to identify the most suitable technology in Indian conditions with minimal environmental impact, interact with the technology technical teams, then generate a technical process specific to Indian conditions and further examining the environmental impact and advantages/ disadvantages of the suggested process. The most important finding from the study was the recognition that most of the current municipal waste treatment technologies being employed, operate sub-optimally in Indian conditions. Therefore, the study using the available data, generated heat and mass balance of processes to arrive at the final technical process, which was broadly divided into Waste processing, Waste Treatment, Power Generation, through various permutations and combinations at each stage to ensure that the process is techno-commercially viable in Indian conditions. Then environmental impact was arrived through secondary sources and a comparison of environmental impact of different technologies was tabulated. The major advantages of the suggested process are the effective use of waste for resource generation both in terms of maximised power output or conversion to eco-friendly products like biofuels or chemicals using advanced technologies, minimum environmental impact and the least landfill requirement. The major drawbacks are the capital, operations and maintenance costs. The existing technologies in use in Indian municipalities have their own limitations and the shortlisted technology is far superior to other technologies in vogue. Treatment of Municipal Solid Waste with an efficient green power generation is possible through a combination of suitable environment-friendly technologies. A combination of bio-reactors and plasma-based gasification technology is most suitable for Indian Waste and in turn for Asian waste conditions.Keywords: calorific value, gas fermentation, landfill, municipal solid waste, plasma gasification, syngas
Procedia PDF Downloads 184824 Developing Motorized Spectroscopy System for Tissue Scanning
Authors: Tuba Denkceken, Ayse Nur Sarı, Volkan Ihsan Tore, Mahmut Denkceken
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The aim of the presented study was to develop a newly motorized spectroscopy system. Our system is composed of probe and motor parts. The probe part consists of bioimpedance and fiber optic components that include two platinum wires (each 25 micrometer in diameter) and two fiber cables (each 50 micrometers in diameter) respectively. Probe was examined on tissue phantom (polystyrene microspheres with different diameters). In the bioimpedance part of the probe current was transferred to the phantom and conductivity information was obtained. Adjacent two fiber cables were used in the fiber optic part of the system. Light was transferred to the phantom by fiber that was connected to the light source and backscattered light was collected with the other adjacent fiber for analysis. It is known that the nucleus expands and the nucleus-cytoplasm ratio increases during the cancer progression in the cell and this situation is one of the most important criteria for evaluating the tissue for pathologists. The sensitivity of the probe to particle (nucleus) size in phantom was tested during the study. Spectroscopic data obtained from our system on phantom was evaluated by multivariate statistical analysis. Thus the information about the particle size in the phantom was obtained. Bioimpedance and fiber optic experiments results which were obtained from polystyrene microspheres showed that the impedance value and the oscillation amplitude were increasing while the size of particle was enlarging. These results were compatible with the previous studies. In order to motorize the system within the motor part, three driver electronic circuits were designed primarily. In this part, supply capacitors were placed symmetrically near to the supply inputs which were used for balancing the oscillation. Female capacitors were connected to the control pin. Optic and mechanic switches were made. Drivers were structurally designed as they could command highly calibrated motors. It was considered important to keep the drivers’ dimension as small as we could (4.4x4.4x1.4 cm). Then three miniature step motors were connected to each other along with three drivers. Since spectroscopic techniques are quantitative methods, they yield more objective results than traditional ones. In the future part of this study, it is planning to get spectroscopic data that have optic and impedance information from the cell culture which is normal, low metastatic and high metastatic breast cancer. In case of getting high sensitivity in differentiated cells, it might be possible to scan large surface tissue areas in a short time with small steps. By means of motorize feature of the system, any region of the tissue will not be missed, in this manner we are going to be able to diagnose cancerous parts of the tissue meticulously. This work is supported by The Scientific and Technological Research Council of Turkey (TÜBİTAK) through 3001 project (115E662).Keywords: motorized spectroscopy, phantom, scanning system, tissue scanning
Procedia PDF Downloads 191823 Application of Combined Cluster and Discriminant Analysis to Make the Operation of Monitoring Networks More Economical
Authors: Norbert Magyar, Jozsef Kovacs, Peter Tanos, Balazs Trasy, Tamas Garamhegyi, Istvan Gabor Hatvani
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Water is one of the most important common resources, and as a result of urbanization, agriculture, and industry it is becoming more and more exposed to potential pollutants. The prevention of the deterioration of water quality is a crucial role for environmental scientist. To achieve this aim, the operation of monitoring networks is necessary. In general, these networks have to meet many important requirements, such as representativeness and cost efficiency. However, existing monitoring networks often include sampling sites which are unnecessary. With the elimination of these sites the monitoring network can be optimized, and it can operate more economically. The aim of this study is to illustrate the applicability of the CCDA (Combined Cluster and Discriminant Analysis) to the field of water quality monitoring and optimize the monitoring networks of a river (the Danube), a wetland-lake system (Kis-Balaton & Lake Balaton), and two surface-subsurface water systems on the watershed of Lake Neusiedl/Lake Fertő and on the Szigetköz area over a period of approximately two decades. CCDA combines two multivariate data analysis methods: hierarchical cluster analysis and linear discriminant analysis. Its goal is to determine homogeneous groups of observations, in our case sampling sites, by comparing the goodness of preconceived classifications obtained from hierarchical cluster analysis with random classifications. The main idea behind CCDA is that if the ratio of correctly classified cases for a grouping is higher than at least 95% of the ratios for the random classifications, then at the level of significance (α=0.05) the given sampling sites don’t form a homogeneous group. Due to the fact that the sampling on the Lake Neusiedl/Lake Fertő was conducted at the same time at all sampling sites, it was possible to visualize the differences between the sampling sites belonging to the same or different groups on scatterplots. Based on the results, the monitoring network of the Danube yields redundant information over certain sections, so that of 12 sampling sites, 3 could be eliminated without loss of information. In the case of the wetland (Kis-Balaton) one pair of sampling sites out of 12, and in the case of Lake Balaton, 5 out of 10 could be discarded. For the groundwater system of the catchment area of Lake Neusiedl/Lake Fertő all 50 monitoring wells are necessary, there is no redundant information in the system. The number of the sampling sites on the Lake Neusiedl/Lake Fertő can decrease to approximately the half of the original number of the sites. Furthermore, neighbouring sampling sites were compared pairwise using CCDA and the results were plotted on diagrams or isoline maps showing the location of the greatest differences. These results can help researchers decide where to place new sampling sites. The application of CCDA proved to be a useful tool in the optimization of the monitoring networks regarding different types of water bodies. Based on the results obtained, the monitoring networks can be operated more economically.Keywords: combined cluster and discriminant analysis, cost efficiency, monitoring network optimization, water quality
Procedia PDF Downloads 348822 The Latest Salt Caravans: The Chinese Presence between Danakil and Tigray: Interdisciplinary Study to Integrate Chinese and African Relations in Ethiopia: Analyzing Road Evolution and Ethnographic Contexts
Authors: Erika Mattio
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The aim of this project is to study the Chinese presence in Ethiopia, in the area between the Saba River and the Coptic areas of the Tigray, with detailed documentation of the Danakil region, from which the salt pickers caravans departed; the study was created to understand the relationships and consequences of the Chinese advance in these areas, inhabited by tribes linked to ancient, still practiced religious rituals, and home to unique landscapes and archaeological sites. Official estimates of the number of Chinese in Africa vary widely; on the continent, there are increasingly diverse groups of Chinese migrants in terms of language, dialect, class, education, and employment. Based on this and on a very general state of the art, it was decided to increase the studies on this phenomenon, focusing the attention on one of the most interesting countries for its diversity, cultural wealth, and for strong Chinese presence: Ethiopia. The study will be integrated with interdisciplinary investigation methods, such as landscape archeology, historiographic research, participatory anthropology, geopolitics, and cultural anthropology and ethnology. There are two main objectives of the research. The first is to predict what will happen to these populations and how the territory will be modified, trying to monitor the growth of infrastructure in the country and the effects it will have on the population. Risk analyzes will be carried out to understand what the foreign presence may entail, such as the absence of sustenance for local populations, the ghettoization of foreigners, unemployment of natives and the exodus of the population to the capital; the relationships between families and the local population will be analyzed, trying to understand the dynamics of socialization and interaction. Thanks to the use of GIS, the areas affected by the Chinese presence will be geo-referenced and mapped, delimiting the areas most affected and creating a risk analysis, both in desert areas and in archaeologically and historically relevant areas. The second point is to document the life and rituals of Ethiopian populations in order not to lose the aspects of uniqueness that risk being lost. Local interviews will collect impressions and criticisms from the local population to understand if the Chinese presence is perceived as a threat or as a solution. Furthermore, Afar leaders in the Logya area will be interviewed, in truly exclusive research, to understand their links with the foreign presence. From the north, along the Saba river, we will move to the northwest, in the Tigray region, to know the impressions in the Coptic area, currently less threatened by the Chinese presence but still affected by urbanization proposals. There will also be documented the Coptic rituals of Gennà and Timkat, unique expressions of a millennial tradition. This will allow the understanding of whether the Maoist presence could influence the religious rites and forms of belief present in the country, or the country will maintain its cultural independence.Keywords: Ethiopia, GIS, risk perceptions, salt caravans
Procedia PDF Downloads 190821 The Women’s Empowerment and Children’s Bell-Being in Italy: An Empirical Research Starting From the Capability Approach
Authors: Alba Francesca Canta
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The present is one of those times when what normally seems to constitute a reason for living vanishes, particularly in times of crisis, during which certainties of all times crumble, and critical issues emerge, especially in already problematic areas such as the role of women and children. This paper aims to explore the issue of gender and highlight the importance of education for people’s development and well-being. The study is part of the broader framework of the capability approach, a multidimensional approach based on the need to consider a person’s wealth by virtue of their opportunity and freedom to live a ‘life of worth. The results of empirical research conducted in 2020 will be presented, the main objective of which was to measure, through qualitative (project techniques, focus groups, interviews with key informants) and quantitative (questionnaire) methods, the level of empowerment of women in two Italian territories and the consequent well-being of their children. By means of the relationship study, the present research results show that a higher level of women’s empowerment corresponds to a higher level of children’s well-being in a positive virtuous process. The opportunity structure and education are the main driving guide both to women’s empowerment and children’s well-being, emphasizing the importance of education to gender culture as a key factor for the development of the whole society. Among all the traumatic events that broke the harmony of the world and caused an abrupt turn in all areas of society, the crisis of democracy and education are some of the harshest. Nevertheless, education continues to be a fundamental pillar of Global Development Agendas, and above all, democratic education is the main factor in the development of a generative society, capable of forming people who know how to live in society. In this context, recovering democratic and inclusive education can be the key to a breakthrough. In the capability approach Sen, and other Scholars, point out education from two different perspectives: a. education as a fundamental right capable of influencing other real fields of people’s life (i.e., being educated to prevent illness, to vote, etc.) and b. spread communitarian education, tolerance, inclusive, democratic, and respectful, capable of forming human beings. This kind of educational system can directly lead to a general process of gender education that presupposes respect for essential principles: equality, uniqueness, and the participation of all in the processes of defining a democratic society. Many practices of women and children’s exclusions essentially derive from social factors (norms, values, quality of institutions, relations of power, educational and cultural practices) that can build strong barriers. Respect for these principles and education for gender culture could foster the renewal of society and the acquisition of fundamental skills for a generative and inclusive society, such as critical skills, cosmopolitan skills, and narrative imagination.Keywords: capability approach, children’s well-being, education, women’s empowerment
Procedia PDF Downloads 66820 Predictors of Motor and Cognitive Domains of Functional Performance after Rehabilitation of Individuals with Acute Stroke
Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel
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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.Keywords: functional performance, predictors, stroke, recovery
Procedia PDF Downloads 144819 A Qualitative Study to Analyze Clinical Coders’ Decision Making Process of Adverse Drug Event Admissions
Authors: Nisa Mohan
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Clinical coding is a feasible method for estimating the national prevalence of adverse drug event (ADE) admissions. However, under-coding of ADE admissions is a limitation of this method. Whilst the under-coding will impact the accurate estimation of the actual burden of ADEs, the feasibility of the coded data in estimating the adverse drug event admissions goes much further compared to the other methods. Therefore, it is necessary to know the reasons for the under-coding in order to improve the clinical coding of ADE admissions. The ability to identify the reasons for the under-coding of ADE admissions rests on understanding the decision-making process of coding ADE admissions. Hence, the current study aimed to explore the decision-making process of clinical coders when coding cases of ADE admissions. Clinical coders from different levels of coding job such as trainee, intermediate and advanced level coders were purposefully selected for the interviews. Thirteen clinical coders were recruited from two Auckland region District Health Board hospitals for the interview study. Semi-structured, one-on-one, face-to-face interviews using open-ended questions were conducted with the selected clinical coders. Interviews were about 20 to 30 minutes long and were audio-recorded with the approval of the participants. The interview data were analysed using a general inductive approach. The interviews with the clinical coders revealed that the coders have targets to meet, and they sometimes hesitate to adhere to the coding standards. Coders deviate from the standard coding processes to make a decision. Coders avoid contacting the doctors for clarifying small doubts such as ADEs and the name of the medications because of the delay in getting a reply from the doctors. They prefer to do some research themselves or take help from their seniors and colleagues for making a decision because they can avoid a long wait to get a reply from the doctors. Coders think of ADE as a small thing. Lack of time for searching for information to confirm an ADE admission, inadequate communication with clinicians, along with coders’ belief that an ADE is a small thing may contribute to the under-coding of the ADE admissions. These findings suggest that further work is needed on interventions to improve the clinical coding of ADE admissions. Providing education to coders about the importance of ADEs, educating clinicians about the importance of clear and confirmed medical records entries, availing pharmacists’ services to improve the detection and clear documentation of ADE admissions, and including a mandatory field in the discharge summary about external causes of diseases may be useful for improving the clinical coding of ADE admissions. The findings of the research will help the policymakers to make informed decisions about the improvements. This study urges the coding policymakers, auditors, and trainers to engage with the unconscious cognitive biases and short-cuts of the clinical coders. This country-specific research conducted in New Zealand may also benefit other countries by providing insight into the clinical coding of ADE admissions and will offer guidance about where to focus changes and improvement initiatives.Keywords: adverse drug events, clinical coders, decision making, hospital admissions
Procedia PDF Downloads 120818 Nursery Treatments May Improve Restoration Outcomes by Reducing Seedling Transplant Shock
Authors: Douglas E. Mainhart, Alejandro Fierro-Cabo, Bradley Christoffersen, Charlotte Reemts
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Semi-arid ecosystems across the globe have faced land conversion for agriculture and resource extraction activities, posing a threat to the important ecosystem services they provide. Revegetation-centered restoration efforts in these regions face low success rates due to limited soil water availability and high temperatures leading to elevated seedling mortality after planting. Typical methods to alleviate these stresses require costly post-planting interventions aimed at improving soil moisture status. We set out to evaluate the efficacy of applying in-nursery treatments to address transplant shock. Four native Tamaulipan thornscrub species were compared. Three treatments were applied: elevated CO2, drought hardening (four-week exposure each), and antitranspirant foliar spray (the day prior to planting). Our goal was to answer two primary questions: (1) Do treatments improve survival and growth of seedlings in the early period post-planting? (2) If so, what underlying physiological changes are associated with this improved performance? To this end, we measured leaf gas exchange (stomatal conductance, light saturated photosynthetic rate, water use efficiency), leaf morphology (specific leaf area), and osmolality before and upon the conclusion of treatments. A subset of seedlings from all treatments have been planted, which will be monitored in coming months for in-field survival and growth.First month field survival for all treatment groups were high due to ample rainfall following planting (>85%). Growth data was unreliable due to high herbivory (68% of all sampled plants). While elevated CO2 had infrequent or no detectable influence on all aspects of leaf gas exchange, drought hardening reduced stomatal conductance in three of the four species measured without negatively impacting photosynthesis. Both CO2 and drought hardening elevated leaf osmolality in two species. Antitranspirant application significantly reduced conductance in all species for up to four days and reduced photosynthesis in two species. Antitranspirants also increased the variability of water use efficiency compared to controls. Collectively, these results suggest that antitranspirants and drought hardening are viable treatments for reducing short-term water loss during the transplant shock period. Elevated CO2, while not effective at reducing water loss, may be useful for promoting more favorable water status via osmotic adjustment. These practices could improve restoration outcomes in Tamaulipan thornscrub and other semi-arid systems. Further research should focus on evaluating combinations of these treatments and their species-specific viability.Keywords: conservation, drought conditioning, semi-arid restoration, plant physiology
Procedia PDF Downloads 86817 Assessment of Nuclear Medicine Radiation Protection Practices Among Radiographers and Nurses at a Small Nuclear Medicine Department in a Tertiary Hospital
Authors: Nyathi Mpumelelo; Moeng Thabiso Maria
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BACKGROUND AND OBJECTIVES: Radiopharmaceuticals are used for diagnosis, treatment, staging and follow up of various diseases. However, there is concern that the ionizing radiation (gamma rays, α and ß particles) emitted by radiopharmaceuticals may result in exposure of radiographers and nurses with limited knowledge of the principles of radiation protection and safety, raising the risk of cancer induction. This study aimed at investigation radiation safety awareness levels among radiographers and nurses at a small tertiary hospital in South Africa. METHODS: An analytical cross-sectional study. A validated two-part questionnaire was implemented to consenting radiographers and nurses working in a Nuclear Medicine Department. Part 1 gathered demographic information (age, gender, work experience, attendance to/or passing ionizing radiation protection courses). Part 2 covered questions related to knowledge and awareness of radiation protection principles. RESULTS: Six radiographers and five nurses participated (27% males and 73% females). The mean age was 45 years (age range 20-60 years). The study revealed that neither professional development courses nor radiation protection courses are offered at the Nuclear Medicine Department understudy. However, 6/6 (100%) radiographers exhibited a high level of awareness of radiation safety principles on handling and working with radiopharmaceuticals which correlated to their years of experience. As for nurses, 4/5 (80%) showed limited knowledge and awareness of radiation protection principles irrespective of the number of years in the profession. CONCLUSION: Despite their major role of caring for patients undergoing diagnostic and therapeutic treatments, the nurses showed limited knowledge of ionizing radiation and associated side effects. This was not surprising since they never received any formal basic radiation safety course. These findings were not unique to this Centre. A study conducted in a Kuwaiti Radiology Department also established that the vast majority of nurses did not understand the risks of working with ionizing radiation. Similarly, nurses in an Australian hospital exhibited knowledge limitations. However, nursing managers did provide the necessary radiation safety training when requested. In Guatemala and Saudi Arabia, where there was shortage of professional radiographers, nurses underwent radiography training, a course that equipped them with basic radiation safety principles. The radiographers in the Centre understudy unlike others in various parts of the world demonstrated substantial knowledge and awareness on radiation protection. Radiations safety courses attended when an opportunity arose played a critical role in their awareness. The knowledge and awareness levels of these radiographers were comparable to their counterparts in Sudan. However, it was much more above that of their counterparts in Jordan, Nigeria, Nepal and Iran who were found to have limited awareness and inadequate knowledge on radiation dose. Formal radiation safety and awareness courses and workshops can play a crucial role in raising the awareness of nurses and radiographers on radiation safety for their personal benefit and that of their patients.Keywords: radiation safety, radiation awareness, training, nuclear medicine
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