Search results for: unit weight

Authors: Huda Abdelrhman Osman Ahmed, Paul Feyi Waboso

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Introduction: Placenta accreta spectrum (PAS) disorders present a significant challenge in obstetric management due to the high risk of hemorrhage and potential complications at delivery. This case describes a 27+3 weeks gestation in a patient with placenta accreta managed with classical cesarean section and peripartum hysterectomy. Case Description: AGravida 4P3 patient presented at 27+3 weeks gestation with painless, unprovoked vaginal bleeding and an estimated blood loss (EBL) of 300 mL. At the 20+5 week anomaly scan, a placenta previa was identified anterior, covering the os anterior uterus and containing lacunae with signs of myometrial thinning. At a 24+1 week scan conducted at a tertiary center, further imaging indicated placenta increta with invasion into the myometrium and potential areas of placenta percreta. The patient’s past obstetric history included three previous cesarean sections, with no significant medical or surgical history. Social history revealed heavy smoking but no alcohol use. No drug allergies were reported. Given the risks associated with PAS, a management plan was formulated, including an MRI at a later stage and cesarean delivery with a possible hysterectomy between 34-36 weeks. However, at 27+3 weeks, the patient experienced another episode of vaginal bleeding EBL 500 ml, necessitating immediate intervention. Management: As the patient was unstable, she was not transferred to the tertiary center. Completed and informed consent was obtained. MDT planning-group and cross-matching 4 units, uterotonics. Tranexamic acid blood products, cryo, cell salvage, 2 obstetric consultants and an anesthetic consultant, blood bank aware and hematologist. HDU bed and ITU availability. This study assisted in performing a classical Caesarean section, Where the urologist inserted JJ ureteric stents. Following this, we also assisted in a total abdominal hysterectomy with the conservation of ovaries. 4 units RBC and 1 unit FFP were transfused. The total blood loss was 2.3 L. Outcome: The procedure successfully achieved hemostasis, and the neonate was delivered with subsequent transfer to a neonatal intensive care unit for management. The patient’s postoperative course was monitored closely with no immediate complications. Discussion: This case highlights the complexity and urgency in managing placenta accreta spectrum disorders, particularly with the added challenges posed by remote location and limited tertiary support. The need for rapid decision-making and interdisciplinary coordination is emphasized in such high-risk obstetric cases. The case also underscores the potential for surgical intervention and the importance of family involvement in emergent care decisions. Conclusion: Placenta accreta spectrum disorders demand meticulous planning and timely intervention. This case contributes to understanding PAS management at earlier gestational ages and provides insights into the challenges posed by access to tertiary care, especially in urgent situations.

Keywords: Accreta, Hysterectomy, 3MDT, prematurity

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Authors: Noureddine Mahmoudi

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The use of natural fibers in the development of composite materials is a sector in full expansion. These fibers were used for their low cost, their availability and their renewable character. The fibers of the palm (palm tree) were used as reinforcement in polypropylene (PP). The date palm fibers have some potential because of their ecological and economic interest. Both unmodified and compatibilized fibers are used. Compatibilization was carried out with the use of maleic anhydride copolymers. The morphology and mechanical properties were characterized by electron microscopy scanning (SEM) and tensile tests. The influence of fiber content on mechanical properties of composite PP / date palm has been evaluated and demonstrated, that the maximum stress and elongation decreases with increasing fiber volume rate. On the other hand, an increase of the tensile modulus has been noticed, but after the fibers improvement, the maximum stress increases significantly up to 25% weight.

Keywords: plant fiber, palm, SEM, compatibilizer

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Authors: Rattanan Tippayaphalapholgul, Yasothorn Sapsathiarn

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Composites of piezoelectric materials are widely use in practical applications such as nondestructive testing devices, smart adaptive structures and medical devices. A thorough understanding of coupled electro-elastic response and properties of piezocomposite are crucial for the development and design of piezoelectric composite materials used in advanced applications. The micromechanics analysis is employed in this paper to determine the response and engineering properties of the piezocomposite. A mechanical imperfect interface bonding between piezoelectric inclusion and polymer matrix is taken into consideration in the analysis. The micromechanics analysis is based on the Boundary Element Method (BEM) together with the periodic micro-field micromechanics theory. A selected set of numerical results is presented to investigate the influence of volume ratio and interface bonding condition on effective piezocomposite material coefficients and portray basic features of coupled electroelastic response within the domain of piezocomposite unit cell.

Keywords: effective engineering properties, electroelastic response, imperfect interface, piezocomposite

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Authors: S. Kurt, B. C. Demirbag

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Meeting employees’ expectations from an organization physically and mentally is a result of one’s assessing his or her work and its environment as well as his feeling about them. It was to determine the job satisfaction levels of the nurses in public hospitals. This descriptive study was carried out with 404 nurses (60%) accepting to take part in the study voluntarily and working in the same hospital for at least three months from 673 nurses working in hospitals depending on The Secretaryship of Public Hospital Association in Rize. The study aimed to reach the whole population by not taking samples. The data were collected by the personal information form (16 questions) prepared by the researcher, and the job satisfaction scale (36 articles) between June 1st and August 30th, 2014. According to scale, mean scores of nurses’ job satisfaction were 3.23±0.51. In addition, it was determined that the factors such as nurses’s age, marital status, childbearing, place of duty, position in workplace, being liked of job, education status, work experience, weekly working hours, maturing in professional practice, unit worked, hospital worked and colleagues affected the job satisfaction levels of nurses (p <0.05). In conclusion; the nurses’ general job satisfaction levels were moderate level.

Keywords: hospitals, job satisfaction level, nurses, public hospitals

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Authors: Marcin Michalak

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Due to the increasing efforts on saving our natural environment a change in the structure of energy resources can be observed - an increasing fraction of a renewable energy sources. In many countries traditional underground coal mining loses its significance but there are still countries, like Poland or Germany, in which the coal based technologies have the greatest fraction in a total energy production. This necessitates to make an effort to limit the costs and negative effects of underground coal mining. The longwall complex is as essential part of the underground coal mining. The safety and the effectiveness of the work is strongly dependent of the diagnostic state of powered roof supports. The building of a useful and reliable diagnostic system requires a lot of data. As the acquisition of a data of any possible operating conditions it is important to have a possibility to generate a demanded artificial working characteristics. In this paper a new approach of modelling a leg pressure in the single unit of powered roof support. The model is a result of the analysis of a typical working cycles.

Keywords: machine modelling, underground mining, coal mining, structure

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Authors: Lin Wenli, Fu Linchun, Zhang Yi, Wu Ming

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To meet the demands of long-life and high-intelligence for satellites, the electrical power system should be provided with self-health condition evaluation capability. Any over-stress events in operations should be recorded. Based on Linear stresses accumulation damage theory, accumulative damage analysis was performed on thermal-mechanical-electrical united stresses for three components including the solar array, the batteries and the power conditioning unit. Then an overall health percentage evaluation model for satellite electrical power system was built. To obtain the accurate quantity for system health percentage, an automatic feedback closed-loop correction method for all coefficients in the evaluation model was present. The evaluation outputs could be referred as taking earlier fault-forecast and interventions for Ground Control Center or Satellites self.

Keywords: satellite electrical power system, health percentage, linear stresses accumulation damage, evaluation model

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Authors: Yavuz Yardim

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FRP systems have been largely used to improve the performance of structural members, due to their high strength to weight ratio and corrosion resistance. Application of this strengthening procedure in circular columns has resulted quite beneficial in increasing their seismic and axial capacity. Whereas in the rectangular ones, strength enhancement was considerably less due to stress concentration in the corner. In this work three anchorage configurations are tested for their efficiency in increasing the uniformity of confinement pressure in the CFRP strengthened non-circular sections. There is a slight increase in the axial strength of specimens as a general trend. More specifically fan anchorage reached an increase of 17.5% compared to the unanchored specimens. The study shows that uniformity of confining pressure has increased by adding anchorage.

Keywords: rectangular columns, FRP, confinement, anchorage

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Authors: Piya Roychoudhury, Ruma Pal

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Cyanobacteria, commonly known as blue green algae were found to be an effective bioreagent for nanoparticle synthesis. Nowadays silver nanoparticles (AgNPs) are very popular due to their antimicrobial and anti-proliferative activity. To exploit these characters in different biotechnological fields, it is very essential to synthesize more stable, non-toxic nano-silver. For this reason silver-gold alloy (Ag-AuNPs) nanoparticles are of great interest as they are more stable, harder and more effective than single metal nanoparticles. In the present communication we described a simple technique for rapid synthesis of biocompatible AgNP and Ag-AuNP employing cyanobacteria, Leptolyngbya and Lyngbya respectively. For synthesis of AgNP the biomass of Leptolyngbya valderiana (200 mg Fresh weight) was exposed to 9 mM AgNO3 solution (pH 4). For synthesis of Ag-AuNP Lyngbya majuscula (200 mg Fresh weight) was exposed to equimolar solution of hydrogen tetra-auro chlorate and silver nitrate (1mM, pH 4). After 72 hrs of exposure thallus of Leptolyngyba turned brown in color and filaments of Lyngbya turned pink in color that indicated synthesis of nanoparticles. The produced particles were extracted from the cyanobacterial biomass using nano-capping agent, sodium citrate. Firstly, extracted brown and pink suspensions were taken for Energy Dispersive X-ray (EDAX) analysis to confirm the presence of silver in brown suspension and presence of both gold and silver in pink suspension. Extracted nanoparticles showed a distinct single plasmon band (AgNP at 411 nm; Ag-Au NP at 481 nm) in Uv-vis spectroscopy. It was revealed from Transmission electron microscopy (TEM) that all the synthesized particles were spherical in nature with a size range of ~2-25 nm. In X-ray powder diffraction (XRD) analysis four intense peaks appeared at 38.2°, 44.5°, 64.8°and 77.8° which confirmed the crystallographic nature of synthesized particles. Presence of different functional groups viz. N-H, C=C, C–O, C=O on the surface of nanoparticles were recorded by Fourier transform infrared spectroscopy (FTIR). Scanning Electron microscopy (SEM) images showed the surface topography of metal treated filaments of cyanobacteria. The stability of the particles was observed by Zeta potential study. Antibiotic property of synthesized particles was tested by Agar well diffusion method against gram negative bacteria Pseudomonas aeruginosa. Overall, this green-technique requires low energy, less manufacturing cost and produces rapidly eco-friendly metal nanoparticles.

Keywords: cyanobacteria, silver nanoparticles, silver-gold alloy nanoparticles, spectroscopy

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Authors: Merve Aygün Esastürk, Deren Ataç Yılmaz, Görkem Oğur, Emre Özgen Kuzu, Sadık Ödemiş

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Hydrocracker plants are one of the most complicated and most profitable units in the refinery process. It takes long chain paraffinic hydrocarbons as feed and turns them into smaller and more valuable products, mainly kerosene and diesel under high pressure with the excess amount of hydrogen. Controlling the product qualities well directly contributes to the unit profit. Control of a plant is mainly based on PID and MPC controllers. Controlling the reaction section is important in terms of reaction severity. However, controlling the fractionation section is more crucial since the end products are separated in fractionation section. In this paper, the importance of well-configured base layer control mechanism, composed of PID controllers, is highlighted. For this purpose, two different base layer control scheme is applied in a hydrocracker fractionator column performances of schemes, which is a direct contribution to better product quality, are compared.

Keywords: controller, distillation, configuration selection, hydrocracker, model predictive controller, proportional-integral-derivative controller

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Authors: Majid Javanmard

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In this study, the effects of coating with whey protein concentrate (7.5% w/v) alone and/or in combination with rice bran oil (0.2, 0.4, 0.6 g in 100 ml coating solution) and Zataria multiflora extract (1 and 2 μL in 100 ml coating solution) on the quality attributes and egg shelf life were carefully observed and analyzed. Weight loss, Haugh index, yolk index, pH, air cell depth, shell strength and the impact of this coating on the microbial load of the eggs surface were studied at the end of each week (during the 4 weeks of storage in a room environment temperature and humidity). After 4 weeks of storage, it was observed that the weight loss in all of the treated eggs with whey protein concentrate and 0.2 gr of rice bran oil (experimental group) was significantly lower than that of the control group(P < 0/05). With regard to Haugh index and yolk index, egg shelf life increased about 4 weeks compared with the control samples. Haugh Index changes revealed that the coated samples remained at grade A after 3 weeks of storage, while the control samples were relegated from grade AA to B after one week. Haugh and yolk Indices in all coated eggs were more than those of the control group. In the coated groups, Haugh and yolk indices of the coated samples with whey protein concentrate and 0.2 g rice bran oil and with whey protein concentrate and 0.2g of rice bran oil and 1 micro liter of Zataria multiflora extract were more than those of the other coated eggs and the control group eggs. PH values of the control group were higher than those of the coated groups during the storage of the eggs. The shell strength of the coated group was more than that of the control group (uncoated) and in coated samples, whey protein concentrate and 0.2 gr of rice bran oil coated samples had high shell strength. In the other treatments, no significant differences were observed. The depth of the air cell of the coated groups was determined to be less than that of the control group during the storage period. The minimum inhibitory concentration was 1 μL of Zataria multiflora extract. The results showed that 1 μL concentration of Zataria multiflora extract reduces the microbial load of the egg shell surface to 87% and 2 μL reduced total bacterial load to zero. In sensory evaluation, from evaluator point of view, the coated eggs had more overall acceptance than the uncoated group (control), and in the treatment group coated eggs, those containing a low percentage of rice bran oil had higher overall acceptability. In conclusion, coating as a practical and cost effective method can maintain the quality parameters of eggs and lead to durability of supply conditions in addition to the product marketability.

Keywords: edible coating, chicken egg, whey protein concentrate, rice bran oil, Zataria multiflora extract, shelf life

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Authors: Oveis Abedinia, Noradin Ghadimi, Nasser Mikaeilvand, Roza Poursoleiman, Asghar Poorfaraj

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In this paper a robust Fuzzy Proportional Integral Differential (PID) controller is applied to multi-machine power system based on Modified Shuffled Frog Leaping (MSFL) algorithm. This newly proposed controller is more efficient because it copes with oscillations and different operating points. In this strategy the gains of the PID controller is optimized using the proposed technique. The nonlinear problem is formulated as an optimization problem for wide ranges of operating conditions using the MSFL algorithm. The simulation results demonstrate the effectiveness, good robustness and validity of the proposed method through some performance indices such as ITAE and FD under wide ranges operating conditions in comparison with TS and GSA techniques. The single-machine infinite bus system and New England 10-unit 39-bus standard power system are employed to illustrate the performance of the proposed method.

Keywords: fuzzy PID, MSFL, multi-machine, low frequency oscillation

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Authors: J. Stejskal, P. Hajek

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The goal of this article is the analysis of knowledge transfer at the regional level of the Czech Republic. We show how goals of enterprises´ innovative activities are related to the rate of cooperation with different actors within regional innovative systems as well as in other world regions. The results show that the most important partners of enterprises are their suppliers and clients in most Czech regions. The cooperation rate of enterprises correlates significantly mainly with enterprises´ efforts to enter new markets and reduce labour costs per unit output. The meaning of this cooperation decreases with the increase of partner’s distance. Regarding the type of a cooperating partner, cooperation within an enterprise had to do with the increase of market share and decrease of labour costs. On the other hand, cooperation with clients had to do with efforts to replace outdated products or processes or enter new markets. We can pay less attention to the cooperation with government authorities and organizations. The reasons for marginalization of this cooperation should be submitted to further detailed investigation.

Keywords: knowledge, transfer, innovative process, Czech republic, region

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Authors: Hyuk Sung Yoon, In-Lee Choi, Mohammad Zahirul Islam, Jun Pill Baek, Ho-Min Kang

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The strawberry ‘Maehyang’ cultivated in South Korea has been increased to export to Southeast Asia. The degradation of quality often occurs in strawberries during short export period. Botrytis cinerea has been known to cause major damage to the export strawberries and the disease was caused during shipping and distribution. This study was conducted to find out the sterilized effect of chlorine dioxide(ClO2) gas and high concentration of CO2 gas injection for ‘Maehyang’ strawberry and it was packaged with oxygen transmission rate (OTR) films. The strawberry was harvested at 80% color changed stage and packaged with OTR film and perforated film (control). The treatments were a MAP used by with 20,000 cc·m-2·day·atm OTR film and gas injection in packages. The gas type of ClO2 and CO2 were injected into OTR film packages, and treatments were 6 mg/L ClO2, 15% CO2, and they were combined. The treated strawberries were stored at 3℃ for 30 days. Fresh weight loss rate was less than 1% in all OTR film packages but it was more than 15% in a perforated film treatment that showed severe deterioration of visual quality during storage. Carbon dioxide concentration within a package showed approximately 15% of the maximum CO2 concentration in all treatments except control until the 21st day, it was the tolerated range of maximum CO2 concentration of strawberry in recommended CA or MA conditions. But, it increased to almost 50% on the 30th day. Oxygen concentration showed a decrease down to approximately 0% in all treatments except control for 25 days. Ethylene concentration was shown to be steady until the 17th day, but it quickly increased on the 17th day and dropped down on the final storage day (30th day). All treatments did not show any significant differences in gas treatments. Firmness increased in CO2 (15%) and ClO2 (6mg/L) + CO2 (15%) treatments during storage. It might be the effect of high concentration CO2 known by reducing decay and cell wall degradation. The soluble solid decreased in all treatments during storage. These results were caused to use up the sugar by the increase of respiration during storage. The titratable acidity showed a similarity in all treatments. Incidence of fungi was 0% in CO2 (15%) and ClO2 (6mg/L)+ CO2 (15%), but was more than 20% in a perforated film treatment. Consequently, The result indicates that Chloride Dioxide(ClO2) and high concentration of CO2 inhibited fungi growth. Due to the fact that fresh weight loss rate and incidence of fungi were lower, the ClO2(6mg/L)+ CO2(15%) prove to be most efficient in sterilization. These results suggest that Chloride Dioxide (ClO2) and high concentration of CO2 gas injection treatments were an effective decontamination technique for improving the safety of strawberries.

Keywords: chloride dioxide, high concentration of CO2, modified atmosphere condition, oxygen transmission rate films

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Authors: Sinem O. Aktan, Musa Y. Akkurt

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Experimental pressure calibration methods can be classified into three areas: (1) measurements in liquid or gas systems, (2) measurements in static-solid media systems, and (3) measurements in dynamic shock systems. Fluid (liquid and gas) systems high accuracies can be obtainable and commonly used for the calibration method of a pressure sensor. Pressure calibrations can be performed for metrological traceability in two ways, which are on-site (field) and in the laboratory. Laboratory and on-site calibration procedures and the requirements of the DKD-R-6-1 and Euramet cg-17 guidelines will also be addressed. In this study, calibration methods of direct and indirect reading pressure sensor and measurement uncertainty contributions will be explained.

Keywords: pressure metrology, pressure calibration, dead-weight tester, pressure uncertainty

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Authors: A. Sottomayor, M. Perez Duque, M. C. Henriques

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Introduction: Migration is not a new phenomenon; nomads often traveled, seeking better living conditions, including food and water. The increase of migrations affects all countries, rising health-related challenges. In Portugal, we have had migrant movements in the last decades, pairing with economic behavior. Irregular immigrants are detained in Santo António detention center from Portuguese Immigration and Borders Service (USHA-SEF) in Porto until court decision for a maximum of 60 days. It is the only long stay officially designated detention center for immigrants in Portugal. Immigrant health is important for public health (PH). It affects and is affected by the community. The XXVII Portuguese Government considered immigrant integration, including access to health, health promotion, protection and reduction of inequities a political priority. Many curative, psychological and legal services are provided for detainees, but until 2015, no structured health promotion or prevention actions were being held at USHA-SEF. That year, Porto Occidental PH Local Unit started to provide vaccination and health literacy on this theme for detainees and SEF workers. Our activities include a vaccine lecture, a medical consultation with vaccine prescription and administration, along with documented proof of vaccination. All vaccines are volunteer and free of charge. This action reduces the risk of importation and transmission of diseases, contributing to world eradication and elimination programs. We aimed to characterize the demography of irregular immigrant detained at UHSA-SEF and describe our activity. Methods: All data was provided by Porto Occidental Public Health Unit. All paper registers of vaccination were uploaded to MicrosoftExcel®. We included all registers and collected demographic variables, nationality, vaccination date, category, and administered vaccines. Descriptive analysis was performed using MicrosoftExcel®. Results: From 2015 to 2018, we delivered care to 256 individuals (179 immigrants; 77 workers). Considering immigrants, 72% were male, and 8 (16%) women were pregnant. 85% were between 20-54 years (ᵡ=30,8y; 2-71y), and 11 didn’t report any age. Migrants came from 48 countries, and India had the highest number (9%). MMR and Tetanus vaccines had > 90% vaccination rate and Poliomyelitis, hepatitis B and flu vaccines had around 85% vaccination rates. We had a consistent number of refusals. Conclusion: Our irregular migrant population comes from many different countries, which increases the risk of disease importation. Pregnant women are present as a particular subset of irregular migrants, and vaccination protects them and the baby. Vaccination of migrant is valuable for them and for the countries in which they pass. It contributes to universal health coverage, for eradication programmes and accomplishment of the Sustainable Development Goals. Peer influence may present as a determinant of refusals so we must consistently educate migrants before vaccination. More studies would be valuable, particularly on the migrant trajectory, duration of stay, destiny after court decision and health impact.

Keywords: migrants, public health, universal health coverage, vaccination

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Authors: Soumitr Sanjay Dubey, Shubhajit Roy Chowdhury, Rahul Shrestha

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In this paper, we have presented a novel approach of calculating eigenvalues of any matrix for the first time on Field Programmable Gate Array (FPGA) using Triangular Systolic Arra (TSA) architecture. Conventionally, additional computation unit is required in the architecture which is compliant to the algorithm for determining the eigenvalues and this in return enhances the delay and power consumption. However, recently reported works are only dedicated for symmetric matrices or some specific case of matrix. This works presents an architecture to calculate eigenvalues of any matrix based on QR algorithm which is fully implementable on FPGA. For the implementation of QR algorithm we have used TSA architecture, which is further utilising CORDIC (CO-ordinate Rotation DIgital Computer) algorithm, to calculate various trigonometric and arithmetic functions involved in the procedure. The proposed architecture gives an error in the range of 10−4. Power consumption by the design is 0.598W. It can work at the frequency of 900 MHz.

Keywords: coordinate rotation digital computer, three angle complex rotation, triangular systolic array, QR algorithm

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Authors: In-Gun Kim, Hyun-Seok Hong, Dong-Woo Kang, Ju Lee

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An Inverter type arc-welding machine is inclined to be designed for higher frequency in order to reduce the size and cost. The need of the core material reconsideration for high frequency pulse transformer is more important since core loss grows as the frequency rises. An arc welding machine’s pulse transformer is designed using an Area Product (Ap) method and is considered margin air gap core design in order to prevent the burning of the IGBT by the inrush current. Finally, the reduction of the core weight and the core size are compared according to different materials for 30kW inverter type arc welding machine.

Keywords: pulse transformers, welding, inrush current, air gaps

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Authors: Emad A. Jaffar Al-Mulla

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In this study, a biopolymer-based nanocomposite was successfully prepared through melt blending technique. Two biodegradable polymers, polycaprolactone and starch, environmental friendly and obtained from renewable, easily available raw materials, have been chosen. Fatty hydrazide, synthesized from palm oil, has been used as a surfactant to modify montmorillonite (natural clay) for preparation of polycaprolactone/starch nanocomposite. X-ray diffraction and transmission electron microscopy were used to characterize nanocomposite formation. Compatibility of the blend was improved by adding 3% weight modified clay. Higher biodegradability and thermal stability of nanocomopeite were also observed compared to those of the polycaprolactone/starch blend. This product will solve the problem of plastic waste, especially disposable packaging, and reduce the dependence on petroleum-based polymers and surfactants.

Keywords: polycaprolactone, starch, biodegradable, nanocomposite

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Authors: Manar Y. Abd El-Aziz, Alyaa E. Morgham, Amira A. El-Fallal, Heba Tolla E. Abo El Naga

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Sport wears almost preferred with knitted fabrics, specially interlock construction. But, there is a need for higher comfortability and functional properties for fabrics to be more fitted to this application. This study compared cotton and polyester microfibers and blended them to improve the functional activity of interlock in sport wear by mercerized and non-mercerized. also, fabric dyeing and dyeability are affected by mercerization. Many functional properties, such as UV protection as well as antimicrobial activity. The changes in different mechanical as well as physical properties were investigated. The washing fastness properties of the dyed fabrics are also given. The changes in moisture regain, loss in weight, and burst and burst elongation for all mercerized fabrics have been studied.

Keywords: interlock, mercirization, dyeability, function properties, moisture management

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Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

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Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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Authors: Daniela Magalhaes, Jorge Pedro, Pedro Souteiro, Joao S. Neves, Sofia Castro-Oliveira, Vanessa Guerreiro, Rita Bettencourt- Silva, Maria M. Costa, Ana Varela, Joana Queiros, Paula Freitas, Davide Carvalho

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Introduction: Obesity is an independent risk factor for renal dysfunction. Our aims were: (1) evaluate the impact of bariatric surgery (BS) on renal function; (2) clarify the factors determining the postoperative evolution of the glomerular filtration rate (GFR); (3) access the occurrence of oxalate-mediated renal complications. Methods: We investigated a cohort of 1448 obese patients who underwent bariatric surgery. Those with basal GFR (GFR0) < 30mL/min or without information about the GFR 2-year post-surgery (GFR2) were excluded. Results: We included 725 patients, of whom 647 (89.2%) women, with 41 (IQR 34-51) years, a median weight of 112.4 (IQR 103.0-125.0) kg and a median BMI of 43.4 (IQR 40.6-46.9) kg/m2. Of these, 459 (63.3%) performed gastric bypass (RYGB), 144 (19.9%) placed an adjustable gastric band (AGB) and 122 (16.8%) underwent vertical gastrectomy (VG). At 2-year post-surgery, excess weight loss (EWL) was 60.1 (IQR 43.7-72.4) %. There was a significant improve of metabolic and inflammatory status, as well as a significant decrease in the proportion of patients with diabetes, arterial hypertension and dyslipidemia (p < 0.0001). At baseline, 38 (5.2%) of subjects had hyperfiltration with a GFR0 ≥ 125mL/min/1.73m2, 492 (67.9%) had a GFR0 90-124 mL/min/1.73m2, 178 (24.6%) had a GFR0 60-89 mL/min/1.73m2, and 17 (2.3%) had a GFR0 < 60 mL/min/1.73m2. GFR decreased in 63.2% of patients with hyperfiltration (ΔGFR=-2.5±7.6), and increased in 96.6% (ΔGFR=22.2±12.0) and 82.4% (ΔGFR=24.3±30.0) of the subjects with GFR0 60-89 and < 60 mL/min/1.73m2, respectively ( p < 0.0001). This trend was maintained when adjustment was made for the type of surgery performed. Of 321 patients, 10 (3.3%) had a urinary albumin excretion (UAE) > 300 mg/dL (A3), 44 (14.6%) had a UAE 30-300 mg/dL (A2) and 247 (82.1%) has a UAE < 30 mg/dL (A1). Albuminuria decreased after surgery and at 2-year follow-up only 1 (0.3%) patient had A3, 17 (5.6%) had A2 and 283 (94%) had A1 (p < 0,0001). In multivariate analysis, the variables independently associated with ΔGFR were BMI (positively) and fasting plasma glucose (negatively). During the 2-year follow-up, only 57 of the 725 patients had transient urinary excretion of calcium oxalate crystals. None has records of oxalate-mediated renal complications at our center. Conclusions: The evolution of GFR after BS seems to depend on the initial renal function, as it decreases in subjects with hyperfiltration, but tends to increase in those with renal dysfunction. Our results suggest that BS is associated with improvement of renal outcomes, without significant increase of renal complications. So, apart the clear benefits in metabolic and inflammatory status, maybe obese adults with nondialysis-dependent CKD should be referred for bariatric surgery evaluation.

Keywords: albuminuria, bariatric surgery, glomerular filtration rate, renal function

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Authors: J. Al-Dmour, A. Sagahyroon, A. Al-Ali, S. Abusnana

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Radio Frequency Based Identification Systems have emerged as one of the possible valuable solutions that can be utilized in healthcare systems. Nowadays, RFID tags are available with built-in human vital signs sensors such as Body Temperature, Blood Pressure, Heart Rate, Blood Sugar level and Oxygen Saturation in Blood. This work proposes the design, implementation, and testing of an integrated mobile RFID-based health care system. The system consists of a wireless mobile vital signs data acquisition unit (RFID-DAQ) integrated with a fuzzy-logic–based software algorithm to monitor and assess patients conditions. The system is implemented and tested in ‘Rashid Center for Diabetes and Research’, Ajman, UAE. System testing results are compared with the Modified Early Warning System (MEWS) that is currently used in practice. We demonstrate that the proposed and implemented system exhibits an accuracy level that is comparable and sometimes better than the widely adopted MEWS system.

Keywords: healthcare, fuzzy logic, MEWS, RFID

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Authors: Min Zhou, Kaixuan Lin, Yaping Huang

Abstract:

In this paper, the industrial space of metropolitan area in Wuhan is taken as a sample. First of all, it puts forward that the structure of service economy, circle gradient relocation and high degree of regional collaboration are the rules of industrial spatial development in the modern world cities. Secondly, using the economic statistics and land use vector data (1993, 2004, 2010, and 2013) of Wuhan, it analyzes the present situation of industry development and the characteristics of industrial space layout from three aspects of the industrial economic structure, industrial layout, and industrial regional synergy. Then, based on the industrial development regularity of world cities, it puts forward to construct the industrial spatial level of ‘complex industrial concentration area + modular industry unit’ and the industrial spatial structure of ‘13525’. Finally, it comes up with the optimization tactics of the industrial space’s transformation in the future under the background of new economic era.

Keywords: big city of metropolitan area, industrial space, characteristics, layout, strategy

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Authors: Kwangho Lee, Joongmyeon Bae

Abstract:

Fuel cells are spotlighted in the world for being highly efficient and environmentally friendly. A hydrogen fuel for a fuel cell is obtained from a number of sources. Most of fuel cell for APU(Auxiliary power unit) system using diesel fuel as a hydrogen source. Diesel fuel has many advantages, such as high hydrogen storage density, easy to transport and also well-infra structure. However, conventional diesel reforming system for PEMFC(Proton exchange membrane fuel cell) requires a large volume and complex CO removal system for the lower the CO level to less than 10ppm. In addition, the PROX(Preferential Oxidation) reaction cooling load is needed because of the strong exothermic reaction. However, the hydrogen separation membrane that we propose can be eliminated many disadvantages, because the volume is small and permeates only pure hydrogen. In this study, we were conducted to the pressurized diesel reforming and water-gas shift reaction experiment for the hydrogen permeable membrane application.

Keywords: hydrogen, diesel, reforming, ATR, WGS, PROX, membrane, pressure

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Authors: Rahmat Purwoko, Bambang Riyanto Trilaksono

Abstract:

This paper gives comparison of INS/GNSS architecture namely Loosely Coupled and Tightly Coupled using Hardware in the Loop Simulation in Guided Missile RKX-200 rocket model. INS/GNSS Tightly Coupled architecture requires pseudo-range, pseudo-range rate, and position and velocity of each satellite in constellation from GPS (Global Positioning System) measurement. The Loosely Coupled architecture use estimated position and velocity from GNSS receiver. INS/GNSS architecture also requires angular rate and specific force measurement from IMU (Inertial Measurement Unit). Loosely Coupled arhitecture designed using 15 states Kalman Filter and Tightly Coupled designed using 17 states Kalman Filter. Integration algorithm calculation using ECEF frame. Navigation System implemented Zedboard All Programmable SoC.

Keywords: kalman filter, loosely coupled, navigation system, tightly coupled

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Authors: Hattie Hope Makumbe, Bhekisisa Dlamini, Frederick Tabit

Abstract:

Listeria monocytogenes is one of the most important foodborne pathogens associated with ready-to-eat (RTE) food. This study investigated the incidence of Listeria monocytogenes in 80 RTE food sold in the formal (dairy and processed meat) and informal markets (vegetable salads, beef stew, and rice) of Johannesburg, South Africa. High Enterobacteriaceae, S. aureus, and E. coli counts were obtained, which ranged from 1.9-7.5 log CFU/g. Listeria monocytogenes microbial counts in the food samples ranged from 3.5-6.0 log colony forming unit per gram except in cooked rice. The Listeria monocytogenes isolates were identified using biochemical tests and confirmed with the Biolog identification system and PCR analyses. The percentage incidence for Listeria monocytogenes in ready to eat food was 12.5%. When Minimum Inhibitory Concentrations were under consideration, all disinfectants were effective against Listeria monocytogenes strains. For antimicrobial work, rates of resistance amongst the antibiotics ranged from 17-100%. Therefore, more effective preventive control strategies for Listeria monocytogenes are needed to reduce the prevalence of the pathogen in RTE food that is sold in Johannesburg.

Keywords: Listeria monocytogenes, Listeria species, ready to eat food, sanitiser efficacy

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Authors: Ewuola E. O., Sokunbi O. A., Oyedemi O. M., Sanni K. M

Abstract:

Moringa oleifera leaf has been traditionally used in the local medicine as an ingredient in some herbal formulations for blood purifier, cholesterol reducing agent, immune and reproductive enhancers. Twenty-four pubertal rabbit are divided equally into four groups were administered with varied concentrations of crude extract of the leaves of Moringa oleifera gavage at doses of 2.5ml/kg body weight (BW) in every 48 hours for 63 days. These rabbits were allotted into four treatments and each treatment was replicated six times to investigate the effect of administered crude Moringa oleifera leaf extract (CMOLE) on haematology and reproductive performance of pubertal rabbit does. Four experimental treatments were used. The animals on the control (T1) were administered water only. Rabbits on treatments 2, 3, and 4 were administered 100ml CMOLE/L, 200ml CMOLE/L, and 300ml CMOLE/L, respectively. The does were placed on extract two weeks before mating, five weeks after mating and continued for another two weeks after kindling. Six proven untreated bucks were used for the mating of the twenty-four treated does and these bucks were randomly allotted to the does such that each buck mated at least one treated does in each treatment. The same management practices and experimental diets were given ad libitum to all animals. Blood was sampled from the gestating does at the third trimester for haematological analysis. The haematology results showed that treated rabbits with 100ml CMOLE/L with mean corpuscular volume value of 93.38fl significantly (p < 0.05) higher than those on the control which is water only (82.24fl) but not significantly different from T3 (200ml CMOLE/L) and T4 (300ml CMOLE/L) which had mean values of 91.69fl and 91.49fl, respectively. While the erythrocyte counts, leukocyte counts, haematocrit, haemoglobin concentration, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, lymphocyte, neutrophil, monocyte, and eosinophil count were not significantly different across the treatments. For platelets, treated animals on T2 (100ml CMOLE/L) had the highest numerical value of 148.80 x 109/L which was identical with those on T3 (200ml CMOLE/L) with mean value of 141.50x109/L but significantly (p < 0.05) higher than those on T4 (300ml CMOLE/L) with mean value of 135.00 x 109/L and those on the control which had the least mean value of 126.60 x 109/L. The percentage conception rate of the treated animals was higher than those in the control group. The animals administered 300ml CMOLE/L had the apparently highest litter size of 5.75, while gestation length and litter weight tended to decline with increase in CMOLE concentrations The investigation demonstrated the potential effect of crude Moringa oleifera leaf extract on pubertal rabbit does. The administration of up to 300ml crude Moringa oleifera leaf extract per liter did not adversely affect but improved the haematological response and reproductive potential in gestating rabbit does.

Keywords: conception, haematology, moringa leaf extract, rabbit does

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Authors: Sumi Manjipparambil Surendran, Subrata Majumdar

Abstract:

Aim: The aim of the study is to find out if low PAPP-A (Pregnancy-Associated Plasma Protein A) levels in the first trimester are associated with adverse obstetric outcome. Methods: A retrospective study was carried out on 114 singleton pregnancies having undergone combined test screening. Results: There is statistically significant increased incidence of low birth weight infants in the low PAPP-A group. However, significant association was not found in the incidence of pre-eclampsia, miscarriage, and placental abruption. Conclusion: Low PAPP-A in the first trimester is associated with fetal growth restriction. Recommendation: Women with low PAPP-A levels in first trimester pregnancy screening require consultant-led care and serial growth scans.

Keywords: pregnancy, pregnancy-associated plasma protein A, PAPP-A, fetal growth restriction, trimester

Procedia PDF Downloads 142

Authors: David Glassmeyer

Abstract:

Quantitative reasoning is necessary to robustly understand mathematical concepts ranging from elementary to university levels. Quantitative reasoning involves identifying and representing quantities and the relationships between these quantities. Without reasoning quantitatively, students often resort to memorizing formulas and procedures, which have negative impacts when they encounter mathematical topics in the future. This study investigated how high school students’ quantitative reasoning could be fostered within a unit on arc measure and angle relationships. Arc measure, or the measure of a central angle that cuts off a portion of a circle’s circumference, is often confused with arclength. In this study, the researcher redesigned an activity to clearly distinguish arc measure and arc length by using a quantitative reasoning framework. Data were collected from high school students to determine if this approach impacted their understanding of these concepts. Initial data indicates the approach was successful in supporting students’ quantitative reasoning of these topics. Implications for the work are that teachers themselves may also benefit from considering mathematical definitions from a quantitative reasoning framework and can use this activity in their own classrooms.

Keywords: arc length, arc measure, quantitative reasoning, student content knowledge

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Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim

Abstract:

The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.

Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis

Procedia PDF Downloads 400